Three essays on maternal and newborn health in Uganda

Abstract

Maternal and newborn health have not improved enough in Uganda to meet national and global development targets. The maternal mortality ratio in the country as of June 2023 was 336/100,000 live births, compared to the Uganda national target 211/100,000 live births and the global target of 70/100,000 live births. Since 2006, neonatal mortality rate as of June 2023 had stagnated at 27/1000 compared to the national target of 19/1000 live births and the global 12/1000 live births targets. Using data from the 2016 Uganda Demographic and Health Survey, this dissertation examined factors that influence maternal and newborn health in Uganda. Predictors of maternal health include but are not limited to socio-economic factors, antenatal care, distance to health facility, and place of residence. Predictors of newborn health included but not limited to socio-economic characteristics, reproductive characteristics, and number of children. Three essays make up this dissertation. The first essay fitted the binary multilevel model with facility delivery (n = 7749). The second essay fitted the multinomial model with birth weight (n = 587 – LBW & n = 1457 - macrosomia). The third essay, both logistic and multinomial models were fitted with preterm births (n = 1,537). Findings showed facility delivery was positively associated with attending antenatal care more than four visits and living within 5 kilometers of a health facility. Low birth weight was positively associated with preterm birth and home delivery. Whereas higher than normal birth weight (>4000grams), was positively associated with frequent births (intervals <2 years) and having a male fetus. Preterm birth was positively associated with unwanted pregnancies and internet use. There is a need to improve antenatal care attendance and facility delivery through social marketing to promote behavioral change via radios which were found to be significant. Provide information through newspapers, reduce frequent births and unwanted pregnancies. Provide economic empowerment to the poorest and those in rural areas to reduce low birth weight and improve facility delivery.