Analysis of dropout across the continuum of maternal health care in Tanzania findings from a cross-sectional household survey

The ‘continuum of care’ is proposed as a key framework for the delivery of maternal, neonatal and child health services. This study examined the extent of dropout as well as factors associated with retention across the MNCH continuum from antenatal care (ANC), through skilled birth attendance (SBA),...

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Veröffentlicht in:Health policy and planning Jg. 32; H. 6; S. 791 - 799
Hauptverfasser: Mohan, Diwakar, LeFevre, Amnesty E, George, Asha, Mpembeni, Rose, Bazant, Eva, Rusibamayila, Neema, Killewo, Japhet, Winch, Peter J, Baqui, Abdullah H
Format: Journal Article
Sprache:Englisch
Veröffentlicht: England Oxford University Press 01.07.2017
Oxford Publishing Limited (England)
Schlagworte:
Adolescent
Adult
Age
Age Factors
Bias
Catchment areas
Childrens health
Community Health Workers
Continuity of Patient Care - statistics & numerical data
Counseling
Cross-Sectional Studies
Districts
Dropping out
Family planning
Family Planning Services
Family therapy
Female
Health care
Health education
Health services
Health status
Help seeking behavior
Households
Humans
Low income groups
Maternal & child health
Maternal characteristics
Maternal Health Services - statistics & numerical data
Medical personnel
Medical workers
Middle Aged
Mothers
Neonates
Older women
ORIGINAL ARTICLES
Patient Acceptance of Health Care - statistics & numerical data
Polls & surveys
Postpartum period
Pregnancy
Prenatal care
Retention
Rural areas
Rural communities
Sampling
Socioeconomic Factors
Surveys and Questionnaires
Tanzania
Threats
Visits
Wealth
Women
Tanzania
maternal health
care pathway
Care continuum
Tanzania
ISSN:0268-1080, 1460-2237, 1460-2237
Online-Zugang:Volltext
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Abstract The ‘continuum of care’ is proposed as a key framework for the delivery of maternal, neonatal and child health services. This study examined the extent of dropout as well as factors associated with retention across the MNCH continuum from antenatal care (ANC), through skilled birth attendance (SBA), to postnatal care (PNC). We analyzed data from 1931 women who delivered in the preceding 2–14 months, from a twostage cluster sampling household survey in four districts of Tanzania’s Morogoro region. The survey was conducted in 2011 as a part of a baseline for an independent evaluation of a maternal health program. Using the Anderson model of health care seeking, we fitted logistic models for three transition stages in the continuum. Only 10% of women received the ‘recommended’care package (4+ANC visits, SBA, and 1+PNC visit), while 1% reported not having care at any stage. Receipt of four ANC visits was positively associated with women being older in age (age 20–34 years—OR: 1.77, 95% CI: 1.22–2.56; age 35–49 years—2.03, 1.29–3.2), and knowledge of danger signs (1.75, 1.39–2.1). A pro-rich bias was observed in facility-based deliveries (proxy for SBA), with women from the fourth (1.66, 1.12–2.47) and highest quintiles of household wealth (3.4, 2.04–5.66) and the top tertile of communities by wealth (2.9, 1.14–7.4). Higher rates of facility deliveries were also reported with antenatal complications (1.37, 1.05–1.79), and 4+ANC visits (1.55, 1.14–2.09). Returning for PNC was highest among the wealthiest communities (2.25, 1.21–4.44); catchment areas of a new PNC program (1.89, 1.03–3.45); knowledge of danger signs (1.78, 1.13–2.83); community health worker counselling (4.22, 1.97–9.05); complicated delivery (3.25, 1.84–5.73); and previous health provider counselling on family planning (2.39, 1.71–3.35). Dropout from maternal care continuum is high, especially for the poorest, in rural Tanzania. Interactions with formal health system and perceived need for future services appear to be important factors for retention. ”连续照护”是孕产妇、新生儿和儿童健康服务提供的关键框 架。MNCH 连续照护是从产前护理 （ANC） 、熟练助产护 理 （SBA） 到产后护理（PNC） 的连续过程, 本研究调查中途 退出 MNCH连续照护和继续使用的相关因素。 我们在坦桑尼亚莫罗戈罗省的四个区采用二阶段整群抽样住 户调查, 收集并分析了过去2-14个月分娩的 1931 位妇女的数 据并分析。该调查于 2011 年进行, 是一项孕产妇健康项目独 立评估基线调查的一部分。采用安德森模型分析求医行为, 建 立 Logistic 模型分析连续照护中的三个过渡阶段。 仅10%的妇女接受了推荐的整体护理 （4+ANC, SBA和1+PNC）, 1%的妇女未在任何阶段使用 MUCH 护理。接受四次 ANC 检查与年龄呈正相关（20–34 岁： OR=1.77, 95%CI 1.22–2.56； 35–49 岁： OR=2.03, 95%CI 1.29–3.2）, 与对危 险体征的了解也呈正相关 （1.75, 1.39–2.1） 。院内分娩 （SBA 的代理变量） 显示偏向富人的偏倚, 最富裕五分之一 和其次家庭的妇女院内分娩较高 （3.4, 2.04–5.66； 1.66, 1.12–2.47）, 最富裕的三分之一社区的妇女院内分娩也较高 （2.9, 1.14–7.4） 。 高院内分娩率还与产前并发症 （1.37, 1.05–1.79） 和接受4þ ANC 检查相关（1.55, 1.14–2.09） 。 与 返回医疗机构接受PNC 关联最强的是最富裕社区 （2.25, 1.21–4.44） ；新 PNC 项目服务地区 （1.89, 1.03–3.45） ； 了 解危险体征 （1.78, 1.13–2.83） ； 有社区卫生工作者咨询服务 （4.22, 1.97–9.05） ； 并发症分娩 （3.25, 1.84–5.73）； 和既 往计划生育咨询 （2.39, 1.71–3.35） 。 中途退出连续孕产妇保健的比例较高, 尤其是在坦桑尼亚贫困 人口和农村地区。与卫生体系的接触和对未来医疗服务需求 的预估可能是继续使用孕产妇保健的重要因素。 El ‘continuo de la atención’ se propone como un marco clave para la prestación de servicios de salud materna, neonatal e infantil (SMNI). Este estudio examinó el grado de deserción, así como los factores asociados con la retención a través del continuo de SMNI desde el cuidado prenatal (CPN), a través de la asistencia especializada en el parto (AEP), a la atención postnatal (APN). Analizamos los datos de 1931 mujeres que dieron a luz entre los 2 y 14 meses anteriores, de una encuesta de hogares de muestreo por grupos de dos etapas en cuatro distritos de la región de Morogoro en Tanzania. La encuesta se llevó a cabo en 2011 como parte de una línea de base para una evaluación independiente de un programa de salud materna. Usando el modelo de Anderson de la búsqueda de atención de salud, ajustamos los modelos logísticos para tres etapas de transición en el continuo. Sólo el 10% de las mujeres recibieron el paquete de atención “recomendado” (4+ visitas de CPN, AEP y 1 visita APN), mientras que el 1% informó que no había recibido atención en ninguna etapa. Haber recibido cuatro visitas de CPN se asoció positivamente con mujeres mayores en edad (edad 20-34 años—RP: 1.77, IC 95%: 1.22-2.56, edad 35 a 49 años—2.03, 1.29-3.2) y conocimiento de las señales de peligro (1.75, 1.39 – 2.1). Se observó un sesgo favorable a los ricos en los partos basados en instalaciones (lo cual representa la AEP), con las mujeres del cuarto quintil (1.66, 1.12-2.47) y el quintil más altos de la riqueza de los hogares (3.4, 2.04-5.66) y el tercio superior de las comunidades por riqueza (2.9, 1.14-7.4). También se reportaron tasas más altas de partos en instalaciones con complicaciones prenatales (1.37, 1.05-1.79), y 4+ visitas de CPN (1.55, 1.14- 2.09). El regreso a la APN fue mayor entre las comunidades más ricas (2.25, 1.21-4.44); áreas de captación de un nuevo programa de APN (1.89, 1.03-3.45); conocimiento de señales de peligro (1.78, 1.13-2.83); asesoramiento de trabajadores comunitarios de salud (4.22, 1.97-9.05); parto complicado (3.25, 1.84 – 5.73); y asesoramiento previo de proveedores de salud sobre planeación familiar (2.39, 1.71-3.35). La deserción del continuo de la atención materna es alta, especialmente para los más pobres, en las zonas rurales de Tanzania. Las interacciones con el sistema formal de la salud y la necesidad percibida de servicios futuros parecen ser factores importantes para la retención.
AbstractList The ‘continuum of care’ is proposed as a key framework for the delivery of maternal, neonatal and child health services. This study examined the extent of dropout as well as factors associated with retention across the MNCH continuum from antenatal care (ANC), through skilled birth attendance (SBA), to postnatal care (PNC). We analyzed data from 1931 women who delivered in the preceding 2–14 months, from a two-stage cluster sampling household survey in four districts of Tanzania’s Morogoro region. The survey was conducted in 2011 as a part of a baseline for an independent evaluation of a maternal health program. Using the Anderson model of health care seeking, we fitted logistic models for three transition stages in the continuum. Only 10% of women received the ‘recommended’ care package (4+ ANC visits, SBA, and 1+ PNC visit), while 1% reported not having care at any stage. Receipt of four ANC visits was positively associated with women being older in age (age 20–34 years—OR: 1.77, 95%CI: 1.22–2.56; age 35–49 years—2.03, 1.29–3.2), and knowledge of danger signs (1.75, 1.39 –2.1). A pro-rich bias was observed in facility-based deliveries (proxy for SBA), with women from the fourth (1.66, 1.12–2.47) and highest quintiles of household wealth (3.4, 2.04–5.66) and the top tertile of communities by wealth (2.9, 1.14–7.4). Higher rates of facility deliveries were also reported with antenatal complications (1.37, 1.05–1.79), and 4+ ANC visits (1.55, 1.14–2.09). Returning for PNC was highest among the wealthiest communities (2.25, 1.21–4.44); catchment areas of a new PNC program (1.89, 1.03–3.45); knowledge of danger signs (1.78, 1.13–2.83); community health worker counselling (4.22, 1.97–9.05); complicated delivery (3.25, 1.84–5.73); and previous health provider counselling on family planning (2.39, 1.71–3.35). Dropout from maternal care continuum is high, especially for the poorest, in rural Tanzania. Interactions with formal health system and perceived need for future services appear to be important factors for retention.
Abstract The ‘continuum of care’ is proposed as a key framework for the delivery of maternal, neonatal and child health services. This study examined the extent of dropout as well as factors associated with retention across the MNCH continuum from antenatal care (ANC), through skilled birth attendance (SBA), to postnatal care (PNC). We analyzed data from 1931 women who delivered in the preceding 2–14 months, from a two-stage cluster sampling household survey in four districts of Tanzania’s Morogoro region. The survey was conducted in 2011 as a part of a baseline for an independent evaluation of a maternal health program. Using the Anderson model of health care seeking, we fitted logistic models for three transition stages in the continuum. Only 10% of women received the ‘recommended’ care package (4+ ANC visits, SBA, and 1+ PNC visit), while 1% reported not having care at any stage. Receipt of four ANC visits was positively associated with women being older in age (age 20–34 years—OR: 1.77, 95%CI: 1.22–2.56; age 35–49 years—2.03, 1.29–3.2), and knowledge of danger signs (1.75, 1.39 –2.1). A pro-rich bias was observed in facility-based deliveries (proxy for SBA), with women from the fourth (1.66, 1.12–2.47) and highest quintiles of household wealth (3.4, 2.04–5.66) and the top tertile of communities by wealth (2.9, 1.14–7.4). Higher rates of facility deliveries were also reported with antenatal complications (1.37, 1.05–1.79), and 4+ ANC visits (1.55, 1.14–2.09). Returning for PNC was highest among the wealthiest communities (2.25, 1.21–4.44); catchment areas of a new PNC program (1.89, 1.03–3.45); knowledge of danger signs (1.78, 1.13–2.83); community health worker counselling (4.22, 1.97–9.05); complicated delivery (3.25, 1.84–5.73); and previous health provider counselling on family planning (2.39, 1.71–3.35). Dropout from maternal care continuum is high, especially for the poorest, in rural Tanzania. Interactions with formal health system and perceived need for future services appear to be important factors for retention.
The ‘continuum of care’ is proposed as a key framework for the delivery of maternal, neonatal and child health services. This study examined the extent of dropout as well as factors associated with retention across the MNCH continuum from antenatal care (ANC), through skilled birth attendance (SBA), to postnatal care (PNC). We analyzed data from 1931 women who delivered in the preceding 2–14 months, from a twostage cluster sampling household survey in four districts of Tanzania’s Morogoro region. The survey was conducted in 2011 as a part of a baseline for an independent evaluation of a maternal health program. Using the Anderson model of health care seeking, we fitted logistic models for three transition stages in the continuum. Only 10% of women received the ‘recommended’care package (4+ANC visits, SBA, and 1+PNC visit), while 1% reported not having care at any stage. Receipt of four ANC visits was positively associated with women being older in age (age 20–34 years—OR: 1.77, 95% CI: 1.22–2.56; age 35–49 years—2.03, 1.29–3.2), and knowledge of danger signs (1.75, 1.39–2.1). A pro-rich bias was observed in facility-based deliveries (proxy for SBA), with women from the fourth (1.66, 1.12–2.47) and highest quintiles of household wealth (3.4, 2.04–5.66) and the top tertile of communities by wealth (2.9, 1.14–7.4). Higher rates of facility deliveries were also reported with antenatal complications (1.37, 1.05–1.79), and 4+ANC visits (1.55, 1.14–2.09). Returning for PNC was highest among the wealthiest communities (2.25, 1.21–4.44); catchment areas of a new PNC program (1.89, 1.03–3.45); knowledge of danger signs (1.78, 1.13–2.83); community health worker counselling (4.22, 1.97–9.05); complicated delivery (3.25, 1.84–5.73); and previous health provider counselling on family planning (2.39, 1.71–3.35). Dropout from maternal care continuum is high, especially for the poorest, in rural Tanzania. Interactions with formal health system and perceived need for future services appear to be important factors for retention. ”连续照护”是孕产妇、新生儿和儿童健康服务提供的关键框 架。MNCH 连续照护是从产前护理 （ANC） 、熟练助产护 理 （SBA） 到产后护理（PNC） 的连续过程, 本研究调查中途 退出 MNCH连续照护和继续使用的相关因素。 我们在坦桑尼亚莫罗戈罗省的四个区采用二阶段整群抽样住 户调查, 收集并分析了过去2-14个月分娩的 1931 位妇女的数 据并分析。该调查于 2011 年进行, 是一项孕产妇健康项目独 立评估基线调查的一部分。采用安德森模型分析求医行为, 建 立 Logistic 模型分析连续照护中的三个过渡阶段。 仅10%的妇女接受了推荐的整体护理 （4+ANC, SBA和1+PNC）, 1%的妇女未在任何阶段使用 MUCH 护理。接受四次 ANC 检查与年龄呈正相关（20–34 岁： OR=1.77, 95%CI 1.22–2.56； 35–49 岁： OR=2.03, 95%CI 1.29–3.2）, 与对危 险体征的了解也呈正相关 （1.75, 1.39–2.1） 。院内分娩 （SBA 的代理变量） 显示偏向富人的偏倚, 最富裕五分之一 和其次家庭的妇女院内分娩较高 （3.4, 2.04–5.66； 1.66, 1.12–2.47）, 最富裕的三分之一社区的妇女院内分娩也较高 （2.9, 1.14–7.4） 。 高院内分娩率还与产前并发症 （1.37, 1.05–1.79） 和接受4þ ANC 检查相关（1.55, 1.14–2.09） 。 与 返回医疗机构接受PNC 关联最强的是最富裕社区 （2.25, 1.21–4.44） ；新 PNC 项目服务地区 （1.89, 1.03–3.45） ； 了 解危险体征 （1.78, 1.13–2.83） ； 有社区卫生工作者咨询服务 （4.22, 1.97–9.05） ； 并发症分娩 （3.25, 1.84–5.73）； 和既 往计划生育咨询 （2.39, 1.71–3.35） 。 中途退出连续孕产妇保健的比例较高, 尤其是在坦桑尼亚贫困 人口和农村地区。与卫生体系的接触和对未来医疗服务需求 的预估可能是继续使用孕产妇保健的重要因素。 El ‘continuo de la atención’ se propone como un marco clave para la prestación de servicios de salud materna, neonatal e infantil (SMNI). Este estudio examinó el grado de deserción, así como los factores asociados con la retención a través del continuo de SMNI desde el cuidado prenatal (CPN), a través de la asistencia especializada en el parto (AEP), a la atención postnatal (APN). Analizamos los datos de 1931 mujeres que dieron a luz entre los 2 y 14 meses anteriores, de una encuesta de hogares de muestreo por grupos de dos etapas en cuatro distritos de la región de Morogoro en Tanzania. La encuesta se llevó a cabo en 2011 como parte de una línea de base para una evaluación independiente de un programa de salud materna. Usando el modelo de Anderson de la búsqueda de atención de salud, ajustamos los modelos logísticos para tres etapas de transición en el continuo. Sólo el 10% de las mujeres recibieron el paquete de atención “recomendado” (4+ visitas de CPN, AEP y 1 visita APN), mientras que el 1% informó que no había recibido atención en ninguna etapa. Haber recibido cuatro visitas de CPN se asoció positivamente con mujeres mayores en edad (edad 20-34 años—RP: 1.77, IC 95%: 1.22-2.56, edad 35 a 49 años—2.03, 1.29-3.2) y conocimiento de las señales de peligro (1.75, 1.39 – 2.1). Se observó un sesgo favorable a los ricos en los partos basados en instalaciones (lo cual representa la AEP), con las mujeres del cuarto quintil (1.66, 1.12-2.47) y el quintil más altos de la riqueza de los hogares (3.4, 2.04-5.66) y el tercio superior de las comunidades por riqueza (2.9, 1.14-7.4). También se reportaron tasas más altas de partos en instalaciones con complicaciones prenatales (1.37, 1.05-1.79), y 4+ visitas de CPN (1.55, 1.14- 2.09). El regreso a la APN fue mayor entre las comunidades más ricas (2.25, 1.21-4.44); áreas de captación de un nuevo programa de APN (1.89, 1.03-3.45); conocimiento de señales de peligro (1.78, 1.13-2.83); asesoramiento de trabajadores comunitarios de salud (4.22, 1.97-9.05); parto complicado (3.25, 1.84 – 5.73); y asesoramiento previo de proveedores de salud sobre planeación familiar (2.39, 1.71-3.35). La deserción del continuo de la atención materna es alta, especialmente para los más pobres, en las zonas rurales de Tanzania. Las interacciones con el sistema formal de la salud y la necesidad percibida de servicios futuros parecen ser factores importantes para la retención.
The 'continuum of care' is proposed as a key framework for the delivery of maternal, neonatal and child health services. This study examined the extent of dropout as well as factors associated with retention across the MNCH continuum from antenatal care (ANC), through skilled birth attendance (SBA), to postnatal care (PNC).We analyzed data from 1931 women who delivered in the preceding 2-14 months, from a two-stage cluster sampling household survey in four districts of Tanzania's Morogoro region. The survey was conducted in 2011 as a part of a baseline for an independent evaluation of a maternal health program. Using the Anderson model of health care seeking, we fitted logistic models for three transition stages in the continuum.Only 10% of women received the 'recommended' care package (4+ ANC visits, SBA, and 1+ PNC visit), while 1% reported not having care at any stage. Receipt of four ANC visits was positively associated with women being older in age (age 20-34 years-OR: 1.77, 95%CI: 1.22-2.56; age 35-49 years-2.03, 1.29-3.2), and knowledge of danger signs (1.75, 1.39 -2.1). A pro-rich bias was observed in facility-based deliveries (proxy for SBA), with women from the fourth (1.66, 1.12-2.47) and highest quintiles of household wealth (3.4, 2.04-5.66) and the top tertile of communities by wealth (2.9, 1.14-7.4). Higher rates of facility deliveries were also reported with antenatal complications (1.37, 1.05-1.79), and 4+ ANC visits (1.55, 1.14-2.09). Returning for PNC was highest among the wealthiest communities (2.25, 1.21-4.44); catchment areas of a new PNC program (1.89, 1.03-3.45); knowledge of danger signs (1.78, 1.13-2.83); community health worker counselling (4.22, 1.97-9.05); complicated delivery (3.25, 1.84-5.73); and previous health provider counselling on family planning (2.39, 1.71-3.35).Dropout from maternal care continuum is high, especially for the poorest, in rural Tanzania. Interactions with formal health system and perceived need for future services appear to be important factors for retention.The 'continuum of care' is proposed as a key framework for the delivery of maternal, neonatal and child health services. This study examined the extent of dropout as well as factors associated with retention across the MNCH continuum from antenatal care (ANC), through skilled birth attendance (SBA), to postnatal care (PNC).We analyzed data from 1931 women who delivered in the preceding 2-14 months, from a two-stage cluster sampling household survey in four districts of Tanzania's Morogoro region. The survey was conducted in 2011 as a part of a baseline for an independent evaluation of a maternal health program. Using the Anderson model of health care seeking, we fitted logistic models for three transition stages in the continuum.Only 10% of women received the 'recommended' care package (4+ ANC visits, SBA, and 1+ PNC visit), while 1% reported not having care at any stage. Receipt of four ANC visits was positively associated with women being older in age (age 20-34 years-OR: 1.77, 95%CI: 1.22-2.56; age 35-49 years-2.03, 1.29-3.2), and knowledge of danger signs (1.75, 1.39 -2.1). A pro-rich bias was observed in facility-based deliveries (proxy for SBA), with women from the fourth (1.66, 1.12-2.47) and highest quintiles of household wealth (3.4, 2.04-5.66) and the top tertile of communities by wealth (2.9, 1.14-7.4). Higher rates of facility deliveries were also reported with antenatal complications (1.37, 1.05-1.79), and 4+ ANC visits (1.55, 1.14-2.09). Returning for PNC was highest among the wealthiest communities (2.25, 1.21-4.44); catchment areas of a new PNC program (1.89, 1.03-3.45); knowledge of danger signs (1.78, 1.13-2.83); community health worker counselling (4.22, 1.97-9.05); complicated delivery (3.25, 1.84-5.73); and previous health provider counselling on family planning (2.39, 1.71-3.35).Dropout from maternal care continuum is high, especially for the poorest, in rural Tanzania. Interactions with formal health system and perceived need for future services appear to be important factors for retention.
Author Winch, Peter J
Bazant, Eva
LeFevre, Amnesty E
Mpembeni, Rose
Mohan, Diwakar
George, Asha
Rusibamayila, Neema
Killewo, Japhet
Baqui, Abdullah H
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  givenname: Diwakar
  surname: Mohan
  fullname: Mohan, Diwakar
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  givenname: Amnesty E
  surname: LeFevre
  fullname: LeFevre, Amnesty E
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  givenname: Asha
  surname: George
  fullname: George, Asha
– sequence: 4
  givenname: Rose
  surname: Mpembeni
  fullname: Mpembeni, Rose
– sequence: 5
  givenname: Eva
  surname: Bazant
  fullname: Bazant, Eva
– sequence: 6
  givenname: Neema
  surname: Rusibamayila
  fullname: Rusibamayila, Neema
– sequence: 7
  givenname: Japhet
  surname: Killewo
  fullname: Killewo, Japhet
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  surname: Winch
  fullname: Winch, Peter J
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  givenname: Abdullah H
  surname: Baqui
  fullname: Baqui, Abdullah H
BackLink https://www.ncbi.nlm.nih.gov/pubmed/28334973$$D View this record in MEDLINE/PubMed
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ContentType Journal Article
Copyright The Author 2017
The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com 2017
The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com
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– notice: The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com 2017
– notice: The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
– notice: The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com
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Issue 6
Keywords maternal health
care pathway
Care continuum
Tanzania
Language English
License The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
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Snippet The ‘continuum of care’ is proposed as a key framework for the delivery of maternal, neonatal and child health services. This study examined the extent of...
Abstract The ‘continuum of care’ is proposed as a key framework for the delivery of maternal, neonatal and child health services. This study examined the...
The 'continuum of care' is proposed as a key framework for the delivery of maternal, neonatal and child health services. This study examined the extent of...
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SubjectTerms Adolescent
Adult
Age
Age Factors
Bias
Catchment areas
Childrens health
Community Health Workers
Continuity of Patient Care - statistics & numerical data
Counseling
Cross-Sectional Studies
Districts
Dropping out
Family planning
Family Planning Services
Family therapy
Female
Health care
Health education
Health services
Health status
Help seeking behavior
Households
Humans
Low income groups
Maternal & child health
Maternal characteristics
Maternal Health Services - statistics & numerical data
Medical personnel
Medical workers
Middle Aged
Mothers
Neonates
Older women
ORIGINAL ARTICLES
Patient Acceptance of Health Care - statistics & numerical data
Polls & surveys
Postpartum period
Pregnancy
Prenatal care
Retention
Rural areas
Rural communities
Sampling
Socioeconomic Factors
Surveys and Questionnaires
Tanzania
Threats
Visits
Wealth
Women
Subtitle findings from a cross-sectional household survey
Title Analysis of dropout across the continuum of maternal health care in Tanzania
URI https://www.jstor.org/stable/48509204
https://www.ncbi.nlm.nih.gov/pubmed/28334973
https://www.proquest.com/docview/2431016984
https://www.proquest.com/docview/1881263923
Volume 32
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