Place-specific factors associated with adverse maternal and perinatal outcomes in Southern Mozambique: a retrospective cohort study
Objectives To identify and measure the place-specific determinants that are associated with adverse maternal and perinatal outcomes in the southern region of Mozambique. Design Retrospective cohort study. Choice of variables informed by literature and Delphi consensus. Setting Study conducted duri...
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| Language: | English |
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BMJ Publishing Group
2021
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| Online Access: | https://bmjopen.bmj.com/content/bmjopen/9/2/e024042.full.pdf http://hdl.handle.net/11408/4398 |
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| author | Makanga, Prestige Tatenda Sacoor, Charfudin Schuurman, Nadine Lee, Tang Vilanculo, Faustino Carlos Munguambe, Khatia Boene, Helena Ukah, Ugochinyere Vivian Vidler, Marianne Magee, Laura A Sevene, Esperanca von Dadelszen, Peter Firoz, Tabassum CLIP Working Group |
| author_facet | Makanga, Prestige Tatenda Sacoor, Charfudin Schuurman, Nadine Lee, Tang Vilanculo, Faustino Carlos Munguambe, Khatia Boene, Helena Ukah, Ugochinyere Vivian Vidler, Marianne Magee, Laura A Sevene, Esperanca von Dadelszen, Peter Firoz, Tabassum CLIP Working Group |
| author_sort | Makanga, Prestige Tatenda |
| collection | DSpace |
| description | Objectives To identify and measure the place-specific determinants that are associated with adverse maternal and perinatal outcomes in the southern region of Mozambique.
Design Retrospective cohort study. Choice of variables informed by literature and Delphi consensus.
Setting Study conducted during the baseline phase of a community level intervention for pre-eclampsia that was led by community health workers.
Participants A household census identified 50493 households that were home to 80483 women of reproductive age (age 12–49 years). Of these women, 14617
had been pregnant in the 12 months prior to the census, of which 9172 (61.6%) had completed their pregnancies.
Primary and secondary outcome measures A combined fetal, maternal and neonatal outcome was calculated for all women with completed pregnancies.
Results A total of six variables were statistically significant (p≤0.05) in explaining the combined outcome.
These included: geographic isolation, flood proneness,access to an improved latrine, average age of reproductive age woman, family support and fertility rates. The performance of the ordinary least squares model was an adjusted R2
=0.69. Three of the variables (isolation, latrine score and family support) showed significant geographic variability in their effect on rates of adverse outcome.
Accounting for this modest non-stationary effect through geographically weighted regression increased the adjusted R2
to 0.71.
Conclusions The community exploration was successful in identifying context-specific determinants of maternal health. The results highlight the need for designing targeted interventions that address the place-specific social determinants of maternal health in the study area. The geographic process of identifying and measuring these determinants, therefore, has implications for
multisectoral collaboration. |
| format | Article |
| id | ir-11408-4398 |
| institution | My University |
| language | English |
| publishDate | 2021 |
| publisher | BMJ Publishing Group |
| record_format | dspace |
| spelling | ir-11408-43982022-06-27T13:49:06Z Place-specific factors associated with adverse maternal and perinatal outcomes in Southern Mozambique: a retrospective cohort study Makanga, Prestige Tatenda Sacoor, Charfudin Schuurman, Nadine Lee, Tang Vilanculo, Faustino Carlos Munguambe, Khatia Boene, Helena Ukah, Ugochinyere Vivian Vidler, Marianne Magee, Laura A Sevene, Esperanca von Dadelszen, Peter Firoz, Tabassum CLIP Working Group maternal and perinatal outcomes Place-specific factors Southern Mozambique cohort study Objectives To identify and measure the place-specific determinants that are associated with adverse maternal and perinatal outcomes in the southern region of Mozambique. Design Retrospective cohort study. Choice of variables informed by literature and Delphi consensus. Setting Study conducted during the baseline phase of a community level intervention for pre-eclampsia that was led by community health workers. Participants A household census identified 50493 households that were home to 80483 women of reproductive age (age 12–49 years). Of these women, 14617 had been pregnant in the 12 months prior to the census, of which 9172 (61.6%) had completed their pregnancies. Primary and secondary outcome measures A combined fetal, maternal and neonatal outcome was calculated for all women with completed pregnancies. Results A total of six variables were statistically significant (p≤0.05) in explaining the combined outcome. These included: geographic isolation, flood proneness,access to an improved latrine, average age of reproductive age woman, family support and fertility rates. The performance of the ordinary least squares model was an adjusted R2 =0.69. Three of the variables (isolation, latrine score and family support) showed significant geographic variability in their effect on rates of adverse outcome. Accounting for this modest non-stationary effect through geographically weighted regression increased the adjusted R2 to 0.71. Conclusions The community exploration was successful in identifying context-specific determinants of maternal health. The results highlight the need for designing targeted interventions that address the place-specific social determinants of maternal health in the study area. The geographic process of identifying and measuring these determinants, therefore, has implications for multisectoral collaboration. 2021-06-07T13:42:09Z 2021-06-07T13:42:09Z 2019 Article 2044-6055 https://bmjopen.bmj.com/content/bmjopen/9/2/e024042.full.pdf http://hdl.handle.net/11408/4398 en BMJ Open;Vol.9 open BMJ Publishing Group |
| spellingShingle | maternal and perinatal outcomes Place-specific factors Southern Mozambique cohort study Makanga, Prestige Tatenda Sacoor, Charfudin Schuurman, Nadine Lee, Tang Vilanculo, Faustino Carlos Munguambe, Khatia Boene, Helena Ukah, Ugochinyere Vivian Vidler, Marianne Magee, Laura A Sevene, Esperanca von Dadelszen, Peter Firoz, Tabassum CLIP Working Group Place-specific factors associated with adverse maternal and perinatal outcomes in Southern Mozambique: a retrospective cohort study |
| title | Place-specific factors associated with adverse maternal and perinatal outcomes in Southern Mozambique: a retrospective cohort study |
| title_full | Place-specific factors associated with adverse maternal and perinatal outcomes in Southern Mozambique: a retrospective cohort study |
| title_fullStr | Place-specific factors associated with adverse maternal and perinatal outcomes in Southern Mozambique: a retrospective cohort study |
| title_full_unstemmed | Place-specific factors associated with adverse maternal and perinatal outcomes in Southern Mozambique: a retrospective cohort study |
| title_short | Place-specific factors associated with adverse maternal and perinatal outcomes in Southern Mozambique: a retrospective cohort study |
| title_sort | place-specific factors associated with adverse maternal and perinatal outcomes in southern mozambique: a retrospective cohort study |
| topic | maternal and perinatal outcomes Place-specific factors Southern Mozambique cohort study |
| url | https://bmjopen.bmj.com/content/bmjopen/9/2/e024042.full.pdf http://hdl.handle.net/11408/4398 |
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