Impact of the Changes in Women’s Characteristics over Time on Antenatal Health Care Utilization in Egypt (2000-2008)
Affiliation(s)
1 School of Humanities and Social Sciences, the American University in Cairo, Cairo, Egypt. 2 Department of Statistics, Faculty of Economics and Political Science, Cairo University, Giza, Egypt. 3 Social Research Center of the American University in Cairo, Cairo, Egypt. 4 Faculty of Arts and Social Sciences, Kingston University, London, UK,. 5 Faculty of Commerce, South Valley University, Qena, Egypt.
1 School of Humanities and Social Sciences, the American University in Cairo, Cairo, Egypt. 2 Department of Statistics, Faculty of Economics and Political Science, Cairo University, Giza, Egypt. 3 Social Research Center of the American University in Cairo, Cairo, Egypt. 4 Faculty of Arts and Social Sciences, Kingston University, London, UK,. 5 Faculty of Commerce, South Valley University, Qena, Egypt.
ABSTRACT
Objectives: This study empirically assesses the impact of the changes in women’s characteristics, empowerment, availability and quality of health services on woman’s decision to use antenatal care (ANC) and the frequency of that use during the period 2000-2008. Study Design: The study is a cross-sectional analytical study using 2000 and 2008 Egypt Demographic and Health Surveys. Methods: The assessment of the studied impact is conducted using the Zero-inflated Negative Binomial Regression. In addition, Factor Analysis technique is used to construct some of the explanatory variables such as women’s empowerment, the availability and quality of health services indicators. Results: Utilization of antenatal health care services is greatly improved from 2000 to 2008. Availability of health services is one of the main determinants that affect the number of antenatal care visits in 2008. Wealth index and quality of health services play an important role in raising the level of antenatal care utilization in 2000 and 2008. However, the impact of the terminated pregnancy on receiving ANC increased over time. Conclusions: Further research of the determinants of antenatal health care utilization is needed, using more updated measures of women’s empowerment, availability and quality of health services. In order to improve the provision of antenatal health care services, it is important to understand barriers to antenatal health care utilization. Therefore, it is advisable to collect information from women about the reasons for not receiving antenatal care.
Objectives: This study empirically assesses the impact of the changes in women’s characteristics, empowerment, availability and quality of health services on woman’s decision to use antenatal care (ANC) and the frequency of that use during the period 2000-2008. Study Design: The study is a cross-sectional analytical study using 2000 and 2008 Egypt Demographic and Health Surveys. Methods: The assessment of the studied impact is conducted using the Zero-inflated Negative Binomial Regression. In addition, Factor Analysis technique is used to construct some of the explanatory variables such as women’s empowerment, the availability and quality of health services indicators. Results: Utilization of antenatal health care services is greatly improved from 2000 to 2008. Availability of health services is one of the main determinants that affect the number of antenatal care visits in 2008. Wealth index and quality of health services play an important role in raising the level of antenatal care utilization in 2000 and 2008. However, the impact of the terminated pregnancy on receiving ANC increased over time. Conclusions: Further research of the determinants of antenatal health care utilization is needed, using more updated measures of women’s empowerment, availability and quality of health services. In order to improve the provision of antenatal health care services, it is important to understand barriers to antenatal health care utilization. Therefore, it is advisable to collect information from women about the reasons for not receiving antenatal care.
KEYWORDS
Women’s Characteristics, Antenatal Health Care, Women’s Empowerment, Zero-Inflated Negative Binomial Regression, Egypt
Women’s Characteristics, Antenatal Health Care, Women’s Empowerment, Zero-Inflated Negative Binomial Regression, Egypt
Cite this paper
Zaky, H. , Armanious, D. , Hussein, M. , (2015) Impact of the Changes in Women’s Characteristics over Time on Antenatal Health Care Utilization in Egypt (2000-2008). Open Journal of Obstetrics and Gynecology, 5, 542-552. doi: 10.4236/ojog.2015.510078.
Zaky, H. , Armanious, D. , Hussein, M. , (2015) Impact of the Changes in Women’s Characteristics over Time on Antenatal Health Care Utilization in Egypt (2000-2008). Open Journal of Obstetrics and Gynecology, 5, 542-552. doi: 10.4236/ojog.2015.510078.
References
[1] World Health Organization (WHO) (2014) Facts Sheet: Maternal Mortality.
http://www.who.int/mediacentre/factsheets/fs348/en/ [2] Asundep, N.N., Carson, A.P., Turpin, C.A., Tameru, B., Agidi, A.T., Zhang, K., et al. (2013) Determinants of Access to Antenatal Care and Birth Outcomes in Kumasi, Ghana. Journal of Epidemiology and Global Health, 3, 279-288.
http://dx.doi.org/10.1016/j.jegh.2013.09.004 [3] Furuta, M. and Salway, S. (2006) Women’s Position within the Household as a Determinant of Maternal Health Care Use in Nepal. International Family Planning Perspectives, 32, 17-27.
http://dx.doi.org/10.1363/3201706 [4] Kamiya, Y. (2011) Women’s Autonomy and Reproductive Health Care Utilization: Empirical Evidence from Tajikistan. Health Policy, 102, 304-313.
http://dx.doi.org/10.1016/j.healthpol.2011.04.001 [5] Pebley, A., Goldman, N. and Rodriguez, G. (1996) Prenatal and Delivery Care and Childhood Immunization in Gautemala: Do Family and Community Matter? Demography, 33, 231-247.
http://dx.doi.org/10.2307/2061874 [6] Zaky, H.H., Armanious, D.M. and Hussein, M.A. (2014) Testing for the Endogenous Nature between Women’s Empowerment and Antenatal Health Care Utilization: Evidence from a Cross-Sectional Study in Egypt. BioMed Research International, 2014, Article ID: 403402. [7] Bloom, S.S., Wypij, D. and Gupta, M.D. (2001) Dimensions of Women’s Autonomy and the Influence on Maternal Health Care Utilization in a North Indian City. Demography, 38, 67-78.
http://dx.doi.org/10.1353/dem.2001.0001 [8] Gage, A. (2007) Barriers to the Utilization of Maternal Health Care in Rural Mali. Social Science and Medicine, 65, 1666-1682.
http://dx.doi.org/10.1353/dem.2001.0001 [9] Zaky, H.H., Armanious, D.M. and Hussein, M.A. (2012) Impact of Women’s Empowerment and Other Indicators on Antenatal Health Care Utilization in Egypt. Proceedings of the Annual Meeting of Population Association of America (PAA’12), San Francisco. [10] Cameron, A.C. and Trivedi, P.K. (2005) Microeconometrics: Methods and Applications. Cambridge University Press, New York.
http://dx.doi.org/10.1017/CBO9780511811241 [11] Lambert, D. (1992) Zero-Inflated Poisson Regression, with an Application to Defects in Manufacturing. Technometrics, 34, 1-14.
http://dx.doi.org/10.2307/1269547 [12] World Health Organization (WHO). Media Centre: New Releases 2004. [Cited 2013 Sep 30].
http://www.who.int/mediacentre/news/releases/2004/pr22/en/ [13] Institute for Digital Research and Education (IDRE). Stata Annotated Output. [Cited 2014 Aug 28].
http://statistics.ats.ucla.edu/stat/stata/output/Stata_ZINB.htm [14] Alexandre, P.K., Saint-Jean, G., Crandall, L. and Fevrin, E. (2005) Prenatal Care Utilization in Rural and Urban Areas of Haiti. Revista Panamericana de Salud Pública, 18, 84-92.
http://dx.doi.org/10.1590/S1020-49892005000700002 [15] Sepehri, A., Sarma, S., Simpson, W. and Moshiri, S. (2008) How Important Are Individual, Household and Commune Characteristics in Explaining Utilization of Maternal Health Services in Vietnam? Social Science and Medicine, 67, 1009-1017.
http://dx.doi.org/10.1016/j.socscimed.2008.06.005 [16] Singh, A., Mukherjee, S. and Chandra, R. (2012) Inter-District Variation in Socio-Economic Inequalities in Maternal Healthcare Utilization in Rural Assam, 2007-2008. Journal of North East India Studies, 2, 94-103. [17] Sharma, V., Mohan, U., Das, V. and Awasthi, S. (2012) Utilization Pattern of Antenatal Care in Lucknow under National Rural Health Mission. Indian Journal of Community Health, 24, 32-36. [18] Titaley, C.R., Dibley, M.J. and Roberts, C.L. (2010) Factors Associated with Underutilization of Antenatal Care Services in Indonesia: Results of Indonesia Demographic and Health Survey 2002/2003 and 2007. BMC Public Health, 10, 485-494.
http://dx.doi.org/10.1186/1471-2458-10-485 [19] Rani, M., Bonu, S. and Harvey, S. (2007) Differentials in the Quality of Antenatal Care in India. International Journal for Quality in Health Care, 20, 62-71.
http://dx.doi.org/10.1093/intqhc/mzm052
[1] World Health Organization (WHO) (2014) Facts Sheet: Maternal Mortality.
http://www.who.int/mediacentre/factsheets/fs348/en/ [2] Asundep, N.N., Carson, A.P., Turpin, C.A., Tameru, B., Agidi, A.T., Zhang, K., et al. (2013) Determinants of Access to Antenatal Care and Birth Outcomes in Kumasi, Ghana. Journal of Epidemiology and Global Health, 3, 279-288.
http://dx.doi.org/10.1016/j.jegh.2013.09.004 [3] Furuta, M. and Salway, S. (2006) Women’s Position within the Household as a Determinant of Maternal Health Care Use in Nepal. International Family Planning Perspectives, 32, 17-27.
http://dx.doi.org/10.1363/3201706 [4] Kamiya, Y. (2011) Women’s Autonomy and Reproductive Health Care Utilization: Empirical Evidence from Tajikistan. Health Policy, 102, 304-313.
http://dx.doi.org/10.1016/j.healthpol.2011.04.001 [5] Pebley, A., Goldman, N. and Rodriguez, G. (1996) Prenatal and Delivery Care and Childhood Immunization in Gautemala: Do Family and Community Matter? Demography, 33, 231-247.
http://dx.doi.org/10.2307/2061874 [6] Zaky, H.H., Armanious, D.M. and Hussein, M.A. (2014) Testing for the Endogenous Nature between Women’s Empowerment and Antenatal Health Care Utilization: Evidence from a Cross-Sectional Study in Egypt. BioMed Research International, 2014, Article ID: 403402. [7] Bloom, S.S., Wypij, D. and Gupta, M.D. (2001) Dimensions of Women’s Autonomy and the Influence on Maternal Health Care Utilization in a North Indian City. Demography, 38, 67-78.
http://dx.doi.org/10.1353/dem.2001.0001 [8] Gage, A. (2007) Barriers to the Utilization of Maternal Health Care in Rural Mali. Social Science and Medicine, 65, 1666-1682.
http://dx.doi.org/10.1353/dem.2001.0001 [9] Zaky, H.H., Armanious, D.M. and Hussein, M.A. (2012) Impact of Women’s Empowerment and Other Indicators on Antenatal Health Care Utilization in Egypt. Proceedings of the Annual Meeting of Population Association of America (PAA’12), San Francisco. [10] Cameron, A.C. and Trivedi, P.K. (2005) Microeconometrics: Methods and Applications. Cambridge University Press, New York.
http://dx.doi.org/10.1017/CBO9780511811241 [11] Lambert, D. (1992) Zero-Inflated Poisson Regression, with an Application to Defects in Manufacturing. Technometrics, 34, 1-14.
http://dx.doi.org/10.2307/1269547 [12] World Health Organization (WHO). Media Centre: New Releases 2004. [Cited 2013 Sep 30].
http://www.who.int/mediacentre/news/releases/2004/pr22/en/ [13] Institute for Digital Research and Education (IDRE). Stata Annotated Output. [Cited 2014 Aug 28].
http://statistics.ats.ucla.edu/stat/stata/output/Stata_ZINB.htm [14] Alexandre, P.K., Saint-Jean, G., Crandall, L. and Fevrin, E. (2005) Prenatal Care Utilization in Rural and Urban Areas of Haiti. Revista Panamericana de Salud Pública, 18, 84-92.
http://dx.doi.org/10.1590/S1020-49892005000700002 [15] Sepehri, A., Sarma, S., Simpson, W. and Moshiri, S. (2008) How Important Are Individual, Household and Commune Characteristics in Explaining Utilization of Maternal Health Services in Vietnam? Social Science and Medicine, 67, 1009-1017.
http://dx.doi.org/10.1016/j.socscimed.2008.06.005 [16] Singh, A., Mukherjee, S. and Chandra, R. (2012) Inter-District Variation in Socio-Economic Inequalities in Maternal Healthcare Utilization in Rural Assam, 2007-2008. Journal of North East India Studies, 2, 94-103. [17] Sharma, V., Mohan, U., Das, V. and Awasthi, S. (2012) Utilization Pattern of Antenatal Care in Lucknow under National Rural Health Mission. Indian Journal of Community Health, 24, 32-36. [18] Titaley, C.R., Dibley, M.J. and Roberts, C.L. (2010) Factors Associated with Underutilization of Antenatal Care Services in Indonesia: Results of Indonesia Demographic and Health Survey 2002/2003 and 2007. BMC Public Health, 10, 485-494.
http://dx.doi.org/10.1186/1471-2458-10-485 [19] Rani, M., Bonu, S. and Harvey, S. (2007) Differentials in the Quality of Antenatal Care in India. International Journal for Quality in Health Care, 20, 62-71.
http://dx.doi.org/10.1093/intqhc/mzm052