Factors associated with the continuum of care for maternal, newborn and child health in The Gambia: a cross-sectional study using Demographic and Health Survey 2013

Abstract

Objectives: To identify factors associated with the continuum of maternal, newborn and child health care in The Gambia.

Design: A secondary statistical analysis using Demographic and Health Survey conducted in 2013.

Setting: The Gambia.

Participants: 1308 married women (or with a partner) whose most recent children were aged 12-23 months at the time of the survey.

Outcome measures: The main outcome was continuum of care for maternal, newborn and child health. The modified composite coverage index was calculated to express the completion level of continuum of care.

Results: The following factors were associated with the continuum of maternal, newborn and child health care: women's autonomy in decision-making of her own healthcare (β=0.063, p=0.015), having higher educated husbands (β=0.138, p<0.001), listening to the radio at least once a week (β=0.078, p=0.006), having a child with birth order less than 5 (β=0.069, p=0.037), initiating the first antenatal care within 16 weeks of pregnancy (β=0.170, p<0.001), having been informed of signs of pregnancy complications (β=0.057, p=0.029), living in rural areas (β=-0.107, p=0.006) and having higher burden due to distance to health facility (β=-0.100, p<0.001), with an explanatory power of 15.5% (R²=0.155).

Conclusions: Efforts on future policies and programmes should focus on the concept of continuum of care considering the associated factors. In particular, more attention should be given to providing country-wide family planning and education to women, men and community members in The Gambia.

Keywords: health policy; international health services; public health.