Abstract
Abstract
Background
Savings and Internal Lending Communities (SILCs) are a type of informal microfinance mechanism widely adapted in Zambia. The benefits of SILCs paired with other interventions have been studied in many countries. However, limited studies have examined SILCs in the context of maternal health. This study examined the association between having access to SILCs and: 1) household wealth, 2) financial preparedness for birth, and 3) utilization of various reproductive health services (RHSs).
Methods
Secondary analysis was conducted on baseline and endline household survey data collected as part of a Maternity Waiting Home (MWH) intervention trial in 20 rural communities across seven districts of Zambia. Data from 4711 women who gave birth in the previous year (baseline: 2381 endline: 2330) were analyzed. The data were stratified into three community groups (CGs): CG1) communities with neither MWH nor SILC, CG2) communities with only MWH, and CG3) communities with both MWH and SILC. To capture the community level changes with the exposure to SILCs, different women were randomly selected from each of the communities for baseline and endline data, rather than same women being surveyed two times. Interaction effect of CG and timepoint on the outcome variables – household wealth, saving for birth, antenatal care visits, postnatal care visits, MWH utilization, health facility based delivery, and skilled provider assisted delivery – were examined.
Results
Interaction effect of CGs and timepoint were significantly associated only with MWH utilization, health facility delivery, and skilled provider delivery. Compared to women from CG3, women from CG1 had lower odds of utilizing MWHs and delivering at health facility at endline. Additionally, women from CG1 and women from CG2 had lower odds of delivering with a skilled provider compared to women from CG3.
Conclusion
Access to SILCs was associated with increased MWH use and health facility delivery when MWHs were available. Furthermore, access to SILCs was associated with increased skilled provider delivery regardless of the availability of MWH. Future studies should explore the roles of SILCs in improving the continuity of reproductive health services.
Trial registration
NCT02620436.
Publisher
Springer Science and Business Media LLC
Subject
Public Health, Environmental and Occupational Health
Reference43 articles.
1. World Health Organization: Maternal health. 2019. https://www.who.int/healthtopics/maternal-health#tab=tab_1.
2. Richard F, Witter S, Brouwere VD. Reducing financial barriers to obstetric care in low-income countries. Am J Public Health. 2010;100(10):1845–52.
3. United Nations Children’s Fund Maternal mortality: UNICEF DATA. 2019. https://data.unicef.org/topic/maternal-health/maternal-mortality/#:%7E:text=Sub%2DSaharan%20Africans%20suffer%20from,maternal%20deaths%20per%20year%20worldwide.
4. Langlois ÉV, Miszkurka M, Zunzunegui MV, Ghaffar A, Ziegler D, Karp I. Inequities in postnatal care in low- and middle-income countries: a systematic review and meta-analysis. Bull World Health Organ. 2015;93(4):259–270G. https://doi.org/10.2471/blt.14.140996.
5. Sacks E, Masvawure TB, Atuyambe LM, Neema S, Macwan’gi M, Simbaya J, et al. Postnatal care experiences and barriers to care utilization for home- and facility-delivered newborns in Uganda and Zambia. Matern Child Health J. 2017;21(3):599–606. https://doi.org/10.1007/s10995-016-2144-4.
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