Dr. Henna Budhwani, assistant professor in the department of health care organization and policy at the University of Alabama at Birmingham — in collaboration with Dr. Kristine Ria Hearld, assistant professor in UAB’s School of Health Professions; and Ms. Hanne S. Harbison, nurse practitioner in UAB’s division of infectious diseases — recently examined individual and area level factors associated with maternal health care utilization in Pakistan.

[Photo: Dr. Henna Budhwani]

The 2012–2013 Pakistan Demographic and Health Surveys data was used to model five outcomes: 1) prenatal care within the first trimester; 2) four plus prenatal visits; 3) birth attendance by a skilled attendant; 4) birth in a medical facility; and 5) receipt of postnatal care. Less than half of births were to mothers receiving prenatal care in the first trimester, and approximately 57 percent had trained personnel at delivery. Over half were born to mothers who received postnatal care.

Evidence was found to support the positive effect of individual level variables, education, and wealth on the utilization of maternal health care across all five measures. Although, this study did not find unilateral differences between women residing in rural and urban settings, rural women were found to have lower odds of utilizing prenatal services as compared with mothers in urban environments. Additionally, women who cited distance as a barrier had lower odds of receiving postnatal health care but still engaged in prenatal services and often had a skilled attendant present at delivery. The odds of utilizing prenatal care increased when women resided in an area where prenatal utilization was high, and this variability was found across measures across provinces.

The results found in this paper highlight the uneven progress made around improving prenatal, delivery, and postnatal care in Pakistan; disparities persist that may be attributed to factors both at the individual and community level, but may be addressed through a consorted effort to change national policy around women’s health, which should include the promotion of such evidence-based interventions as incentivizing health care workers, promoting girls’ education, and improving transportation options for pregnant women and recent mothers with the intent of ultimately lowering the maternal mortality rate as recommended in the United Nation’s Millennium Development Goal Five.

“Individual and Area Level Factors Associated with Prenatal, Delivery, and Postnatal Care in Pakistan” was published in February  in Maternal and Child Health Journal.

Journal article: http://link.springer.com/article/10.1007/s10995-015-1726-x