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Original Articles
- Institutional Delivery in the Philippines: Does a Minimum of 8 Antenatal Care Visits Matter?
- Felly Philipus Senewe, Agung Dwi Laksono, Roy Glenn Albert Massie, Leny Latifah, Syarifah Nuraini, Rozana Ika Agustiya, Jane Kartika Propiana, Wahyu Pudji Nugraheni
- J Prev Med Public Health. 2025;58(1):44-51. Published online October 22, 2024
- DOI: https://doi.org/10.3961/jpmph.24.245
- 20,721 View
- 720 Download
- 2 Web of Science
- 2 Crossref
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Abstract
Summary
PDF - Objectives
This cross-sectional study investigated the association between the utilization of 8 antenatal care (ANC) visits and delivery in a healthcare institution in the Philippines, using data from the 2022 National Demographic and Health Survey.
Methods
A sample of women who had given birth within the past 3 years was selected for analysis (n=4452). The association between ANC utilization and institutional delivery was assessed using logistic regression models, covariates by relevant socio-demographic factors, and childbirth history.
Results
We found that 97.2% of respondents who completed ANC opted for institutional delivery. A higher proportion of rural residents did not undergo institutional delivery than urban residents (12.9 vs. 6.9%). The group aged 20-24 years had the highest coverage (92.8%), and the group aged 40-44 years had the lowest. Higher education levels, employment, and greater wealth were associated with higher institutional delivery rates. Divorced or widowed mothers (85.1%) and grand multiparous mothers had lower rates than other groups. Multivariable logistic regression analysis showed a significant positive association between ANC utilization and institutional deliveries after adjusting for covariates (adjusted odds ratio, 2.486; 95% confidence interval, 2.485 to 2.487; p<0.001).
Conclusions
ANC visits were associated with deliveries in institutions in the Philippines. Policymakers should promote ANC by ensuring 8 World Health Organization-recommended visits, strengthening programs, conducting community outreach, addressing access barriers, and integrating maternal health services to increase institutional births and improve maternal and infant health. -
SummaryKey Message
This study examines the determinants of institutional delivery in the Philippines, with a focus on compliance with the WHO-recommended eight antenatal care (ANC) visits. Analysis of data from the 2022 National Demographic and Health Survey reveals a strong positive correlation between completing the recommended ANC visits and choosing institutional delivery, alongside significant influences from maternal age, education, marital status, employment, socioeconomic status, and parity. Findings underscore the importance of expanding ANC access and targeted interventions, particularly in underserved areas, to increase institutional delivery rates and improve maternal and neonatal health outcomes.Citations
Citations to this article as recorded by
- Correlates of facility-based childbirth: A health belief model approach using the National Demographic and Health Survey - Philippines
Denise B. Musni, Maria Paz N. Marquez
Philippine Journal of Health Research and Development.2025; 29(4): 34. CrossRef - Prevalence and risk factors of stillbirths among pregnant women from twelve high-volume birthing facilities of Karachi, Pakistan: a longitudinal cohort study
Danya Arif Siddiqi, Muhammad Zia Muneer, Sundus Iftikhar, Mubarak Taighoon Shah, Vijay Kumar Dharma, Fatima Miraj, Mariam Mehmood, Irshad Ali Sodhar, Farrukh Raza Malik, Subhash Chandir
BMC Pregnancy and Childbirth.2025;[Epub] CrossRef
- Antenatal Care Services and Incidence of Low Birth Weight: A Comparison of Demographic and Health Surveys in 4 ASEAN Countries
- Miftahul Arsyi, Besral Besral, Milla Herdayati, Revati Phalkey
- J Prev Med Public Health. 2022;55(6):559-567. Published online November 13, 2022
- DOI: https://doi.org/10.3961/jpmph.22.316
- 10,622 View
- 269 Download
- 5 Web of Science
- 8 Crossref
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Abstract
PDF
Supplementary Material - Objectives
This study aimed to assess the effect of complete coverage and content of available antenatal care (ANC) on the incidence of low birth weight (LBW) in 4 countries belonging to the Association of Southeast Asian Nations (ASEAN).
Methods
Measures of complete coverage and content of ANC services included the frequency of ANC visits and the seven service components (blood pressure measurement, iron supplementation, tetanus toxoid immunization, explanations of pregnancy complications, urine sample test, blood sample test, and weight measurement). The complete coverage and content of ANC services were assessed as high if more than 4 ANC visits and all seven components were delivered. Multivariable logistic regression with complex survey designs was conducted using Demographic Health Survey data from the 4 ASEAN countries in question from 2014 to 2017.
Results
The proportion of LBW infants was higher in the Philippines (13.8%) than in Indonesia (6.7%), Cambodia (6.7%), or Myanmar (7.5%). Poor ANC services were associated with a 1.30 times higher incidence of LBW than a high level of complete coverage and content of ANC services (adjusted odds ratio [aOR], 1.30; 95% confidence interval [CI], 1.11 to 1.52). In addition, the risk of LBW was higher in the Philippines than in other countries (aOR, 2.25; 95% CI, 2.01 to 2.51) after adjusting for mothers’ demographic/socioeconomic factors, health behaviors, and other factors.
Conclusions
In sum, complete coverage and content of ANC services were significantly associated with the incidence of LBW in Indonesia, Cambodia, and Myanmar. The Philippines did not show statistically significant results for this relationship, but had a higher risk of LBW with poor ANC. -
Summary
Citations
Citations to this article as recorded by- Scoping Review of Health Care–Seeking Behavior and Antenatal Care Visits Among Pregnant Adolescents in Low- and Middle-Income Countries
Siti Khuzaiyah, Khadizah Haji Abdul-Mumin, Sarena Haji Hashim
Nursing for Women's Health.2026; 30(2): 120. CrossRef - Frequency of Low Birth Weight Neonates in Mothers with Low Serum Ferritin Levels
Samra Khan, Falak Naz Baloch, Rabia Bosan, Aiman Khan, Muneeba Khan, Zakir Ali Punar, Zobia Munaf
Pakistan Journal of Health Sciences.2025; : 60. CrossRef - Factors Associated With Low Birth Weight Among Under‐Five Children in Sub‐Saharan Africa: Evidence From Demographic and Health Surveys of 58,857 Children
Sulaimon T. Adedokun, Sanni Yaya
Health Science Reports.2025;[Epub] CrossRef - Synergistic associations of antenatal care visits and iron-folic acid supplementation with low birth weight: a pooled analysis of national surveys from six south Asian countries
Vishnu Khanal, Sangita Bista, Shiva Raj Mishra
BMC Public Health.2024;[Epub] CrossRef - The association of Chinese and American antenatal care utilization indices with birth outcomes
Haibo Zhou, Yi Yang, Peihan Chi, Haoyue Cheng, Xialidan Alifu, Yiwen Qiu, Ye Huang, Libi Zhang, Diliyaer Ainiwan, Yan Zhuang, Hui Liu, Zhi Chen, Yunxian Yu
Frontiers in Public Health.2024;[Epub] CrossRef - Relationship of sociodemographic factors and low birth weight in toddlers
Nikmatur Rohmah, Indah Wulandari, Agil Khoironi Firdaus, Nabilah Auliya, Novannisa Imanda, Dwi Ningtyas Anggraini
Frontiers of Nursing.2024; 11(4): 479. CrossRef - Effect of the enhancing nutrition and antenatal infection treatment (ENAT) intervention on birth weight in Ethiopia: a cluster randomized controlled trial
Y Mekonnen, E Wolde, A Bekele, Z Mehari, S Abebe, T Hagos, Y Tadesse, T Taye, G Asire, T Nigatu, S Kumar, S Girma, M Salasibew
BMC Pregnancy and Childbirth.2023;[Epub] CrossRef - Compliance with the World Health Organization’s 2016 prenatal care contact recommendation reduces the incidence rate of adverse birth outcomes among pregnant women in northern Ghana
Leticia Achangebe Akum, Eunice Amina Offei, Mary Rachael Kpordoxah, Daudi Yeboah, Abdul-Nasir Issah, Michael Boah, Sanjoy Kumer Dey
PLOS ONE.2023; 18(6): e0285621. CrossRef
- A Regionalization Model to Increase Equity of Access to Maternal and Neonatal Care Services in Iran
- Zahra Mohammadi Daniali, Mohammad Mehdi Sepehri, Farzad Movahedi Sobhani, Mohammad Heidarzadeh
- J Prev Med Public Health. 2022;55(1):49-59. Published online December 28, 2021
- DOI: https://doi.org/10.3961/jpmph.21.401
- 7,391 View
- 165 Download
- 5 Web of Science
- 10 Crossref
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Abstract
PDFSupplementary Material
- Objectives
Access to maternal and neonatal care services (MNCS) is an important goal of health policy in developing countries. In this study, we proposed a 3-level hierarchical location-allocation model to maximize the coverage of MNCS providers in Iran.
Methods
First, the necessary criteria for designing an MNCS network were explored. Birth data, including gestational age and birth weight, were collected from the data bank of the Iranian Maternal and Neonatal Network national registry based on 3 service levels (I, II, and III). Vehicular travel times between the points of demand and MNCS providers were considered. Alternative MNCS were mapped in some cities to reduce access difficulties.
Results
It was found that 130, 121, and 86 MNCS providers were needed to respond to level I, II, and III demands, respectively, in 373 cities. Service level III was not available in 39 cities within the determined travel time, which led to an increased average travel time of 173 minutes to the nearest MNCS provider.
Conclusions
This study revealed inequalities in the distribution of MNCS providers. Management of the distribution of MNCS providers can be used to enhance spatial access to health services and reduce the risk of neonatal mortality and morbidity. This method may provide a sustainable healthcare solution at the policy and decision-making level for regional, or even universal, healthcare networks. -
Summary
Citations
Citations to this article as recorded by- Global, Regional and National Burden of Maternal Obstructed Labour and Uterine Rupture, 1990–2021: Global Burden of Disease Study 2021
Zhifeng Guo, Wangquan Ji, Mengqing Yan, Yang Shi, Teng Chen, Fanghui Bai, Yu Wu, Zhe Guo, Linlin Song
Paediatric and Perinatal Epidemiology.2025; 39(2): 135. CrossRef - Survival estimate and geographic trajectory in the antepartum period of preterm infants with neonatal death outcome
Carolina Luiza Bezerra Silva Webster Barbosa, Eliane Rolim de Holanda, Luciana Pedrosa Leal, Ana Paula Esmeraldo Lima, Amanda Priscila de Santana Cabral Silva, Vânia Pinheiro Ramos
Ciência & Saúde Coletiva.2025;[Epub] CrossRef - Estimativa de sobrevida e trajetória geográfica no anteparto de prematuros com desfecho de óbito neonatal
Carolina Luiza Bezerra Silva Webster Barbosa, Eliane Rolim de Holanda, Luciana Pedrosa Leal, Ana Paula Esmeraldo Lima, Amanda Priscila de Santana Cabral Silva, Vânia Pinheiro Ramos
Ciência & Saúde Coletiva.2025;[Epub] CrossRef - Epidemiology and Clinical Features of COVID-19 among 4,015 Neonates in Iran: Results of the National Study from the Iranian Maternal and Neonatal Network
David A. Schwartz, Parisa Mohagheghi, Fereshteh Moshfegh, Nazanin Zafaranloo, Narjes Khalili, Mohammad Heidarzadeh, Abbas Habibelahi, Roya Ghafoury, Fatemeh Afrashteh
American Journal of Perinatology.2024; 41(S 01): e1698. CrossRef - Global burden and inequality of maternal and neonatal disorders: based on data from the 2019 Global Burden of Disease study
R Peng, Y Tong, M Yang, J Wang, L Yang, J Zhu, Yu Liu, H Wang, Z Shi, Ya Liu
QJM: An International Journal of Medicine.2024; 117(1): 24. CrossRef - Multi-objective mammography unit location–allocation problem: A case study
Marcos Vinícius Andrade de Campos, Romário dos Santos Lopes de Assis, Marcone Jamilson Freitas Souza, Eduardo Camargo de Siqueira, Maria Amélia Lopes Silva, Sérgio Ricardo de Souza
Operations Research for Health Care.2024; 41: 100430. CrossRef - An integrated location–allocation model for reducing disparities and increasing accessibility to public health screening centers
João Flávio de Freitas Almeida, Lásara Fabrícia Rodrigues, Luiz Ricardo Pinto, Francisco Carlos Cardoso de Campos
Healthcare Analytics.2024; 6: 100349. CrossRef - Association Between Maternal Co-morbidities and Cesarean Delivery Outcomes: A Retrospective Study
Sara Farzadi, Fatemeh Hosseinzadeh, Soheil Soltanipour, Samaneh Ghazanfar Tehran, Maryam Kounani, Mahin Tayefeh Ashrafiyeh, Gelareh Biazar
Modern Care Journal.2024;[Epub] CrossRef - Enhancing geographical access to cardiovascular disease healthcare services in Lagos State, Nigeria
Oluwaseun Addie, Olalekan John Taiwo
Open Health.2024;[Epub] CrossRef - An optimization model for equitable accessibility to magnetic resonance imaging technology in developing countries
João Flávio de Freitas Almeida, Samuel Vieira Conceição, Virgínia Silva Magalhães
Decision Analytics Journal.2022; 4: 100105. CrossRef
PerspectiveTOP- Group Antenatal Care: A Paradigm Shift to Explore for Positive Impacts in Resource-poor Settings
- Bhanu Pratap Singh Gaur, Jyothi Vasudevan, Bhabani Pegu
- J Prev Med Public Health. 2021;54(1):81-84. Published online December 8, 2020
- DOI: https://doi.org/10.3961/jpmph.20.349
- 7,791 View
- 162 Download
- 9 Web of Science
- 11 Crossref
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Abstract
PDF
- The delivery of high-quality antenatal care is a perennial global concern for improving maternal and neonatal outcomes. Antenatal care is currently provided mainly on a one-to-one basis, but growing evidence has emerged to support the effectiveness of group antenatal care. Providing care in a small group gives expectant mothers the opportunity to have discussions with their peers about certain issues and concerns that are unique to them and to form a support system that will improve the quality and utilization of antenatal care services. The aim of this article is to promote group antenatal care as a means to increase utilization of healthcare.
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Summary
Citations
Citations to this article as recorded by- Integrating group antenatal care into routine services: a registry-based cohort study in Geita, Tanzania
Augustino Hellar, Raymond Bandio, Edwin Ernest, Ahmad Makuwani, Alen Kinyina, Phineas Sospeter, Hamid Mandali, Yusuph Kulindwa, Isaac Lyatuu, Wilfred Kafuku, Frank Phiri, Cyprian Mtani, James Tumaini Kengia, Omari Sukari, Husna Athumani, James Hellar, Ntu
BMC Global and Public Health.2026;[Epub] CrossRef - Qualitative evaluation of a package of implementation strategies codesigned to support the introduction of multiple micronutrient supplementation (MMS) for pregnant women in Bamako, Mali
Aissata Ba, Monica J. Fox, Adama Mamby Keita, Kristen M. Hurley, Shannon E. King, Samba Sow, Kounandji Diarra, Mahamane Djiteye, Baba Seydou Kanté, Moussa Coulibaly, Ousmane Dembele, Lisa M. Noguchi, Pooja Sripad, Peter J. Winch
Maternal & Child Nutrition.2025;[Epub] CrossRef - Belonging: a meta-theme analysis of women’s community-making in group antenatal and postnatal care
Anna Horn, Marsha Orgill, Deborah L. Billings, Wiedaad Slemming, Astrid Van Damme, Mathilde Crone, Malibongwe Gwele, Nathalie Leister, Ashna D. Hindori-Mohangoo, Katrien Beeckman, Susan Bradley, Manodj P. Hindori, Jedidia Abanga, Julia Ryan, Hana Bucinca,
Frontiers in Public Health.2025;[Epub] CrossRef - Utilization, satisfaction, and perceived maternal health benefits of group antenatal care in Karu LGA, North Central, Nigeria
Yahaya Maikasuwa Suleiman, Wamanyi Yohanna, Stephen Olaide Aremu, Gani Isah Halidu, Akyala Ishaku Adamu
BMC Pregnancy and Childbirth.2025;[Epub] CrossRef - Exploring the acceptability and impact of group antenatal care: a qualitative study among women in selected health facilities in Burkina Faso
Blami Dao, Yvette Ouedraogo, Maxwell Mhlanga, Andre Kone
Reproductive Health.2025;[Epub] CrossRef - Improving health literacy through group antenatal care: results from a cluster randomized controlled trial in Ghana
Jody R. Lori, Vida Ami Kukula, Liya Liu, Veronica E.A. Apetorgbor, Bidisha Ghosh, Elizabeth Awini, Nancy Lockhart, Georgina Amankwah, Ruth Zielinski, Cheryl A. Moyer, John Williams
BMC Pregnancy and Childbirth.2024;[Epub] CrossRef - Magnitude, disparity, and predictors of poor-quality antenatal care service: A systematic review and meta-analysis
Dereje Bayissa Demissie, Gebeyaw Molla, Firew Tiruneh Tiyare, Abebe Sorsa Badacho, Ashenif Tadele
SAGE Open Medicine.2024;[Epub] CrossRef - WHO antenatal care policy and prevention of malaria in pregnancy in sub-Saharan Africa
Bolanle Olapeju, Michael Bride, Julie R. Gutman, Katherine Wolf, Scolastica Wabwire, Deborah Atobrah, Felicia Babanawo, Otubea Owusu Akrofi, Christian Atta-Obeng, Benjamin Katienefohoua Soro, Fady Touré, Emmanuel Shekarau, Zoé M. Hendrickson
Malaria Journal.2024;[Epub] CrossRef - Effect of group antenatal care versus individualized antenatal care on birth preparedness and complication readiness: a cluster randomized controlled study among pregnant women in Eastern Region of Ghana
Vida A. Kukula, Elizabeth Awini, Bidisha Ghosh, Veronica Apetorgbor, Ruth Zielinski, Georgina Amankwah, Winfred K. Ofosu, Katherine James, John E. O. Williams, Jody R. Lori, Cheryl A. Moyer
BMC Pregnancy and Childbirth.2024;[Epub] CrossRef - Group Antenatal Care Start-Up in the Indian Private Sector: An Implementation Journey to Improve Quality of Care
Tara Danielle Kinra, Vanisree Ramanathan, Chinmay Pramod Umarji, Peg Dublin, Sharon Schindler Rising
Global Journal on Quality and Safety in Healthcare.2024; 7(4): 191. CrossRef - Adolescents’ experiences with group antenatal care: Insights from a mixed‐methods study in Senegal
Ashley Vandermorris, Britt McKinnon, Mohamadou Sall, Adrian Witol, Mahamadou Traoré, Fatma Lamesse‐Diedhiou, Diego G. Bassani
Tropical Medicine & International Health.2021; 26(12): 1700. CrossRef
Original Articles- Prenatal care utilization pattern and its determinants in rural Korea.
- Jang Rak Kim, Jung Han Park, Jae Kyong Lee, Sang Hong Seo, Joon Yong Bang
- Korean J Prev Med. 1993;26(4):599-613.
- 2,770 View
- 25 Download
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Abstract
PDF
- To study the pattern of prenatal care utilization and its determinants in rural Korea, 976 mothers(65.5%) out of 1,489 living mothers in Chinyang, Sachon and Hapchon Counties in Kyongsangnam Province who had delivered a baby between July 1, 1990 and June 30, 1991 were interviewed by the Myon health workers from January 3 through February 15, 1992. The Andersen's behavioral model for health service utilization was applied to develop the frames for analysis. The dependent variable was a number of prenatal care visits. And the independent variables included in the model were the variables pertaining to the predisposing, enabling, medical need and other components. The proportion of mother who had ever received the prenatal care service for the index pregnancy was 97.3%. However, the proportion of mothers who had made more than 10 visits was only 20.6%, which indicated that majority of mothers had paid far less visits than recommended 10~12 visits for each normal pregnancy. The low utilization of prenatal care services(none or less than 4 visits) was related to mother's low educational level, the high birth order, beneficiary of the medical aid, the absence of clinic in the community, no diagnosed disease of mother during pregnancy, and mothers engaged in farming. Inequity of access seemed to exist because social structure variables and the variables of enabling component were important predictors. And there seemed to be high mutability in equalizing the distribution of prenatal care services because the variables of enabling component such as type of medical security and whether there was a clinic or not in the community were substantially important.
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Summary
- Comparative Analysis of Delivery Management in Various Medical Facilities.
- Jung Han Park, Young Sook You, Jang Rak Kim
- Korean J Prev Med. 1989;22(4):555-577.
- 2,593 View
- 20 Download
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Abstract
PDF
- This study was conducted to compare the delivery management including laboratory tests, medication and surgical procedures for the delivery in various medical facilities. Two university hospitals, two general hospitals, three hospitals, two private obstetric clinics, and two midwifery clinics in a large city were selected as they permitted the investigators to abstract the required data from the medical and accounting records. The total number of deliveries occurred at these 11 facilities between 15 January and 15 February, 1989 was 789 among which 606(76.8%) were vaginal deliveries and 183(23.3%) were C-sections. For the normal vaginal deliveries, CBC, Hb/Hct level, blood typing, VDRL, hepatitis B antigen and antibody, and urinalysis were routinely done except the private clinics and midwifery clinics which did not test for hepatitis B and Hb/Hct level at all. In one university hospital ultrasonography was performed in 71.4% of the mothers and in one general hospital liver function test was done in 76.7% of the mothers. For the C-section, chest X-ray, bleeding / clotting time and liver function test were routinely done in addition to the routine tests for the normal vaginal deliveries. Episiotomy was performed in 97.2% of the vaginal deliveries. The type and duration of fluid infused and antibiotics administered showed a wide variation among the medical facilities. In one university hospital antibiotics was not administered after C-section at all while in the general hospitals and hospitals one or two antibiotics were administered for one week on the average. In one private clinic one pint of whole blood was transfused routinely. A wide variation was observed among the medical facilities in the use of vitamin, hemostatics, oxytocics, antipyreptics, analgesics, anti-inflammatory agents, sedatives, digestives, stool softeners, antihistamines, and diuretics. Mean hospital day for the norma vaginal deliveries of primipara was 2.6 days with little variation except one hospital with 3.5 days. Mean hospital day for the C-section of primipara was 7.5 days and that of multipara was 7.6 days and it ranged between 6.5 days and 9.4 days. Average hospital fee for a normal vaginal delivery without the medical insurance coverage was 182,100 Won for the primipara and 167,300 Won for the multipara. In case of the primipara covered by the medical insurance a mother paid 82,400 Won and a multiparous mother paid 75,600 Won. Average hospital fee for a C-section without the medical insurance was 946,500 Won for the primipara and 753,800 Won for the multipara. In case of the primipara covered by the medical insurance a mother paid 256,200 Won and a multiparous mother paid 253,700 Won. Average hospital fee for a normal vaginal delivery in the university hospitals showed a remarkable difference, 268,000 Won vs 350,000 Won, as well as for the C-section. A wide variation in the laboratory tests performed for a normal vaginal delivery and a C-section as well as in the medication and hospital days brought about a big difference in the hospital fee and some hospitals were practicing the case payment system. Thus, standardization of the medical care to a certain level is warranted for the provision of adequate medical care for delivery.
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