Realized Access to Antenatal Care Utilization in Uganda: Household Welfare and Governance Implications

Authors

  • Ibrahim Mike Okumu
  • Edward Bbaale

DOI:

https://doi.org/10.61538/ajer.v4i2.442

Abstract

This study explores into realized access to antenatal care utilisation in Uganda. This emanates from the fact that access to antenatal care is still a national nemesis, (National Service Delivery Survey Report, 2005). In Uganda, the Ministry of Health (MoH) recommends that a pregnant woman should attend antenatal care at least four times during pregnancy. Also she should attend antenatal care monthly during the first seven months, every two weeks in the eighth month, then weekly until birth. On the whole however, 42 percent of expecting women sought for antenatal care at least four times during pregnancy, 52 percent of them one to three visits which of course is below the MoH recommendation while six percent did not seek care at all, (Uganda Demographic Household Survey, 2000/2001). This clearly indicates the under utilization of antenatal care; with such a state of affairs, no wonder Uganda’s maternal mortality rate of 505 per 100,000 live births is high given the Millennium Development Goals maternal mortality rate target of 131 per 100,000 live births by 2015 (UNDP, 2007). Against that background, this study sought to establish the factors which determine realized access to antenatal care. More importantly the paper unearths the interaction between realised access to antenatal care, governance and household welfare. The study unearthed that both governance and household welfare to a great extent explain antenatal care utilisation.

Author Biographies

Ibrahim Mike Okumu

School of Economics, Makerere University,

Edward Bbaale

School of Economics, Makerere University, ebbaale@bams.mak.ac.ug

References

Aday LA, Andersen RM (1981) “Equity of access to medical care: a conceptual and empirical overview†Medical Care, Dec; 19(12 Suppl):4–27.

Aday L A, Andersen RM, (1974) ‘A framework for the study of access to medical care.’ Antenatal Care Research 9: 208-220.

Agresti A. (2002) Categorical Data Analysis, Second edition, Wiley & Sons, Inc, New Jersey.

Andersen M. R. (1998) “The multiple and changing faces of access,†Medical Care, 36(3):

-253.

Andersen M. R. (1995) “Revisiting the behavioral model and access to medical are: does it matter?†Journal of Health and Social Behavior, 36(1): 1-10.

Anna M., Van E., Hanneke M., Ohiambo F., Ayisi J. G., Ilse E. B., Rosen H. D., Kubaje A., Slustker L., and Lindblade A. K., (2006). Use of antenatal services and delivery of care among women in rural Western Kenyan: a community based survey.

Asada, Y. and G. Kephart (2007). “Equity in antenatal care use and intensity of use in Canada.†MC Health Services Research.

Bass, D. N., and L. S. Noelker (1987). “The influence of family caregivers on elders’ use of In-home services: An expanded conceptual framework.†Journal of Health and Social Behavior 28: 184-96.

Birch S, Abelson J (1993) ‘Is reasonable access what we want? Implications of, and challenges to, current Canadian policy on equity in health care.’ International Journal of Antenatal care. 1993; 23(4): 629-653.

Birch S, Eyles J, Newbold K(1993). ‘Equitable access to health care: methodological extensions to the analysis of physician utilization in Canada.’ Health Economics; 2:

-101.

Broyles R W, Manga P, Binder A D, Angus D E, Charette A(1983). ‘The use of physician services under a national health insurance scheme.’ Medical Care. 1983; 21(11): 1037-

Cockcroft, A. (1996). "Performance and perceptions of health and agricultural services in Uganda: a report based findings of the baseline services delivery survey.: World Bank, CIET International, Economic Development Institute, Washington D.C.

Elo T (1992) “Utilization of maternal health care services in Peru: the role of women’s education,â€Health Transitional Review, 2(1): 49-69.

Evans R G, Stoddart G L (1990)“Producing health, consumer health care.†Social Science and Medicine, 31: 1347-63.

Fiedler J L(1980) “A review of the literature on access and utilization of medical care with special emphasis on the rural primary care,†Social Science and Medicine, 15, 129-

Fosu G B (1984) “Childhood morbidity and health services utilization: cross-national comparisons of user-related factors from DHS data,†Social Science and Medicine, 38: 1209-1220.

Greene W H (2000) Econometric Analysis. New Jersey: Prentice-Hall, Inc. Fourth

Edition

Griffiths P, Stephenson R(2001) “Understanding users perspectives of barriers to maternal health care use in Maharashtra, India.†Journal of Biosocial Science, 33(3): 339-59.

Heard J N, Larse U, Hozumi D (2004) “Investigating Access to reproductive antenatal care using GIS: Proximity to services and the use of modern contraceptives in Malawi,†African Journal of Reproductive Health, 8(2): 164-179.

Hutchison P, Habte D, Mulusa M (1999) “Health Care in Uganda: Selected Issue†World Bank Discussion Paper, No. 404.

Kasirye I, Ssewanyana S, Nabyonga J, Lawson D (2004) “Demand for health care services in Uganda: Implications for poverty Reduction,†Economic Policy Research Center, Makerere University.

Kelley M A, Perloff D J, Morris M N, W Lui W(1992). “Primary care arrangements and access to care among African-American women in three Chicago communities.†Women and Health; 18: 91-106.

Lalonde Marc (1975). A new perpective on the health of Canadians Ottawa, Canada: Information Canada,

Lewis E C, Fein R, Mechanic D (1976) A right to health: the problems of access to primary medical care. New York: Wiley-Interscience,

Long J, Freese J (2001). Regression Models for Categorical Dependent Variables Using Stata. Stata Press

Manga P(1978). The income distribution effect of medical insurance in Ontario. Occasional Paper 6, Ontario Economic Council.

Manga P, Broyles W R, Angus E D (1987). ‘The determinants of hospital utilization under a universal public insurance program in Canada.’ Medical Care; 25(7): 658-670.

Mwaniki P K, Kabiru W E, Mbugua G (2002). Utilization of antenatal and maternity services by mothers seeking child welfare services in Mbeere District, Eastern Province, Kenya. East African Medical Journal, 79(4): 184-7.

Ndyomugyenyi R, Neema S, Magnussen P (1998). The use of formal and informal services for antenatal care and malaria treatment in rural Uganda. Health Policy and Planning. 13(1): 94-102.

Pindyck S R, Rubinfeld L D (1998) Econometric Models and Economic Forecasts. Fourth Edition, Irwin McGraw-Hill publishers.

Healthy people (2000) National health promotion and disease prevention objective: full report, with commentary DHHS publication No. PHS 91-50212. Washington D.C.: U.S. Government printing office.

Rosnau P V(1994) “Reflections on the cost consequences of the new gene technology for health policy.†International Journal of Technology Assessment in Health Care.10: 546- 61.

Sara Allin (2006) Equity in the use of antenatal care in Canada and its provinces. London School of Economics, Health Working Paper, 3/2006.

Sohani B. Salim (2005) Health care access of the very poor. needs of the very poor. Meeting the health related needs of the very poor: DFID Workshop paper 11/2005, Aga Khan Health Service, Kenya.

True W R, Romeis C J, Health C A, Flick H L, Shaw L, Eisen A S, Goldberg J, Lyons J M

(1994). “Genetic and environmental contributions to health care need and utilization:

A twin analysis.†Unpublished paper St. Louis, MO: School of Public Health, St. Louis University Medical Centre,

Uganda Bureau of Statistics (2004) National Service Delivery Survey Report. Uganda Bureau of Statistics, Kampala, Uganda,

United Nations Development Program (2007). Millenium Development Goals: Uganda Progress Report, 2007.

Uganda Debt Networ (2004) The poverty reduction strategy papers and resource allocation to the health sector in Uganda. ISBN: 9970-838-16-1, Discussion paper No. 7/2004.

Uganda Poverty Status Report (2005) Progress in implementing the Poverty Eradication Action Plan. Ministry of Finance Planning and Economic Development, Kampala, Uganda, 2005.

Winikoff B, Sullivan M (1987) Assessing the Role of Family Planning in Reducing Maternal Mortality. Studies in Family Planning, 18 ( 3): pp. 128-143.

Yergan J, LoGerfo J, Shortell S, Bergner M, Diehr P, Richardson W (1981). “Health Status as a Measure of Need for Medical Care: A Critique†Medical Care, 19 (12): 57-68,

Supplement

Downloads