Identifying inequities in maternal and child health through risk stratification to inform health systems strengthening in Northern Togo

Katharine J. McCarthy, Sandra Flavia Braganza, Kevin P. Fiori, Christophe Gbeleou, Vivien Kpakpo, Andrew Lopez, Jennifer Schechter, Alicia Singham Goodwin, Heidi E. Jones

Research output: Contribution to journalArticle

Abstract

Objective In Togo, substantial progress in maternal and child health is needed to reach global development goals. To better inform clinic and community-based health services, this study identifies factors associated with maternal and child health care utilization in the Kara region of Northern Togo. Methods We conducted a population-representative household survey of four health clinic catchment areas of 1,075 women of reproductive age in 2015. Multivariable logistic regression was used to model individual and structural factors associated with utilization of four maternal and child health services. Key outcomes were: facility-based delivery, maternal postnatal health check by a health professional within the first six weeks of birth, childhood vaccination, and receipt of malaria medication for febrile children under age five within 72 hours of symptom onset. Results 83 percent of women who gave birth in the last 2 years delivered at a health facility. In adjusted models, the strongest predictor of facility delivery in the rural catchment areas was proximity to a health center, with women living under three kilometers having 3.7 (95% CI 1.7, 7.9) times the odds of a facility birth. Only 11 percent of women received a health check by a health provider at any time in the postnatal period. Postnatal health checks were less likely for women in the poorest households and for women who resided in rural areas.

Original languageEnglish (US)
Article numbere0173445
JournalPLoS One
Volume12
Issue number3
DOIs
StatePublished - Mar 1 2017

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Togo
Health
health services
Parturition
women's health
household surveys
Catchment Area (Health)
Patient Acceptance of Health Care
postpartum period
Community Health Services
health care workers
childhood
rural areas
Health Facilities
malaria
Structural Models
signs and symptoms (animals and humans)
drug therapy
fever
Child Care

ASJC Scopus subject areas

  • Medicine(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Identifying inequities in maternal and child health through risk stratification to inform health systems strengthening in Northern Togo. / McCarthy, Katharine J.; Braganza, Sandra Flavia; Fiori, Kevin P.; Gbeleou, Christophe; Kpakpo, Vivien; Lopez, Andrew; Schechter, Jennifer; Goodwin, Alicia Singham; Jones, Heidi E.

In: PLoS One, Vol. 12, No. 3, e0173445, 01.03.2017.

Research output: Contribution to journalArticle

McCarthy, Katharine J. ; Braganza, Sandra Flavia ; Fiori, Kevin P. ; Gbeleou, Christophe ; Kpakpo, Vivien ; Lopez, Andrew ; Schechter, Jennifer ; Goodwin, Alicia Singham ; Jones, Heidi E. / Identifying inequities in maternal and child health through risk stratification to inform health systems strengthening in Northern Togo. In: PLoS One. 2017 ; Vol. 12, No. 3.
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