The influence of travel time to health facilities on stillbirths: a geospatial case-control analysis of facility-based data in Gombe, Nigeria
The influence of travel time to health facilities on stillbirths: a geospatial case-control analysis of facility-based data in Gombe, Nigeria
Access to quality emergency obstetric and newborn care (EmONC); having a skilled attendant at birth (SBA); adequate antenatal care; and efficient referral systems are considered the most effective interventions in preventing stillbirths. We determined the influence of travel time from mother’s area of residence to a tertiary health facility where women sought care on the likelihood of delivering a stillbirth. We carried out a prospective matched case-control study between 1st January 2019 and 31st December 2019 at the Federal Teaching Hospital Gombe (FTHG), Nigeria. All women who experienced a stillbirth after hospital admission during the study period were included as cases while controls were consecutive age-matched (ratio 1:1) women who experienced a live birth. We modelled travel time to health facilities. To determine how travel time to the nearest health facility and the FTHG were predictive of the likelihood of stillbirths, we fitted a conditional logistic regression model. A total of 318 women, including 159 who had stillborn babies (cases) and 159 age-matched women who had live births (controls) were included. We did not observe any significant difference in the mean travel time to the nearest government health facility for women who had experienced a stillbirth compared to those who had a live birth [9.3 mins (SD 7.3, 11.2) vs 6.9 mins (SD 5.1, 8.7) respectively, p=0.077]. However, women who experienced a stillbirth had twice the mean travel time of women who had a live birth (26.3 vs 14.5 mins) when measured from their area of residence to the FTHG where deliveries occurred. Women who lived farther than 60 minutes were 12 times more likely of having a stillborn [OR=12 (1.8, 24.3), p=0.011] compared to those who lived within 15 minutes travel time to the FTHG. We have shown for the first time, the influence of travel time to a major tertiary referral health facility on the occurrence of stillbirths in an urban city in, northeast Nigeria.
Wariri, Oghenebrume
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Onuwabuchi, Egwu
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Korem Alhassan, Jacob Albin
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Dase, Eseoghene
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Jalo, Iliya
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Laima, Christopher Hassan
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Farouk, Halima Usman
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El-Nafaty, Aliyu U
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Okomo, Uduak
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Dotse-Gborgbortsi, Winfred
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7 January 2021
Wariri, Oghenebrume
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Onuwabuchi, Egwu
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Korem Alhassan, Jacob Albin
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Dase, Eseoghene
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Jalo, Iliya
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Laima, Christopher Hassan
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Farouk, Halima Usman
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El-Nafaty, Aliyu U
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Okomo, Uduak
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Dotse-Gborgbortsi, Winfred
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Wariri, Oghenebrume, Onuwabuchi, Egwu, Korem Alhassan, Jacob Albin, Dase, Eseoghene, Jalo, Iliya, Laima, Christopher Hassan, Farouk, Halima Usman, El-Nafaty, Aliyu U, Okomo, Uduak and Dotse-Gborgbortsi, Winfred
(2021)
The influence of travel time to health facilities on stillbirths: a geospatial case-control analysis of facility-based data in Gombe, Nigeria.
PLoS ONE, 16 (1 January), [e0245297].
(doi:10.1371/journal.pone.0245297).
Abstract
Access to quality emergency obstetric and newborn care (EmONC); having a skilled attendant at birth (SBA); adequate antenatal care; and efficient referral systems are considered the most effective interventions in preventing stillbirths. We determined the influence of travel time from mother’s area of residence to a tertiary health facility where women sought care on the likelihood of delivering a stillbirth. We carried out a prospective matched case-control study between 1st January 2019 and 31st December 2019 at the Federal Teaching Hospital Gombe (FTHG), Nigeria. All women who experienced a stillbirth after hospital admission during the study period were included as cases while controls were consecutive age-matched (ratio 1:1) women who experienced a live birth. We modelled travel time to health facilities. To determine how travel time to the nearest health facility and the FTHG were predictive of the likelihood of stillbirths, we fitted a conditional logistic regression model. A total of 318 women, including 159 who had stillborn babies (cases) and 159 age-matched women who had live births (controls) were included. We did not observe any significant difference in the mean travel time to the nearest government health facility for women who had experienced a stillbirth compared to those who had a live birth [9.3 mins (SD 7.3, 11.2) vs 6.9 mins (SD 5.1, 8.7) respectively, p=0.077]. However, women who experienced a stillbirth had twice the mean travel time of women who had a live birth (26.3 vs 14.5 mins) when measured from their area of residence to the FTHG where deliveries occurred. Women who lived farther than 60 minutes were 12 times more likely of having a stillborn [OR=12 (1.8, 24.3), p=0.011] compared to those who lived within 15 minutes travel time to the FTHG. We have shown for the first time, the influence of travel time to a major tertiary referral health facility on the occurrence of stillbirths in an urban city in, northeast Nigeria.
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journal.pone.0245297
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Accepted/In Press date: 24 December 2020
e-pub ahead of print date: 7 January 2021
Published date: 7 January 2021
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© 2021 Wariri et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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Local EPrints ID: 446360
URI: http://eprints.soton.ac.uk/id/eprint/446360
ISSN: 1932-6203
PURE UUID: 115a40ac-1225-4616-8726-18d62578dc63
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Date deposited: 05 Feb 2021 17:31
Last modified: 10 Apr 2024 02:12
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Author:
Oghenebrume Wariri
Author:
Egwu Onuwabuchi
Author:
Jacob Albin Korem Alhassan
Author:
Eseoghene Dase
Author:
Iliya Jalo
Author:
Christopher Hassan Laima
Author:
Halima Usman Farouk
Author:
Aliyu U El-Nafaty
Author:
Uduak Okomo
Author:
Winfred Dotse-Gborgbortsi
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