Quality of maternity care and its determinants along the continuum in Kenya: A structural equation modeling analysis

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Pubblicato in:PLoS One vol. 12, no. 5 (May 2017), p. e0177756
Autore principale: Patrick Opiyo Owili
Altri autori: Miriam Adoyo Muga, Bomar Rojas Mendez, Chen, Bradley
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Public Library of Science
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001 1899376177
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022 |a 1932-6203 
024 7 |a 10.1371/journal.pone.0177756  |2 doi 
035 |a 1899376177 
045 2 |b d20170501  |b d20170531 
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100 1 |a Patrick Opiyo Owili 
245 1 |a Quality of maternity care and its determinants along the continuum in Kenya: A structural equation modeling analysis 
260 |b Public Library of Science  |c May 2017 
513 |a Journal Article 
520 3 |a Background Improving access to delivery services does not guarantee access to quality obstetric care and better survival, and therefore, concerns for quality of maternal and newborn care in low- and middle-income countries have been raised. Our study explored characteristics associated with the quality of initial assessment, intrapartum, and immediate postpartum and newborn care, and further assessed the relationships along the continuum of care. Methods The 2010 Service Provision Assessment data of Kenya for 627 routine deliveries of women aged 15–49 were used. Quality of care measures were assessed using recently validated quality of care measures during initial assessment, intrapartum, and postpartum periods. Data were analyzed with negative binomial regression and structural equation modeling technique. Results The negative binomial regression results identified a number of determinants of quality, such as the level of health facilities, managing authority, presence of delivery fee, central electricity supply and clinical guideline for maternal and neonatal care. Our structural equation modeling (SEM) further demonstrated that facility characteristics were important determinants of quality for initial assessment and postpartum care, while characteristics at the provider level became more important in shaping the quality of intrapartum care. Furthermore we also noted that quality of initial assessment had a positive association with quality of intrapartum care (β = 0.71, p < 0.001), which in turn was positively associated with the quality of newborn and immediate postpartum care (β = 1.29, p = 0.004). Conclusions A continued focus on quality of care along the continuum of maternity care is important not only to mothers but also their newborns. Policymakers should therefore ensure that required resources, as well as adequate supervision and emphasis on the quality of obstetric care, are available. 
651 4 |a Kenya 
651 4 |a Taiwan 
653 |a Neonates 
653 |a Postpartum 
653 |a Survival 
653 |a Mortality 
653 |a Mothers 
653 |a Quality 
653 |a Maternal child nursing 
653 |a Fatalities 
653 |a Quality control 
653 |a Obstetrics 
653 |a Check lists 
653 |a Public health 
653 |a Sustainable development 
653 |a Postpartum period 
653 |a Childrens health 
653 |a Womens health 
653 |a Software 
653 |a Attention 
653 |a Mental disorders 
653 |a Data processing 
653 |a Computer programs 
653 |a Surgery 
653 |a Death 
653 |a Developing countries--LDCs 
653 |a Polls & surveys 
653 |a Quality of care 
653 |a Newborn babies 
653 |a Structural equation modeling 
653 |a Modelling 
653 |a Delivery services 
653 |a Quality assessment 
653 |a Social 
700 1 |a Miriam Adoyo Muga 
700 1 |a Bomar Rojas Mendez 
700 1 |a Chen, Bradley 
773 0 |t PLoS One  |g vol. 12, no. 5 (May 2017), p. e0177756 
786 0 |d ProQuest  |t Health & Medical Collection 
856 4 1 |3 Citation/Abstract  |u https://www.proquest.com/docview/1899376177/abstract/embedded/7BTGNMKEMPT1V9Z2?source=fedsrch 
856 4 0 |3 Full Text  |u https://www.proquest.com/docview/1899376177/fulltext/embedded/7BTGNMKEMPT1V9Z2?source=fedsrch 
856 4 0 |3 Full Text - PDF  |u https://www.proquest.com/docview/1899376177/fulltextPDF/embedded/7BTGNMKEMPT1V9Z2?source=fedsrch