The coverage of continuum of care in maternal, newborn and child health: a cross-sectional study of woman-child pairs in Ghana.

Content Provider	Europe PMC
Author	Shibanuma, Akira Yeji, Francis Okawa, Sumiyo Mahama, Emmanuel Kikuchi, Kimiyo Narh, Clement Enuameh, Yeetey Nanishi, Keiko Oduro, Abraham Owusu-Agyei, Seth Gyapong, Margaret Asare, Gloria Quansah Yasuoka, Junko Ansah, Evelyn Korkor Hodgson, Abraham Jimba, Masamine
Copyright Year	2018
Abstract	IntroductionThe continuum of care has recently received attention in maternal, newborn and child health. It can be an effective policy framework to ensure that every woman and child receives timely and appropriate services throughout the continuum. However, a commonly used measurement does not evaluate if a pair of woman and child complies with the continuum of care. This study assessed the continuum of care based on two measurements: continuous visits to health facilities (measurement 1) and receiving key components of services (measurement 2). It also explored individual-level and area-level factors associated with the continuum of care achievement and then investigated how the continuum of care differed across areas.MethodsIn this cross-sectional study in Ghana in 2013, the continuum of care achievement and other characteristics of 1401 pairs of randomly selected women and children were collected. Multilevel logistic regression was used to estimate the factors associated with the continuum of care and its divergence across 22 areas.ResultsThroughout the pregnancy, delivery and post-delivery stages, 7.9% of women and children achieved the continuum of care through continuous visits to health facilities (measurement 1). Meanwhile, 10.3% achieved the continuum of care by receiving all key components of maternal, newborn and child health services (measurement 2). Only 1.8% of them achieved it under both measurements. Women and children from wealthier households were more likely to achieve the continuum of care under both measurements. Women’s education and complications were associated with higher continuum of care services-based achievement. Variance of a random intercept was larger in the continuum of care services-based model than the visit-based model.ConclusionsMost women and children failed to achieve the continuum of care in maternal, newborn and child health. Those who consistently visited health facilities did not necessarily receive key components of services.
Journal	BMJ Global Health
Volume Number	3
PubMed Central reference number	PMC6135430
Issue Number	4
PubMed reference number	30233827
e-ISSN	20597908
DOI	10.1136/bmjgh-2018-000786
Language	English
Publisher	BMJ Publishing Group
Publisher Date	2018-09-03
Publisher Place	BMA House, Tavistock Square, London, WC1H 9JR
Access Restriction	Open
Rights License	This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. © Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Subject Keyword	maternal health child health health services research cross-sectional survey community-based survey
Content Type	Text
Resource Type	Article
Subject	Health Policy Public Health, Environmental and Occupational Health