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Assessing the Penetration, Fidelity, and Birth Outcomes Associated with the 2016 Who Antenatal Care Policy Across States in Nigeria
Assessing the Penetration, Fidelity, and Birth Outcomes Associated with the 2016 Who Anten...
Assessing the Penetration, Fidelity, and Birth Outcomes Associated with the 2016 Who Antenatal Care Policy Across States in Nigeria

Detailed Information

자료유형  
 학위논문 서양
최종처리일시  
20260202103041
ISBN  
9798315712909
DDC  
614
저자명  
Ikemeh, Christiana.
서명/저자  
Assessing the Penetration, Fidelity, and Birth Outcomes Associated with the 2016 Who Antenatal Care Policy Across States in Nigeria
발행사항  
[Sl] : The University of North Carolina at Chapel Hill, 2025
발행사항  
Ann Arbor : ProQuest Dissertations & Theses, 2025
형태사항  
196 p
주기사항  
Source: Dissertations Abstracts International, Volume: 86-11, Section: A.
주기사항  
Advisor: Trogdon, Justin G.;Shea, Christopher M.
학위논문주기  
Thesis (Ph.D.)--The University of North Carolina at Chapel Hill, 2025.
초록/해제  
요약The World Health Organization (WHO) rolled out the 2016 antenatal care (ANC) policy, including the eight-visit ANC (8vANC) recommendation, to improve women's ANC uptake and ensure positive pregnancy experience. Following the adoption and implementation of the 2016 WHO ANC policy by the Nigerian Federal Ministry of Health in 2017, a national cross-sectional survey conducted in 2021 indicated significant differences in state-level utilization rates of 8vANC. Using a combination of an implementation research approach and multilevel analysis, this study examined the underlying determinants of both the utilization behaviors and selected birth outcomes associated with the 2016 WHO ANC policy in Nigeria.With a post-implementation sample obtained from the Multiple Indicator and Cluster Survey (MICS6) 2021, Aim 1 focused on assessing the underlying determinants attributable to the observed differences in 8vANC utilization. The outcome was defined as the penetration of the WHO 8vANC policy and was measured as the proportion of women who used a minimum of 8vANC out of the total number of women who had live births within two years before the 2021 MICS6. The findings indicated that while women who self-reported their perception of life satisfaction as 'very happy' and 'somewhat happy' had increased odds of 8vANC utilization across states, the perception of wife beating justified 'if she goes out without telling husband' had reduced odds on the penetration of the 8vANC. Aim 2 examined the determinants associated with fidelity to five selected ANC components (the timing of first ANC visit, blood pressure measurement, blood sample test, urinalysis, and tetanus vaccination) among women who completed 8vANC. The findings indicated that 99.7% initiated their first ANC visit within 12 weeks of gestation and the rate of concordance with the five selected ANC components was 83.7%, on average. Aim 3 examined the association of C-sections, low birth weight (LBW), and perinatal death with penetration and fidelity to the policy by generating a main fixed effect labeled as penetration-fidelity. The findings revealed that penetration-fidelity was positively associated with LBW, negatively associated with perinatal death, and insignificantly associated with C-section.
일반주제명  
Public health
일반주제명  
Public policy
키워드  
Antenatal care
키워드  
Birth outcomes
키워드  
Health policy
키워드  
Implementation research
키워드  
Nigeria
키워드  
World Health Organization
기타저자  
The University of North Carolina at Chapel Hill Health Policy and Management
기본자료저록  
Dissertations Abstracts International. 86-11A.
전자적 위치 및 접속  
로그인 후 원문을 볼 수 있습니다.

MARC

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■1001  ▼aIkemeh,  Christiana.
■24510▼aAssessing  the  Penetration,  Fidelity,  and  Birth  Outcomes  Associated  with  the  2016  Who  Antenatal  Care  Policy  Across  States  in  Nigeria
■260    ▼a[Sl]▼bThe  University  of  North  Carolina  at  Chapel  Hill▼c2025
■260  1▼aAnn  Arbor▼bProQuest  Dissertations  &  Theses▼c2025
■300    ▼a196  p
■500    ▼aSource:  Dissertations  Abstracts  International,  Volume:  86-11,  Section:  A.
■500    ▼aAdvisor:  Trogdon,  Justin  G.;Shea,  Christopher  M.
■5021  ▼aThesis  (Ph.D.)--The  University  of  North  Carolina  at  Chapel  Hill,  2025.
■520    ▼aThe  World  Health  Organization  (WHO)  rolled  out  the  2016  antenatal  care  (ANC)  policy,  including  the  eight-visit  ANC  (8vANC)  recommendation,  to  improve  women's  ANC  uptake  and  ensure  positive  pregnancy  experience.  Following  the  adoption  and  implementation  of  the  2016  WHO  ANC  policy  by  the  Nigerian  Federal  Ministry  of  Health  in  2017,  a  national  cross-sectional  survey  conducted  in  2021  indicated  significant  differences  in  state-level  utilization  rates  of  8vANC.  Using  a  combination  of  an  implementation  research  approach  and  multilevel  analysis,  this  study  examined  the  underlying  determinants  of  both  the  utilization  behaviors  and  selected  birth  outcomes  associated  with  the  2016  WHO  ANC  policy  in  Nigeria.With  a  post-implementation  sample  obtained  from  the  Multiple  Indicator  and  Cluster  Survey  (MICS6)  2021,  Aim  1  focused  on  assessing  the  underlying  determinants  attributable  to  the  observed  differences  in  8vANC  utilization.  The  outcome  was  defined  as  the  penetration  of  the  WHO  8vANC  policy  and  was  measured  as  the  proportion  of  women  who  used  a  minimum  of  8vANC  out  of  the  total  number  of  women  who  had  live  births  within  two  years  before  the  2021  MICS6.  The  findings  indicated  that  while  women  who  self-reported  their  perception  of  life  satisfaction  as  'very  happy'  and  'somewhat  happy'  had  increased  odds  of  8vANC  utilization  across  states,  the  perception  of  wife  beating  justified  'if  she  goes  out  without  telling  husband'  had  reduced  odds  on  the  penetration  of  the  8vANC.  Aim  2  examined  the  determinants  associated  with  fidelity  to  five  selected  ANC  components  (the  timing  of  first  ANC  visit,  blood  pressure  measurement,  blood  sample  test,  urinalysis,  and  tetanus  vaccination)  among  women  who  completed  8vANC.  The  findings  indicated  that  99.7%  initiated  their  first  ANC  visit  within  12  weeks  of  gestation  and  the  rate  of  concordance  with  the  five  selected  ANC  components  was  83.7%,  on  average.  Aim  3  examined  the  association  of  C-sections,  low  birth  weight  (LBW),  and  perinatal  death  with  penetration  and  fidelity  to  the  policy  by  generating  a  main  fixed  effect  labeled  as  penetration-fidelity.  The  findings  revealed  that  penetration-fidelity  was  positively  associated  with  LBW,  negatively  associated  with  perinatal  death,  and  insignificantly  associated  with  C-section.
■590    ▼aSchool  code:  0153.
■650  4▼aPublic  health
■650  4▼aPublic  policy
■653    ▼aAntenatal  care
■653    ▼aBirth  outcomes
■653    ▼aHealth  policy
■653    ▼aImplementation  research
■653    ▼aNigeria
■653    ▼aWorld  Health  Organization
■690    ▼a0573
■690    ▼a0630
■690    ▼a0769
■71020▼aThe  University  of  North  Carolina  at  Chapel  Hill▼bHealth  Policy  and  Management.
■7730  ▼tDissertations  Abstracts  International▼g86-11A.
■790    ▼a0153
■791    ▼aPh.D.
■792    ▼a2025
■793    ▼aEnglish
■85640▼uhttp://www.riss.kr/pdu/ddodLink.do?id=T17356817▼nKERIS▼z이  자료의  원문은  한국교육학술정보원에서  제공합니다.

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