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Validation of maternal recall of number of antenatal care visits attended in rural Southern Nepal: a longitudinal cohort study

BMJ open, 2023-12, Vol.13 (12), p.e079029-e079029 [Peer Reviewed Journal]

Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ. ;2023 Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/ . Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. ;Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ. 2023 ;ISSN: 2044-6055 ;EISSN: 2044-6055 ;DOI: 10.1136/bmjopen-2023-079029 ;PMID: 38072474

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  • Title:
    Validation of maternal recall of number of antenatal care visits attended in rural Southern Nepal: a longitudinal cohort study
  • Author: Xie, Xinyu ; Munos, Melinda K ; Lama, Tsering P ; Bryce, Emily ; Khatry, Subarna K ; LeClerq, Steven C ; Katz, Joanne
  • Subjects: Attended births ; Births ; Cohort analysis ; Cohort Studies ; Data collection ; Developing countries ; Family ; Female ; Gestational age ; Global Health ; Health facilities ; Humans ; Infant mortality ; LDCs ; Longitudinal Studies ; Maternal mortality ; Nepal - epidemiology ; Patient Reported Outcome Measures ; Pregnancy ; Prenatal Care ; Public health ; Quality in health care ; Recall ; Rural areas ; Surveys and Questionnaires ; Validity ; Womens health
  • Is Part Of: BMJ open, 2023-12, Vol.13 (12), p.e079029-e079029
  • Description: ObjectivesThis study aimed to examine the validity of maternal recall of total number of antenatal care (ANC) visits during pregnancy and factors associated with the accuracy of maternal recall.DesignThis was a longitudinal cohort study conducted from December 2018 through November 2020.SettingFive government health posts in the Sarlahi district of Southern Nepal.Participants402 pregnant women between ages 15 and 49 who presented for their first ANC visit at the study health posts.Main outcomesThe observed number of ANC visits (gold standard) and the reported number of ANC visits at the postpartum interview (maternal recall).ResultsOn average, women in the study who had a live birth attended 4.7 ANC visits. About 65% of them attended four or more ANC visits during pregnancy as recommended by the Nepal government, and 38.3% of maternal report matched the categorical ANC visits as observed by the gold standard. The individual validity was poor to moderate, with the highest area under the receiver operating characteristic curve (AUC) being 0.69 (95% CI: 0.65 to 0.74) in the 1–3 visits group. Population-level bias (as distinct from individual-level bias) was observed in the 1–3 visits and 4 visits groups, where 1–3 visits were under-reported (inflation factor (IF): 0.69) and 4 ANC visits were highly over-reported (IF: 2.12). The binary indicator ANC4+ (1–3 visits vs 4+ visits) showed better population-level validity (AUC: 0.69; IF: 1.17) compared with the categorical indicators (1–3 visits, 4 visits, 5–6 visits and more than 6 visits). Report accuracy was not associated with maternal characteristics but was related to ANC frequency. Women who attended more ANC visits were less likely to correctly report their total number of visits.ConclusionMaternal report of number of ANC visits during pregnancy may not be a valid indicator for measuring ANC coverage. Improvements are needed to measure the frequency of ANC visits.
  • Publisher: England: British Medical Journal Publishing Group
  • Language: English
  • Identifier: ISSN: 2044-6055
    EISSN: 2044-6055
    DOI: 10.1136/bmjopen-2023-079029
    PMID: 38072474
  • Source: ProQuest One Psychology
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