Advertisement

Canadian Journal of Public Health

, Volume 98, Issue 1, pp 65–69 | Cite as

The Manitoba Healthy Baby Prenatal Benefit Program

Who is Participating?
  • Marni D. BrownellEmail author
  • Anne Guevremont
  • Wendy Au
  • Monica Sirski
Article

Abstract

Background

Programs offering income supplements for lower-income pregnant women have been introduced in order to reduce the incidence of poor perinatal outcomes. This study used a population-based approach to examine the characteristics of mothers who received the Healthy Baby Prenatal Benefit in Manitoba.

Methods

All women giving birth between August 2001 and April 2003 (n=22,643) were studied using de-identified linked administrative data. Multivariate logistic regression was used to determine factors that predicted receipt of the benefit, adjusting for potential confounding effects. Separate regressions were run for all mothers, and for a group of mothers eligible to receive the benefit (N=1962).

Results

Almost 29% of mothers giving birth during the study period received the prenatal benefit. Mothers were more likely to receive the benefit if they: lived outside of Winnipeg; received income assistance during pregnancy; were younger at their first birth; were unmarried; made prenatal physician visits; experienced maternal depression; were having a first birth; and lived in the lowest income areas. Despite all being eligible, only 67% of non-Winnipeg and 80% of Winnipeg women receiving income assistance received the benefit. Factors related to benefit receipt for those eligible were: living in Winnipeg; making prenatal visits; not being a young teen at current birth; and experiencing a first birth.

Conclusion

It is important to look not only at the characteristics of benefit recipients but also at those not receiving the benefit, in order to develop strategies to reach those who may most need and benefit from the program.

MeSH terms

Maternal age prenatal care low-income population social welfare 

Résumé

Contexte

De nouveaux programmes offrent des suppléments de revenu aux femmes enceintes à faible revenu afin de réduire la fréquence des problèmes périnatals. Dans le cadre d’une étude représentative, nous avons examiné les caractéristiques des mères bénéficiaires des allocations prénatales du programme Bébés en santé du Manitoba.

Méthode

Nous avons étudié toutes les femmes ayant accouché entre août 2001 et avril 2003 (N=22 643) à l’aide de données administratives liées, mais non identifiées. Par régression logistique multivariée, nous avons déterminé les facteurs prédisant le fait de toucher des allocations, en tenant compte des variables confusionnelles possibles. Des analyses de régression distinctes ont été exécutées pour toutes les mères et pour un groupe de mères admissibles aux allocations (N=1 962).

Résultats

Près de 29 % des mères ayant accouché pendant la période de l’étude ont touché des allocations prénatales. Elles étaient plus susceptibles d’avoir touché ces allocations si elles: vivaient à l’extérieur de Winnipeg; avaient reçu une aide au revenu pendant leur grossesse; étaient relativement jeunes lors de leur premier accouchement; n’étaient pas mariées; avaient fait des visites prénatales chez le médecin; souffraient de dépression du post-partum; accouchaient pour la première fois; et vivaient dans une région à faible revenu. Bien qu’elles soient toutes admissibles aux allocations, seulement 80 % des femmes vivant à Winnipeg et 67 % des femmes vivant ailleurs au Manitoba qui bénéficiaient d’une aide au revenu touchaient aussi les allocations prénatales. Les facteurs liés à la perception d’allocations chez les femmes admissibles étaient les suivants: vivre à Winnipeg; avoir fait des visites prénatales; ne pas avoir été adolescentes lors de l’accouchement actuel; et en être à leur premier accouchement.

Conclusion

Il est important d’examiner non seulement les caractéristiques des bénéficiaires, mais aussi celles des mères qui ne touchaient pas d’allocations pour pouvoir élaborer des stratégies susceptibles d’atteindre les mères qui pourraient avoir le plus besoin du programme et en tirer le meilleur parti.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Healthy Child Manitoba Office (2004). Annual Report 2003–2004.Google Scholar
  2. 2.
    Finch, BK. Socioeconomic gradients and low birth-weight: Empirical and policy considerations. Health Serv Res 2003;38:1819–41.CrossRefGoogle Scholar
  3. 3.
    Perinatal Education Program of Eastern Ontario. Prevention of Low Birth Weight in Canada: Literature Review and Strategies, 2nd edition. Available online at: https://doi.org/www.beststart.org/ resources/lbw_aware/lbw_rpt/lbw98TOC.html (Accessed August 16, 2005).Google Scholar
  4. 4.
    Kehner BH, Wolin, CM. Impact of income maintenance on low birth weight: Evidence from the Gary experiment. J Human Resources 1980;14:434–62.Google Scholar
  5. 5.
    Rush D. Nutritional services during pregnancy and birthweight: A retrospective matched pair analysis. CMAJ 1981;125:567–76.Google Scholar
  6. 6.
    Higgins AC, Moxley JE, Pencharz PB, Mikolanis D, Dubois S. Impact of the Higgins Nutrition Intervention Program on birth weight: A withinmother analysis. J Am Diet Assoc 1989;89:1097–103.PubMedGoogle Scholar
  7. 7.
    Remier DK, Glied, SA. What other programs can teach us: Increasing participation in health insurance programs. Am J Public Health 2003;93:67–74.CrossRefGoogle Scholar
  8. 8.
    Roos NP, Shapiro E (Eds.). Health and health care: Experience with a population-based health information system. Med Care 1995;33(suppl).Google Scholar
  9. 9.
    Roos NP, Shapiro E (Eds.). Academics at the Policy Interface: Revisiting the Manitoba Centre for Health Policy and Evaluation and its Population-Based Health Information System. Med Care 1999;37(Suppl).Google Scholar
  10. 10.
    Brownell MD, Martens PJ, Kozyrskyj A (Eds.). Improving Children’s Health. How Populationbased Information Can Inform Policy: The Manitoba Experience. Can J Public Health 2002;93(Suppl. 2).Google Scholar
  11. 11.
    Roos LL, Nicol, PJ. A research registry: Uses, development, and accuracy. J Clin Epidemiol 1999;52(1):39–47.CrossRefGoogle Scholar
  12. 12.
    Roos LL, Nicol JP, Cageorge, SM. Using administrative data for longitudinal research: Comparisons with primary data collection. J Chron Dis 1987;40:41–49.CrossRefGoogle Scholar
  13. 13.
    Brownell MD, Mayer T, Martens PJ, Kozyrskyj A, Fergusson P, Bodnarchuk J, et al. Using a population-based health information system to study child health. Can J Public Health 2002;93(Suppl. 2):S9–S14.PubMedPubMedCentralGoogle Scholar
  14. 14.
    Mustard CA, Derksen S, Berthelot JM, Wolfson M. Assessing ecologic proxies for household income: A comparison of household and neighbourhood level income measures in the study of population health status. Health & Place 1999;5:157–71.CrossRefGoogle Scholar
  15. 15.
    Daponte BO, Sanders S, Taylor L. Why do lowincome households not use food stamps? J Human Resources 1998,34:612–28.CrossRefGoogle Scholar
  16. 16.
    Stewart PJ, Dulberg C, Niday P, Nimrod C, Tawagi G. Population attributable risk for prematurity and small for gestation age babies. Final report. 1994.Google Scholar
  17. 17.
    Kogan MD, Martin JA, Alexander GR, Kotechuck M, Venture SJ, Frigoletto, FD. The changing pattern of prenatal care utilization in the United States, 1981–1995, using different prenatal care indices. JAMA 1998;279:1623–28.CrossRefGoogle Scholar
  18. 18.
    Mustard CA, Roos, NP. The relationship of prenatal care and pregnancy complications to birthweight in Winnipeg, Canada. Am J Public Health 1994;84:1450–57.CrossRefGoogle Scholar
  19. 19.
    Larson EH, Hart LG, Rosenblatt, RA. Is non-metropolitan residence a risk factor for poor birth outcome in the U. S.? Soc Sci Med 1997;45(2):171–88.CrossRefGoogle Scholar
  20. 20.
    Delvaux T, Buekens P, Godin I, Boutsen M. Study Group on Barriers and Incentives to Prenatal Care in Europe. Am J Prev Med 2001;21(1):52–59.CrossRefGoogle Scholar
  21. 21.
    Blundell R, Fry V, Walker I. Modelling the takeup of means-tested benefits: The case of housing benefits in the United Kingdom. Econ J 1988;98 (Suppl 390):58–74.CrossRefGoogle Scholar
  22. 22.
    Garrett B, Glied S. Does state AFDC generosity affect child SSI participation? J Policy Analysis Manage 2000;19:275–95.CrossRefGoogle Scholar
  23. 23.
    Dion RM, Pavetti L. Access to and Participation in Medicaid and the Food Stamp Program: A Review of the Recent Literature. Washington, DC: Mathematica Policy Research Inc., 2000.Google Scholar
  24. 24.
    Alexander GR, Kotelchuck M. Assessing the role and effectiveness of prenatal care: History, challenges, and directions for future research. Public Health Reports 2001;116:306–16.CrossRefGoogle Scholar
  25. 25.
    Coley RL, Chase-Lansdale L. Adolescent pregnancy and parenthood. Recent evidence and future directions. Am Psychologist 1998;53:152–66.CrossRefGoogle Scholar
  26. 26.
    Jaffee S, Caspi A, Moffitt TE, Belsky J, Silva P. Why are children born to teen mothers at risk for adverse outcomes in young adulthood: Results from a 20-year longitudinal study. Development and Psychopathology 2001;13:377–97.CrossRefGoogle Scholar
  27. 27.
    Levine JA, Pollack H, Comfort, ME. Academic and behavioral outcomes among the children of young mothers. J Marriage Fam 2001;63:355–69.CrossRefGoogle Scholar

Copyright information

© The Canadian Public Health Association 2007

Authors and Affiliations

  • Marni D. Brownell
    • 1
    • 2
    Email author
  • Anne Guevremont
    • 1
  • Wendy Au
    • 1
  • Monica Sirski
    • 1
  1. 1.Department of Community Health Sciences, Faculty of MedicineUniversity of ManitobaWinnipegCanada
  2. 2.Department of Community Health SciencesUniversity of ManitobaCanada

Personalised recommendations