# name
Factors influencing access of pregnant women and their infants
                to their local healthcare system: a prospective, multi-centre,
                observational study

# metadata.dc.description.abstract[].value
BACKGROUND: The successful implementation of maternal
                vaccination relies on results of clinical trials, considering
                the prenatal and postnatal attendance at selected healthcare
                institutions. This study evaluated factors influencing
                maternal/infant access to healthcare facilities to identify
                potential barriers to participation in future clinical trials on
                maternal vaccination. METHODS: In this prospective,
                multi-centre, observational study, pregnant women (N = 3243)
                were enrolled at ten sites across Panama, the Dominican
                Republic, South Africa, and Mozambique between 2012 and 2014.
                They completed questionnaires at enrolment, delivery, and infant
                follow-up (90 days post-partum) visits, including questions on
                transportation, phone accessibility, alternative childcare,
                gestational age at enrolment, delivery location, and health
                status of their infant. Logistic regression was used to identify
                factors significantly associated with return to study site for
                delivery or infant follow-up visits. RESULTS: Among 3229
                enrolled women with delivery information, 63.6% (range across
                sites: 25.3-91.5%) returned to study site for delivery. Older
                women and those at later gestational age at enrolment were more
                likely to deliver at the study site. While heterogeneities were
                observed at site level, shorter travel time at delivery and
                increased transportation costs at enrolment were associated with
                increased likelihood of women returning to study site for
                delivery. Among 3145 women with live-born infants, 3077 (95.3%)
                provided 90-day follow-up information; of these, 68.9% (range
                across sites: 25.6-98.9%) returned to study site for follow-up
                visits. Women with other children and with lower transportation
                costs at delivery were more likely to return to study site for
                follow-up visits. Among 666 infants reported sick, 94.3% were
                taken to a healthcare facility, with only 41.9% (range across
                sites: 4.9-77.3%) to the study site. CONCLUSION: Although high
                retention was observed from enrolment through 90 days after
                delivery, post-partum surveillance should be broadened beyond
                the study sites and additional follow-up visits should be
                planned within the neonatal period. The factors influencing
                maternal/infant access to healthcare facilities and the issues
                identified in this study should be taken into consideration in
                planning future clinical studies on maternal immunisation in
                low- and middle-income countries.

# metadata.dc.relation.ispartof[].value
BMC Pregnancy and Childbirth, 2018, vol. 18, num. 29

# metadata.dc.source[].value
Articles publicats en revistes (ISGlobal)

# metadata.dc.title[].value
Factors influencing access of pregnant women and their infants
                to their local healthcare system: a prospective, multi-centre,
                observational study