A comparison of booked and unbooked pregnant women presenting in labour at three heatlh facilities in region F, inner city of Johannesburg
Date
2015-09-17
Authors
Gumende, Siphamandla
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Abstract
Antenatal attendance is important for ensuring good pregnancy and birth outcomes therefore booking for care in the antenatal period remains an important gateway to accessing life-saving services and benefits. There is limited evidence on the impact of antenatal booking on birth outcomes in the inner city, Johannesburg. This study aimed to determine the 1) prevalence of antenatal booking and 2) the risk factors for being unbooked and consequences of being unbooked.
Methods
We reviewed birth registers of deliveries between January 2008 and December 2009 from three labour wards within the inner city of Johannesburg. Summary statistics, inferential analysis and logistic regression were conducted using STATA version 12.
Results
Of 12,455 deliveries reviewed, 897 (10.8%) were adolescents. Of total deliveries, 23.8% were HIV positive, 52.2% HIV negative and 24.0% had unknown HIV status. Of women presenting in labour, 14.6% were unbooked. Being unbooked was associated with poor viability (p<0.001), HIV status (p<0.001) and adolescent age (p=0.02), but not pre-term delivery. Also, independent of booking status, having an unknown HIV status was a predictor of poor viability.
Conclusion
The inner city has a significantly lower booking rate than the 95% reported for the country. Being an adolescent or HIV positive was associated with a lower booking rate, raising the
concern that stigma may hinder antenatal attendance. Unbooked women had significantly worse birth outcomes than women who attended antenatal care. The risk of perinatal mortality was associated with an unknown HIV status. Strategies to increase antenatal care particularly for adolescents and HIV positive pregnant women in this region are needed. Further research should be conducted to understand barriers and facilitators of antenatal attendance during pregnancy.
Description
Research report submitted to the University of the Witwatersrand, School of Clinical Medicine in partial fulfilment of the requirements for the degree of Master of Science in Community Paediatrics
February, 2015