ANTENATAL CARE AS A MEANS OF INCREASING BIRTH IN THE HEALTH FACILITY AND REDUCING MATERNAL MORTALITY A SYSTEMATIC REVIEW

Abstract

BACKGROUND: Although there is a general agreement on the importance of antenatal care to improvethe maternal and perinatal health, little is known about its importance to improve health facility deliveryin developing countries. The objective of this study was to assess the association of antenatal care withbirth in health facility.

METHODS: A systematic review with meta-analysis of Mantel–Haenszel odds ratios was conducted byincluding seventeen small scale studies that compared antenatal care and health facility delivery between2003 and 2013. Additionally, national survey data of African countries which included antenatal care,health facility delivery and maternal mortality in their report were included. Data were accessed via acomputer based search from MEDLINE, African Journals Online, HINARI and Google Scholardatabases.RESULTS: The regression analysis of antenatal care with health facility delivery revealed a positivecorrelation. The pooled analysis also demonstrated that woman attending antenatal care had more than7 times increased chance of delivering in a health facility. The comparative descriptive analysis, however,demonstrated a big gap between the proportion of antenatal care and health facility delivery by the sameindividuals (27%-95% vs 4%-45%). Antenatal care and health facility delivery had negative correlationwith maternal mortality.CONCLUSION: The present regression and meta-analysis has identified the relative advantage ofhaving antenatal care to give birth in health facilities. However, the majority of women who hadantenatal care did not show up to a health facility for delivery. Therefore, future research needs to giveemphasis to identifying barriers to health facility delivery despite having antenatal care follow up.