The role of antenatal care on childbirth weight in South Africa
Date
2021
Authors
Molefi, Omphile Ouma Princess
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Abstract
Background: Low birth weight is a public health concern because infants below 2500 grams contribute to a wide range of poor health outcomes. These infants are prone to high infant mortality, morbidity and developmental problems in their childhood lives. Infants' weight at birth contributes to the highest percentage of infant mortality and morbidity. To ensure women's health and mental well-being, the World Health Organisation recommends at least four maternity care visits. Even so, in South Africa, 95 percent of the mothers who attended antenatal care had a live birth and only 76 percent of the mothers attended at least four visits. This study explores socio-demographic factors and on pregnant women, the antenatal care and how it impacts the child weight at birth. Methodology: This study used secondary data from the South Africa Demographic and Health Survey (SADHS) of 2016. The population of interest includes infants born five years preceding the survey. The sample size included 3015 children whose mothers responded to questions on maternal health. The leading independent variable is number of antenatal care visits. Birth weight of the children was recorded into ranked categories: large (4000-6000g) average (2500-3980g) and low (500-2490g). The other independent variables used were the sex of the child, birth order, birth type, maternal age, maternal educational level, duration of pregnancy, race, wealth index, place of residence and exposure to media. The dependent variable is birth weight coded as a dichotomous variable: average birth weight and low birth weight. Data analysis is in three levels. The first level includes the background characteristics of the respondents using a series of frequencies and percentage distributions. The second level involved the cross-tabulation of the outcome variables, birth weight with all the independent variables using the Pearson's chi-square test. The third level involved using stepwise forward Ordinal logistic regression to examine the association between birth weight with antenatal care, socio-economic and demographic characteristics. Results: The findings revealed that more than half (60%) of children were reported being in average birth weight while about 24% reported being in the large birth weight and only 16% of infants born were low birth weight. This study found a statistically significant relationship between no. of antenatal care visits and birth weight. The unadjusted odds ratios depict the odds of the combined large and average birth weight versus low birth weight is 4.0 times [OR=4.037, CI 2.258-7.216] greater among children born in multiple birth type compared to single birth type. The findings further revealed that children born in 9-10 months were significantly less likely to be low birth weight than other pregnancy durations. These findings do support the hypothesis that antenatal care is associated with the child's birth weight. Conclusion: Based on these findings, birth weight is associated with the number of ANC visits attended by the child's mother during gestation.
Description
A research report submitted in partial fulfilment of the requirements for the degree Master of Arts in Demography and Population Studies to the Faculty of Humanities, School of Social Sciences, University of the Witwatersrand, 2021