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Delay In Seeking the First Postnatal Care is Protective ? [message #20355]

Mon, 26 October 2020 08:09

shujaat.smc@gmail.com is currently offline

shujaat.smc@gmail.com
Messages: 75
Registered: July 2020

Senior Member

Dear DHS Representative,

I am using BR File 2017-18 Pakistan, I use the following Commands on STATA 13.1

recode m71 (100/207=0 "WithinAweek") (208/320=1 "AfterOneweek") (998/.="."), gen (TimingofFirstPostNatalCheckup)

tab m71 TimingofFirstPostNatalCheckup

svy linearized, subpop(if bidx==1 & b0==0 & v210!=1) : stcox ib(0).TimingofFirstPostNatalCheckup

I have dropped the Observation from Azad Jammu & Kashmir & Gilgit Baltistan.

Therefore in my total 6 regions, the Univariate analysis is showing HR 0.235 for those women who had their first Postnatal care. (That is the Protective effect of delay in healthcare). p-vale 0.002

Q: Why is this so?

Q Is this phenomenon is known as Ecological Fallacy, provided my coding is correct?

Waiting for your reply

Best Regards

Dr. Hussain

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Re: Delay In Seeking the First Postnatal Care is Protective ? [message #20362 is a reply to message #20355]

Mon, 26 October 2020 09:47

Bridgette-DHS
Messages: 3214
Registered: February 2013

Senior Member

Following is a response from DHS Research & Data Analysis Director, Tom Pullum:

At DHS we have often found similar counter-intuitive relationships. Think of the following research hypothesis: People who go to a doctor often are healthier than people who do NOT go to a doctor often. I would say that this hypothesis may be true if you are talking about preventive care, but it is probably NOT true for other kinds of doctor visits.

It can happen that children and women who get more antenatal care or more (and faster) postnatal care are the ones with problematic pregnancies. If there are no red flags, so to speak, there is less motivation to get more complete care. This may be especially likely in settings where the optimal level of care is less common. I believe that's what you are seeing here. It definitely complicates a causal interpretation.

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Re: Delay In Seeking the First Postnatal Care is Protective ? [message #20363 is a reply to message #20362]

Mon, 26 October 2020 09:50

shujaat.smc@gmail.com
Messages: 75
Registered: July 2020

Senior Member

Dear Tom Pullum,

Thanks a lot for clarifying my concept.

Best Regards

Dr. Hussain

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