Sociodemographic Determinants of Essential Health Interventions for Pregnant Women and Newborns in Papua New Guinea: A Retrospective Exploratory Secondary Analysis of Parental Attributes of Four Provinces
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Abstract The World Health Organization’s Global Strategy for Women’s, Children’s and Adolescents’ Health has underlined the key role of essential health interventions (EHIs). EHIs are considered crucial for addressing major causes of morbidity and mortality, especially those EHIs that have demonstrated high effectiveness and are critical for the health of women, children, and adolescents. These include the interventions that were the focus of this study: antenatal care (ANC) visits, delivery by skilled birth providers (SBPs), and the early initiation of breastfeeding after birth. The need for accelerated EHI efforts is recognised in Papua New Guinea (PNG) and underlined by a lifetime maternal mortality risk that is eight times higher than elsewhere in the East Asia Pacific region. The need for EHIs is also reflected in marked urban–rural disparities in under-five health, with children in rural areas being twice as likely to die before the age of five than their peers in urban centres. While these continuing health challenges for children in rural areas are well-recognised, there has been limited research on the impact of broader socio-economic and related conditions on maternal and newborn health in PNG’s lowland areas. With a geographic focus on the four lowland provinces of East Sepik, West Sepik, Madang and the Autonomous Region of Bougainville, the study investigated the association between parental sociodemographic characteristics and the application of EHIs for pregnant women and newborns. It specifically examined relationships between the sociodemographic attributes of household heads and mothers, and the implementation of ANC, delivery support by an SBP and the early initiation of breastfeeding after delivery. The study applied a quantitative research approach through a secondary analysis of data collected in 2018 by the International Food Policy Research Institute (IFPRI). The original 2018 study involved a rural household survey on food systems, conducted in the four lowland areas of PNG listed above. The current study utilised de-identified data for 291 households available from the open-source dataset accessed via the Harvard Dataverse site. The study investigated the relationship between parental characteristics and EHI practices. Results showed that two household head attributes were statistically significant: the level of education in relation to SBP delivery support (p<.05), and literacy in relation to the number of antenatal visits made (p<.01). Findings on the relationship between the mothers’ characteristics and EHI practices also showed that education, literacy level and primary occupation were statistically significant. Mothers’ level of education was positively associated with the number of ANC visits made (p<.01) and with SBP delivery support (p<.001). Mothers’ primary occupation in agriculture was also statistically significant in relation to the early initiation of breastfeeding (p<.001). In conclusion, this exploratory study found that household heads’ and mothers’ levels of education and literacy were positively associated with the number of ANC visits made and SBP support. It also highlighted the crucial, but under-researched, role that male household heads play in enabling women’s access to ANC and SBP support, and profiled research gaps in the understanding of how sociodemographic attributes such as male education and literacy can improve maternal and newborn health outcomes.