TY - JOUR
T1 - Sexual Relationship Power and Socio-demographic Factors Predicting Contraceptive Use, Antenatal Visits and Sick Child Health Service Use in Northern Togo
AU - Kaplowitz, Elianna T.
AU - Fiori, Kevin P.
AU - Lauria, Molly E.
AU - Gbeleou, Sesso
AU - Miziou, Agnés
AU - Sowu, Etonam
AU - Schechter, Jennifer
AU - Jones, Heidi E.
N1 - Funding Information:
The authors acknowledge and thank the women who participated in this study. The authors also wish to thank the Togolese Ministry of Health, communities of Adabawere, Djamde, Kpindi, and Sarakawa, as well as Integrate Health staff. No funders had any role in the design of this study.
Publisher Copyright:
© 2020, Springer Science+Business Media, LLC, part of Springer Nature.
PY - 2020/7/1
Y1 - 2020/7/1
N2 - Introduction: Implementation of community-based healthcare services offering effective contraception, antenatal care (ANC), and treatment for symptomatic children under five has reduced maternal and child mortality in Togo. However, understanding if women are utilizing these services differentially based on social or demographic factors is important. This study identifies whether sexual relationship and socio-demographic factors are associated with healthcare utilization in four health facility catchment areas. Methods: We conducted a cross-sectional household survey of women aged 15–49 in four health facility catchment areas in 2016 (three rural sites, one urban site). We used multivariable Poisson regression to test whether socio-demographic factors and a validated sexual relationship power scale were associated with contraceptive use, ANC visits, and seeking treatment for symptomatic children under five. Results: Among women not pregnant or desiring pregnancy, older age, lower education, and single relationship status were associated with lower use of effective contraception. Among women who gave birth in two years preceding survey, low relationship power and low wealth quintile were associated with being less likely to attend at least four ANC visits. Women in rural sites were slightly more likely than women in the urban site to report seeking treatment for child under five with malaria, pneumonia, and/or diarrhea symptoms in last 2 weeks. Discussion: Interventions in low-resource settings should explore ways to reach women with low health-service utilization to improve contraceptive use, ANC visits, and treatment for sick children. Furthermore, age, education, marital status, wealth status and sexual relationship power must be considered when targeting maternal health behaviors. Trial Registration: ClinicalTrials.gov Identifier: NCT03773913; Date of registration: 12 Dec.
AB - Introduction: Implementation of community-based healthcare services offering effective contraception, antenatal care (ANC), and treatment for symptomatic children under five has reduced maternal and child mortality in Togo. However, understanding if women are utilizing these services differentially based on social or demographic factors is important. This study identifies whether sexual relationship and socio-demographic factors are associated with healthcare utilization in four health facility catchment areas. Methods: We conducted a cross-sectional household survey of women aged 15–49 in four health facility catchment areas in 2016 (three rural sites, one urban site). We used multivariable Poisson regression to test whether socio-demographic factors and a validated sexual relationship power scale were associated with contraceptive use, ANC visits, and seeking treatment for symptomatic children under five. Results: Among women not pregnant or desiring pregnancy, older age, lower education, and single relationship status were associated with lower use of effective contraception. Among women who gave birth in two years preceding survey, low relationship power and low wealth quintile were associated with being less likely to attend at least four ANC visits. Women in rural sites were slightly more likely than women in the urban site to report seeking treatment for child under five with malaria, pneumonia, and/or diarrhea symptoms in last 2 weeks. Discussion: Interventions in low-resource settings should explore ways to reach women with low health-service utilization to improve contraceptive use, ANC visits, and treatment for sick children. Furthermore, age, education, marital status, wealth status and sexual relationship power must be considered when targeting maternal health behaviors. Trial Registration: ClinicalTrials.gov Identifier: NCT03773913; Date of registration: 12 Dec.
KW - Antenatal care
KW - Care seeking
KW - Child mortality
KW - Contraception
KW - Sexual relationship power
KW - Togo
UR - http://www.scopus.com/inward/record.url?scp=85083981451&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85083981451&partnerID=8YFLogxK
U2 - 10.1007/s10995-020-02948-w
DO - 10.1007/s10995-020-02948-w
M3 - Article
C2 - 32347439
AN - SCOPUS:85083981451
SN - 1092-7875
VL - 24
SP - 845
EP - 855
JO - Maternal and child health journal
JF - Maternal and child health journal
IS - 7
ER -
