학술논문
Pregnancy intention data completeness, quality and utility in population-based surveys: EN-INDEPTH study
Document Type
Report
Author
Yargawa, Judith; Machiyama, Kazuyo; Ponce Hardy, Victoria; Enuameh, Yeetey; Galiwango, Edward; Gelaye, Kassahun; Mahmud, Kaiser; Thysen, Sanne M.; Kadengye, Damazo T.; Gordeev, Vladimir Sergeevich; Blencowe, Hannah; Lawn, Joy E.; Baschieri, Angela; Cleland, John; Byass, Peter; Waiswa, Peter; Akuze, Joseph; Fisker, Ane B.; Martins, Justiniano S. D.; Rodrigues, Amabelia; Biks, Gashaw Andargie; Abebe, Solomon Mokonnen; Ayele, Tadesse Awoke; Bisetegn, Telake Azale; Delele, Tadess Guadu; Gelaye, Kassahun Alemu; Geremew, Bisrat Misganaw; Gezie, Lemma Derseh; Melese, Tesfahun; Mengistu, Mezgebu Yitayal; Tesega, Adane Kebede; Yitayew, Temesgen Azmeraw; Kasasa, Simon; Galigawango, Edward; Gyezaho, Collins; Kaija, Judith; Kajungu, Dan; Nareeba, Tryphena; Natukwatsa, Davis; Tusubira, Valerie; Enuameh, Yeetey A. K.; Asante, Kwaku P.; Dzabeng, Francis; Etego, Seeba Amenga; Manu, Alexander A.; Manu, Grace; Nettey, Obed Ernest; Newton, Sam K.; Owusu-Agyei, Seth; Tawiah, Charlotte; Zandoh, Charles; Alam, Nurul; Delwar, Nafisa; Haider, M. Moinuddin; Imam, Md. Ali; Cousens, Simon; Gordeev, Vladimir S.; Hardy, Victoria Ponce; Kwesiga, Doris
Source
Population Health Metrics. February 8, 2021, Vol. 19 Issue Suppl 1
Subject
Language
English
ISSN
1478-7954
Abstract
Author(s): Judith Yargawa[sup.1] , Kazuyo Machiyama[sup.1] , Victoria Ponce Hardy[sup.1] , Yeetey Enuameh[sup.2,3] , Edward Galiwango[sup.4] , Kassahun Gelaye[sup.5,6] , Kaiser Mahmud[sup.7] , Sanne M. Thysen[sup.8,9,10] , Damazo T. Kadengye[sup.11] [...]
Background An estimated 40% of pregnancies globally are unintended. Measurement of pregnancy intention in low- and middle-income countries relies heavily on surveys, notably Demographic and Health Surveys (DHS), yet few studies have evaluated survey questions. We examined questions for measuring pregnancy intention, which are already in the DHS, and additional questions and investigated associations with maternity care utilisation and adverse pregnancy outcomes. Methods The EN-INDEPTH study surveyed 69,176 women of reproductive age in five Health and Demographic Surveillance System sites in Ghana, Guinea-Bissau, Ethiopia, Uganda and Bangladesh (2017-2018). We investigated responses to survey questions regarding pregnancy intention in two ways: (i) pregnancy-specific intention and (ii) desired-versus-actual family size. We assessed data completeness for each and level of agreement between the two questions, and with future fertility desire. We analysed associations between pregnancy intention and number and timing of antenatal care visits, place of delivery, and stillbirth, neonatal death and low birthweight. Results Missing data were Conclusions We found the pregnancy-specific intention questions to be a much more reliable assessment of pregnancy intention than the desired-versus-actual family size questions, despite a reluctance to report pregnancies as unwanted rather than mistimed. The additional questions were useful and may complement current DHS questions, although these are not the only possibilities. As women with unintended pregnancies were more likely to miss timely and frequent antenatal care, implementation research is required to improve coverage and quality of care for those women. Keywords: Pregnancy intention, Fertility, Measurement, Assessment, Survey, Retrospective reporting, Desired family size, Stillbirth, Neonatal mortality, Low birthweight
Background An estimated 40% of pregnancies globally are unintended. Measurement of pregnancy intention in low- and middle-income countries relies heavily on surveys, notably Demographic and Health Surveys (DHS), yet few studies have evaluated survey questions. We examined questions for measuring pregnancy intention, which are already in the DHS, and additional questions and investigated associations with maternity care utilisation and adverse pregnancy outcomes. Methods The EN-INDEPTH study surveyed 69,176 women of reproductive age in five Health and Demographic Surveillance System sites in Ghana, Guinea-Bissau, Ethiopia, Uganda and Bangladesh (2017-2018). We investigated responses to survey questions regarding pregnancy intention in two ways: (i) pregnancy-specific intention and (ii) desired-versus-actual family size. We assessed data completeness for each and level of agreement between the two questions, and with future fertility desire. We analysed associations between pregnancy intention and number and timing of antenatal care visits, place of delivery, and stillbirth, neonatal death and low birthweight. Results Missing data were Conclusions We found the pregnancy-specific intention questions to be a much more reliable assessment of pregnancy intention than the desired-versus-actual family size questions, despite a reluctance to report pregnancies as unwanted rather than mistimed. The additional questions were useful and may complement current DHS questions, although these are not the only possibilities. As women with unintended pregnancies were more likely to miss timely and frequent antenatal care, implementation research is required to improve coverage and quality of care for those women. Keywords: Pregnancy intention, Fertility, Measurement, Assessment, Survey, Retrospective reporting, Desired family size, Stillbirth, Neonatal mortality, Low birthweight