1. Home
  2. Vol 26, No 9 (2022)
  3. Aikpitanyi

Demand-side barriers to access and utilization of skilled birth care in low and lower-middle-income countries: A scoping review of evidence

Josephine Aikpitanyi(1), Friday Okonofua(2), Lorretta F.C. Ntoimo(3), Sandy Tubeuf(4),


(1) Institute of Health Research and Society (IRSS), Université catholique de Louvain, Belgium
(2) Centre of Excellence in Reproductive Health Innovation, University of Benin, Nigeria
(3) Department of Social Demography and Statistics, Federal University Oye-Ekiti, Nigeria
(4) Institute of Economic and Social Research (IRES), Université catholique de Louvain, Belgium
Corresponding Author

Abstract


A myriad of demand-side factors hamper childbearing women from utilizing needed skilled birth care in low and lower-middleincome countries. The objective of this scoping review is to explore the extent of evidence available on the subject matter and identify knowledge gaps in the reviewed literature. We used the Arksey and O’Malley scoping review framework as a guide for this review and conducted searches on four electronic databases: PubMed, Embase, PsycInfo and Google Scholar. Eligible studies were those published in English and French languages between 2013 and 2022 that discussed demand-side barriers to access and utilization of skilled birth care in low and lower-middle-income countries. Five themes emerged as major types of barriers influencing the utilization of skilled birth care in low and lower-middle-income countries. These were socio-economic and sociodemographic status of women; lack of access to healthcare facilities; cost of healthcare services; ineffective healthcare systems and socio-cultural/religious factors. The identified gap in the literature was the lack of studies on the influence of women’s behaviour and psychological traits as barriers to the use of skilled birth care among reviewed publications. To design effective interventions, it is important to consider all influential factors that determine the utilization of skilled birth care by women in low-resource settings. (Afr J Reprod Health 2022; 26[9]: 31-47).

References


World Health Organization. Trends in maternal mortality:

to 2017: Estimates by WHO, UNICEF, UNFPA,

World Bank Group and the United Nations Population

Division. Geneva: World Health Organisation; 2019.

World Health Orgainization. Integrated Management of

Pregnancy and Childbirth: Standards for Maternal and

Neonatal Care. Geneva: World Health Organization.

Department of making pregnancy safer; 2007.

World health Organization. Working towards achieving the

Sustainable Development Goals: a WHO toolkit.

Geneva: World Health Organization. 2018; Licence:

CC BY-NC-SA 3.0 IGO.

World Health Organization. Health in 2015: From MDGs,

Millennium Development Goals to SDGs, Sustainable

Development Goals. Geneva, World Health

Organisation; 2015.

Wehrmeister FC, Restrepo-Mendez MC, Franca GV, Victora

CG and Barros AJ. Summary indices for monitoring

universal coverage in maternal and child health care.

Bull World Health Organization. 2016;94(12): 903-

Crowe S, Utley M, Costello A and Pagel C. How many births

in sub-Saharan Africa and South Asia will not be

attended by a skilled birth attendant between 2011 and

? BMC Pregnancy and Childbirth. 2012;12(4): 1-

Weldemariam S, Kiros A and Welday M. Utilization of

institutional delivery service and associated factors

among mothers in North West Ethiopian. BMC

Research Notes. 2018;11(1): 1-6.

Doctor HV, Nkhana-Salimu S and Abdulsalam-Anibilowo

M. Health facility delivery in sub-Saharan Africa:

successes, challenges, and implications for the 2030

development agenda. BMC Public Health.

;18(1): 765-70.

Edward A, Krishnan A, Ettyang G, Jung Y, Perry HB, Ghee

AE and Chege J. Can people-centered communityoriented interventions improve skilled birth

attendance? Evidence from a quasi-experimental

study in rural communities of Cambodia, Kenya, and

Zambia. BMC Pregnancy Childbirth. 2020;20(1):

Ajayi AI and Akpan W. Maternal health care services

utilisation in the context of 'Abiye' (safe motherhood)

programme in Ondo State, Nigeria. BMC Public

Health. 2020;20(1): 362.

Gedilu T, Debalkie D and Setegn T. Prevalence and

determinants of institutional delivery service up take

among women in Farta District, Northwest Ethiopia.

Journal of Nursing Care. 2018;7(2): 449-457.

Gebregziabher NK, Zeray AY, Abtew YT, Kinfe TD and

Abrha DT. Factors determining choice of place of

delivery: analytical cross-sectional study of mothers

in Akordet town, Eritrea. BMC Public Health.

;19(1): 924-8.

Shiferaw S, Spigt M, Godefrooij M, Melkamu Y and Tekie

M. Why do women prefer home births in Ethiopia?

BMC Pregnancy and Childbirth. 2013;13(5): 1-10.

World Health Organization. Commission on Social

Determinants of Health - Closing the gap in a

generation: Health equity through action on the social

determinants of health. World Health Organization:

Geneva, Switzerland; 2006.

Gupta I, Joe W and Rudra S. Demand Side Financing in

Health: How far can it address the issue of low

utilization in developing countries? World Health Report Background Paper, No 27. Geneva: World

Health Organization; 2010.

Tsegaye B, Abuhay M, Admasu E, Wubale B, Temesgen K

and Yohannes Z. Level and factors associated with

preference of institutional delivery among pregnant

woman in Debre-tabor town, North West Ethiopia,

: a community based cross sectional study. BMC

research notes. 2019;12(1): 44-50.

Van Rijsbergen B and D’Exelle B. Delivery care in

Tanzania: A comparative analysis of use and

preferences. Journal of World Development.

;43(2): 276-87.

Ganle JK, Mahama MS, Maya E, Manu A, Torpey K and

Adanu R. Understanding factors influencing home

delivery in the context of user‐fee abolition in

Northern Ghana: Evidence from 2014 DHS. The

International Journal of Health Planning and

Management. 2019;34(2): 727-43.

Moyer C and Mustafa A. Drivers and deterrents of facility

delivery in sub-Saharan Africa: a systematic review.

Reproductive Health. 2013;10(40): 1-14.

Kyei-Nimakoh M, Carolan-Olah M and McCann TV.

Access barriers to obstetric care at health facilities in

sub-Saharan Africa-a systematic review. Systematic

Reviews. 2017;6(1): 110-115.

Arksey H and O'Malley L. Scoping studies: towards a

methodological framework. International Journal of

Social Research Methodology. 2005;8(1): 19-32.

United Nations Population Division. Classification of

Country by Region, Income Group and Sub-region of

the World: World Urbanization Prospects.

Department of Economic and Social Affairs: United

Nations Department of Economic and Social

Affairs/Population Division; 2018.

Tricco AC, Lillie E, Zarin W, O'Brien KK, Colquhoun H,

Levac D, Moher D, Peters MDJ, Horsley T, Weeks L,

Hempel S, Akl EA, Chang C, McGowan J, Stewart L,

Hartling L, Aldcroft A, Wilson MG, Garritty C, Lewin

S, Godfrey CM, Macdonald MT, Langlois EV,

Soares-Weiser K, Moriarty J, Clifford T, O ̈zge T and

Straus SE. PRISMA Extension for Scoping Reviews

(PRISMA-ScR): Checklist and Explanation. Annals

of Internal Medicine. 2018;169(7): 467-73.

Asseffa NA, Bukola F and Ayodele A. Determinants of use

of health facility for childbirth in rural Hadiya zone,

Southern Ethiopia. BMC Pregnancy and Childbirth.

;16(1): 355-58.

Ononokpono DN and Odimegwu CO. Determinants of

maternal health care utilization in Nigeria: a

multilevel approach. The Pan African Medical

Journal. 2014;17(Suppl 1): 1-7.

Muhammed A, Donkor E and Naab F. Factors Influencing

Patronage of Supervised Delivery Among Parturients

in Moriki of Zamfara, Nigeria. International Journal

of Childbirth. 2016;6(1): 37-45.

Mehta SR, Parmar GB, Gamit CL, Mansuri BM, Patel PB

and Patel SS. Does Maternal Education Affect

Maternal and Child Health Care Utilization?: A

Community Based Study in a Urban Slum Area of

Western India. International Journal of

Interdisciplinary and Multidisciplinary Studies.

;1(10): 80-7.

Bayo P, Belaid L, Tahir EO, Ochola E, Dimiti A, Greco D

and Zarowsky C. "Midwives do not appreciate

pregnant women who come to the maternity with torn

and dirty clothing": Institutional delivery and

postnatal care in Torit County, South Sudan: a mixed

method study. BMC Pregnancy and Childbirth.

;20(1): 250-264.

Zhou D, Zhou Z, Yang C, Ji L, Ghose B and Tang S.

Sociodemographic characteristics associated with the

utilization of maternal health services in Cambodia.

BMC Health Services Research. 2020;20(1): 781-94.

Abikar R and Karama M. Factors associated with uptake of

skilled attendants’ services during child delivery in

Garissa town, Kenya. East Africa Medical Journal.

;90(11): 365-74.

Solanke BL and Rahman SA. Multilevel analysis of factors

associated with assistance during delivery in rural

Nigeria: implications for reducing rural-urban

inequity in skilled care at delivery. BMC Pregnancy

and Childbirth. 2018;18(1): 438-15.

Habte F and Demissie M. Magnitude and factors associated

with institutional delivery service utilization among

childbearing mothers in Cheha district, Gurage zone,

SNNPR, Ethiopia: A community based cross sectional

study. BMC Pregnancy and Childbirth. 2015;15(1): 1-

Ntenda PAM. Women's status within the household as a

determinant of institutional delivery in Malawi.

Journal of Midwifery and Women's Health. 2019;74:

-56.

Exavery A, Kanté AM, Njozi M, Tani K, Doctor HV,

Hingora A and Phillips JF. Access to institutional

delivery care and reasons for home delivery in three

districts of Tanzania. International Journal for Equity

in Health. 2015;13(1): 1-7.

Hailu D and Berhe H. Determinants of institutional

childbirth service utilisation among women of

childbearing age in urban and rural areas of Tsegedie

district, Ethiopia. Midwifery. 2014;30(11): 1109-17.

Fikre AA and Demissie M. Prevalence of institutional

delivery and associated factors in Dodota Woreda

(district), Oromia regional state, Ethiopia.

Reproductive Health. 2012;9(1): 1-10.

Huda TM, Chowdhury M, El Arifeen S and Dibley MJ.

Individual and community level factors associated

with health facility delivery: A cross sectional

multilevel analysis in Bangladesh. J PloS one.

;14(2): e0211113.

Amporfu E and Grépin KA. Measuring and explaining

changing patterns of inequality in institutional

deliveries between urban and rural women in Ghana:

a decomposition analysis. International Journal for

Equity in Health. 2019;18(1): 123-7.

Dickson KS, Adde KS and Amu H. What influences where

they give birth? Determinants of place of delivery

among women in rural Ghana. International Journal of

Reproductive Medicine. 2016;2016(1): 1-8.

Bayu H, Adefris M, Amano A and Abuhay M. Pregnant

women’s preference and factors associated with

institutional delivery service utilization in Debra

Markos Town, North West Ethiopia: a community

based follow up study. BMC Pregnancy and

Childbirth. 2015;15(1): 15-22


Full Text: PDF

Article Metrics

Abstract View : 1113 times
PDF Download : 353 times

Refbacks

  • There are currently no refbacks.