Trend and projection of skilled birth attendants and institutional delivery coverage for adolescents in 54 low- and middle-income countries, 2000-2030

Md Mizanur Rahman; Hiroko Taniguchi; Raïssa Shiyghan Nsashiyi; Rashedul Islam; Syed Riaz Mahmud; Shafiur Rahman; Jenny Jung; Shahjahan Khan

doi:10.1186/s12916-022-02255-x

Trend and projection of skilled birth attendants and institutional delivery coverage for adolescents in 54 low- and middle-income countries, 2000-2030

BMC Med. 2022 Feb 4;20(1):46. doi: 10.1186/s12916-022-02255-x.

Authors

Md Mizanur Rahman¹, Hiroko Taniguchi², Raïssa Shiyghan Nsashiyi^{2

3}, Rashedul Islam², Syed Riaz Mahmud⁴, Shafiur Rahman⁵, Jenny Jung⁴, Shahjahan Khan⁶

Affiliations

¹ Hitotsubashi Institute for Advanced Study, University of Hitotsubashi, 2-1 Naka, Kunitachi Tokyo, 186-8601, Japan. mizanurrub78@gmail.com.
² Department of Global Health Policy, School of International Health, The University of Tokyo, Tokyo, Japan.
³ Institute for Nature, Health, and Agricultural Research (INHAR), Yaoundé, Cameroon.
⁴ Global Public Health Research Foundation, Dhaka, Bangladesh.
⁵ Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan.
⁶ School of Sciences, Centre for Health Research, University of Southern Queensland, Toowoomba, Australia.

Abstract

Background: Limitations to accessing delivery care services increase the risks of adverse outcomes during pregnancy and delivery for all pregnant women, particularly among adolescents in LMICs. In order to inform adolescent-specific delivery care initiatives and coverage, we conducted a comprehensive analysis of trends, projections and inequalities in coverage of delivery care services among adolescents at national, urban-rural and socio-economic levels in LMICs.

Methods: Using 224 nationally representative cross-sectional survey data between 2000 and 2019, we estimated the coverage of institutional delivery (INSD) and skilled birth attendants (SBA). Bayesian hierarchical regression models were used to estimate trends, projections and determinants of INSD and SBA.

Results: Coverage of delivery care services among adolescents increased substantially at the national level, as well as in both urban and rural areas in most countries between 2000 and 2018. Of the 54 LMICs, 24 countries reached 80% coverage of both INSD and SBA in 2018, and predictions for 40 countries are set to exceed 80% by 2030. The trends in coverage of INSD and SBA of adult mothers mostly align with those for adolescent mothers. Our findings show that urban-rural and wealth-based inequalities to delivery care remain persistent by 2030. In 2018, urban settings across 54 countries had higher rates of coverage exceeding 80% compared to rural for both INSD (45 urban, 16 rural) and SBA (50 urban, 19 rural). Several factors such as household head age ≥ 46 years, household head being female, access to mass media, lower parity, higher education, higher ANC visits and higher socio-economic status could increase the coverage of INSD and SBA among adolescents and adult women.

Conclusions: More than three-quarters of the LMICs are predicted to achieve 80% coverage of INSD and SBA among adolescent mothers in 2030, although with sustained inequalities.

Keywords: Adolescent; Bayesian model; Delivery care; Inequalities; Institutional delivery; Prediction; Skill birth attendants.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Bayes Theorem
Cross-Sectional Studies
Delivery, Obstetric
Developing Countries
Female
Humans
Maternal Health Services*
Middle Aged
Midwifery*
Pregnancy
Prenatal Care
Socioeconomic Factors