Prenatal care utilization in rural areas and urban areas of Haiti.

OBJECTIVES: This study is based on the 2000 Demographic and Health Survey (DHS) conducted in Haiti. Using the DHS information on women aged 15 to 49 who had given birth during the three years preceding the survey interview, this study was intended to: (1) examine the determinants of the likelihood of the women using prenatal care in the rural areas and in the urban areas of the country and (2) for the women who made at least one prenatal care visit, examine the determinants of the number of prenatal visits in the rural areas and the urban areas. METHODS: The multivariate analysis used logistic models to identify which factors explained the decision to seek prenatal care, and negative binomial models were used to determine how many prenatal visits were conducted by the subgroup of women who did make prenatal care visits. RESULTS: Estimated at the mean values of the control variables, the expected probability of using prenatal care services in rural Haiti was 77.16%, compared to 85.83% in urban Haiti. Among users of prenatal care services, mothers in rural areas made an expected number of 3.78 prenatal care visits, compared to 5.06 visits for the women in urban areas. CONCLUSIONS: A substantial percentage of pregnant women have access to prenatal care services in Haiti, but mothers in rural areas who decided to seek care still fell slightly below the four visits recommended by the World Health Organization. The education levels of both mothers and their partners is a dominant predictor of prenatal care use. Longer travel times and greater distances to health centers in rural areas constituted barriers to repeated visits. Policymakers and health care providers need to take these findings into consideration as they decide on the delivery and management of health care services in Haiti.

Prenatal care utilization in rural areas and urban areas of Haiti

OBJETIVOS: El presente estudio se basa en la Encuesta de Demografía y Salud del año 2000 en Haití. Los objetivos del estudio, que se basó en información sobre las mujeres de 15 a 49 años de edad que habían dado a luz en los tres años anteriores a la entre-vista, fueron: 1) examinar los factores que determinan la probabilidad de que las mu-jeres acudan a atención prenatal en las zonas rurales y urbanas del país y 2) dentro del grupo de mujeres con una o más consultas prenatales, examinar los factores que determinan el número de dichas consultas en las zonas rurales y urbanas.MÉTODOS: En el análisis multifactorial se emplearon modelos logísticos para deter-minar qué factores explicaban la decisión de acudir a control prenatal, y se usaron modelos binomiales negativos para determinar el número de consultas prenatales dentro del subgrupo de mujeres que consultaron por lo menos una vez.RESULTADOS: La probabilidad esperada de acudir a control prenatal, determinada según el valor medio de las variables de control, fue de 77,16% en las zonas rurales, en comparación con 85,83% en las zonas urbanas de Haití. Dentro del grupo de mu-jeres que acudieron a servicios de control prenatal, las madres en zonas rurales tuvieron un número esperado de consultas prenatales de 3,78, en comparación con 5,06 en las zonas urbanas. CONCLUSIONES: Un buen porcentaje de mujeres embarazadas tiene acceso a servicios de atención prenatal en Haití, pero las madres en zonas rurales que eligieron acudir a dichos servicios tuvieron un poco menos del mínimo de cuatro consultas recomendado por la Organización Mundial de la Salud. El nivel educativo de las madres y de sus parejas es un factor pronóstico muy importante en relación con el uso de servicios de atención prenatal. Las consultas repetidas se vieron obstaculizadas en las zonas rurales por el mayor tiempo de desplazamiento y la mayor distancia hasta el centro de salud. Los formuladores de políticas y los proveedores de atención sanitaria deben tener en cuenta estos resultados a la hora de tomar decisiones sobre la prestación y administración de los servicios de salud en Haití.

Prenatal care utilization in rural areas and urban areas of Haiti

OBJECTIVES: This study is based on the 2000 Demographic and Health Survey (DHS) conducted in Haiti. Using the DHS information on women ages 15 to 49 who had given birth during the three years preceding the survey interview, this study was intended to: (1) examine the determinants of the likelihood of the women using prenatal care in the rural areas and in the urban areas of the country and (2) for the women who made at least one prenatal care visit, examine the determinants of the number of prenatal visits in the rural areas and the urban areas. METHODS: The multivariate analysis used logistic models to identify which factors explained the decision to seek prenatal care, and negative binomial models were used to determine how many prenatal visits were conducted by the subgroup of women who did make prenatal care visits. RESULTS: Estimated at the mean values of the control variables, the expected probability of using prenatal care services in rural Haiti was 77.16 percent, compared to 85.83 percent in urban Haiti. Among users of prenatal care services, mothers in rural areas made an expected number of 3.78 percent prenatal care visits, compared to 5.06 visits for the women in urban areas. CONCLUSIONS: A substantial percentage of pregnant women have access to prenatal care services in Haiti, but mothers in rural areas who decided to seek care still fell slightly below the four visits recommended by the World Health Organization. The education levels of both mothers and their partners is a dominant predictor of prenatal care use. Longer travel times and greater distances to health centers in rural areas consituted barriers to repeated visits. Policymakers and health care providers need to take these findings into consideration as they decide on the delivery and management of health care services in Haiti (AU)

Prenatal care utilization in rural areas and urban areas of Haiti

OBJECTIVES: This study is based on the 2000 Demograpic Health Survey (DHS) conducted in Haiti. Using the DHS information on women aged 15 to 49 who had given birth during the three years preceding the survey interview, this study was intended to: (1) examine the determinants of the likelihood of the women using prenatal care in the rural areas and in the urban areas of the country and (2)for the women who made at least one prenatal care visit, examine the determinants of the number of prenatal visits in the rural areas and the urban areas. METHODS: The multivariate analysis used logistic models to identify which factors explained the decision to seek prenatal care, and negative binomial models were used to determine how many prenatal visits were conducted by the subgroup of women who did not make prenatal care visits. RESULTS: Estimated at the mean values of the control variables, the expected probability of using prenatal care services in rural Haiti was 77.16 percent, compared to 85.83 percent in urban Haiti. Among users of prenatal care services, mothers in rural areas made an expected number of 3.78 prenatal care visits, compared to 5.06 visits for the women in urban areas. CONCLUSIONS: A substantial percentage of pregnant women have access to prenatal care services in Haiti, but mothers in rural areas who decided to seek care still fell slightly below the four visits recommended by the World Health Organization. The education levels of both mothers and and their partners is a dominant predictor of prenatal care use. Longer travel times and greater distances to health centres in rural areas constituted barriers to repeated visits. Policymakers and health care providers need to take these findings into consideration as they decide on the delivery and management of health care services in Haiti(AU)