Content area
This dissertation examines the determinants influencing maternal and child health outcomes, focusing on the quality of antenatal care (ANC) across diverse contexts in low- and middle-income countries (LMICs). Utilizing interdisciplinary approaches, the research integrates health system measures and governance indicators frameworks to explore how these factors shape ANC practices and outcomes. Chapter 2 investigates the influence of the quality of ANC on early breastfeeding initiation and exclusive breastfeeding among Haitian mothers. Chapter 3 explores the relationship between the quality of ANC and pre-pregnancy folic acid supplementation among Guatemalan women. Chapter 4 develops and validates the Comprehensive Prenatal Care Index, assessing its relationship with preterm birth and small-for-gestational-age outcomes across racial and ethnic groups in the United States. Chapter 5 extends the inquiry to a global scale, analyzing the role of governance and income inequality in shaping ANC 4-7 and ANC 8+ contacts in LMICs. This dissertation contributes to the global health literature by integrating multidimensional approaches to maternal and child health, emphasizing the implications for policymakers, health practitioners, and researchers aiming to improve maternal and child health outcomes worldwide.