Distance to available services for newborns at facilities in Malawi: A secondary analysis of survey and health facility data.

<h4>Background</h4>Malawi has halved the neonatal mortality rate between 1990-2018, however, is not on track to achieve the Sustainable Development Goal 12 per 1,000 live births. Despite a high facility birth rate (91%), mother-newborn dyads may not remain in facilities long enough to re...

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Autores principales: Kimberly Peven, Cath Taylor, Edward Purssell, Lindsay Mallick, Clara R Burgert-Brucker, Louise T Day, Kerry L M Wong, Christabel Kambala, Debra Bick
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Publicado: Public Library of Science (PLoS) 2021
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spelling oai:doaj.org-article:0feb4cb65df3406daba42d987519fc502021-12-02T20:09:37ZDistance to available services for newborns at facilities in Malawi: A secondary analysis of survey and health facility data.1932-620310.1371/journal.pone.0254083https://doaj.org/article/0feb4cb65df3406daba42d987519fc502021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0254083https://doaj.org/toc/1932-6203<h4>Background</h4>Malawi has halved the neonatal mortality rate between 1990-2018, however, is not on track to achieve the Sustainable Development Goal 12 per 1,000 live births. Despite a high facility birth rate (91%), mother-newborn dyads may not remain in facilities long enough to receive recommended care and quality of care improvements are needed to reach global targets. Physical access and distance to health facilities remain barriers to quality postnatal care.<h4>Methods</h4>Using data We used individual data from the 2015-16 Malawi Demographic and Health Survey and facility data from the 2013-14 Malawi Service Provision Assessment, linking households to all health facilities within specified distances and travel times. We calculated service readiness scores for facilities to measure their capacity to provide birth/newborn care services. We fitted multi-level regression models to evaluate the association between the service readiness and appropriate newborn care (receiving at least five of six interventions).<h4>Results</h4>Households with recent births (n = 6010) linked to a median of two birth facilities within 5-10 km and one facility within a two-hour walk. The maximum service environment scores for linked facilities median was 77.5 for facilities within 5-10 km and 75.5 for facilities within a two-hour walk. While linking to one or more facilities within 5-10km or a two-hour walk was not associated with appropriate newborn care, higher levels of service readiness in nearby facilities was associated with an increased risk of appropriate newborn care.<h4>Conclusions</h4>Women's choice of nearby facilities and quality facilities is limited. High quality newborn care is sub-optimal despite high coverage of facility birth and some newborn care interventions. While we did not find proximity to more facilities was associated with increased risk of appropriate care, high levels of service readiness was, showing facility birth and improved access to well-prepared facilities are important for improving newborn care.Kimberly PevenCath TaylorEdward PurssellLindsay MallickClara R Burgert-BruckerLouise T DayKerry L M WongChristabel KambalaDebra BickPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 7, p e0254083 (2021)
institution DOAJ
collection DOAJ
language EN
topic Medicine
R
Science
Q
spellingShingle Medicine
R
Science
Q
Kimberly Peven
Cath Taylor
Edward Purssell
Lindsay Mallick
Clara R Burgert-Brucker
Louise T Day
Kerry L M Wong
Christabel Kambala
Debra Bick
Distance to available services for newborns at facilities in Malawi: A secondary analysis of survey and health facility data.
description <h4>Background</h4>Malawi has halved the neonatal mortality rate between 1990-2018, however, is not on track to achieve the Sustainable Development Goal 12 per 1,000 live births. Despite a high facility birth rate (91%), mother-newborn dyads may not remain in facilities long enough to receive recommended care and quality of care improvements are needed to reach global targets. Physical access and distance to health facilities remain barriers to quality postnatal care.<h4>Methods</h4>Using data We used individual data from the 2015-16 Malawi Demographic and Health Survey and facility data from the 2013-14 Malawi Service Provision Assessment, linking households to all health facilities within specified distances and travel times. We calculated service readiness scores for facilities to measure their capacity to provide birth/newborn care services. We fitted multi-level regression models to evaluate the association between the service readiness and appropriate newborn care (receiving at least five of six interventions).<h4>Results</h4>Households with recent births (n = 6010) linked to a median of two birth facilities within 5-10 km and one facility within a two-hour walk. The maximum service environment scores for linked facilities median was 77.5 for facilities within 5-10 km and 75.5 for facilities within a two-hour walk. While linking to one or more facilities within 5-10km or a two-hour walk was not associated with appropriate newborn care, higher levels of service readiness in nearby facilities was associated with an increased risk of appropriate newborn care.<h4>Conclusions</h4>Women's choice of nearby facilities and quality facilities is limited. High quality newborn care is sub-optimal despite high coverage of facility birth and some newborn care interventions. While we did not find proximity to more facilities was associated with increased risk of appropriate care, high levels of service readiness was, showing facility birth and improved access to well-prepared facilities are important for improving newborn care.
format article
author Kimberly Peven
Cath Taylor
Edward Purssell
Lindsay Mallick
Clara R Burgert-Brucker
Louise T Day
Kerry L M Wong
Christabel Kambala
Debra Bick
author_facet Kimberly Peven
Cath Taylor
Edward Purssell
Lindsay Mallick
Clara R Burgert-Brucker
Louise T Day
Kerry L M Wong
Christabel Kambala
Debra Bick
author_sort Kimberly Peven
title Distance to available services for newborns at facilities in Malawi: A secondary analysis of survey and health facility data.
title_short Distance to available services for newborns at facilities in Malawi: A secondary analysis of survey and health facility data.
title_full Distance to available services for newborns at facilities in Malawi: A secondary analysis of survey and health facility data.
title_fullStr Distance to available services for newborns at facilities in Malawi: A secondary analysis of survey and health facility data.
title_full_unstemmed Distance to available services for newborns at facilities in Malawi: A secondary analysis of survey and health facility data.
title_sort distance to available services for newborns at facilities in malawi: a secondary analysis of survey and health facility data.
publisher Public Library of Science (PLoS)
publishDate 2021
url https://doaj.org/article/0feb4cb65df3406daba42d987519fc50
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