142nd APHA Annual Meeting and Exposition

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An Analysis of Individual and Area Level Factors Associated with Prenatal Care in Pakistan

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014

Henna Budhwani, PhD, MPH , Department of Health Care Organization and Policy, University of Alabama at Birmingham, Birmingham, AL
Kristine Hearld, Ph.D. , Department of Health Services Administration, University of Alabama at Birmingham, Birmingham, AL
Hanne Harbison, MSN, CRNP, MSPH , University of Alabama at Birmingham, Birmingham, AL
The purpose of this paper was to examine individual and area level measures associated with prenatal health care in Pakistan. In 1994, under direction from the Prime Minister's Programme for Family Planning and Primary Care, the Lady Health Worker Programme (LHWP) was established which sought to train 100,000 women as community health workers in rural settings with the intention of shrinking the maternal health care gap. Furthermore, with the Millennium Development Goals (MDG) reaching the end of their cycle in 2015, maternal and child health outcomes, particularly in low- and middle- income nations will likely be reviewed to assess overall global progress.

This analysis used data from the 2012-2013 Demographic and Health Surveys (DHS) for Pakistan and employed multilevel regression models to assess individual and contextual influences on the use of maternal health services.  This project is one of the first to use this recently released data. Evidence was found to support a positive effect of socioeconomic status, specifically education and income, on the utilization of prenatal care. Additionally, this study found that area level factors did indeed affect utilization. The odds of utilizing services increased in regions with high prenatal utilization and higher levels of female education. Although this study did not find a statistically significant difference in utilization of prenatal services between urban and rural areas, women in urban locales were 30% more likely to have a trained medical professional (doctor, nurse, or midwife) at delivery.

Learning Areas:

Advocacy for health and health education
Provision of health care to the public
Public health or related research

Learning Objectives:
Assess progress on equalizing access to prenatal services between rural and urban locales in Pakistan Differentiate between individual and area level effects on utilization of services Discuss the possible influence of the MDGs on progress made

Keyword(s): Prenatal Care, International MCH

Presenting author's disclosure statement:

Not Answered