Maternal health journeys in Vanuatu: A cross-sectional study of antenatal care, supplement use, and birth outcomes reported by Ni-Vanuatu women
1
School of Health, University of the Sunshine Coast, Brisbane, Australia
2
Australian Centre for Pacific Island Research, Sippy Downs, Australia
3
Health Clinic, Wan Smolbag Theatre, Port Vila, Vanuatu
4
Nutrition Centre, Wan Smolbag Theatre, Port Vila, Vanuatu
5
Ministry of Health, Port Vila, Vanuatu
6
Department of Pediatrics: General Pediatrics and Adolescent Medicine, Augusta University, Augusta, United States
Popul. Med. 2026;8(Supplement Supplement 1):A2219
ABSTRACT
BACKGROUND:
Maternal and neonatal health outcomes in Pacific low- and middle-income countries (LMIC) such as Vanuatu are shaped by geographic isolation, health system capacity, and sociocultural factors. Despite national priorities to improve maternal health, inequities in antenatal care (ANC) engagement and maternal nutrition persist, contributing to adverse pregnancy and neonatal outcomes (1–3). Drawing on Ni-Vanuatu women’s reported experiences, this study examines how intersections between health access, health education, and community-based support influence maternal and neonatal health outcomes across diverse regions of Vanuatu.
METHODS:
A cross-sectional study was co-designed with local stakeholders using a women-centred inclusive research approach. Structured surveys were conducted in Bislama (lingua franca of Vanuatu) with 586 women across 27 communities using targeted snowball sampling in women-centric locations. Data were analysed using descriptive and inferential statistics to explore associations between ANC engagement, supplement use, health knowledge and self-reported birth outcomes
RESULTS:
Only 10% of women met WHO-recommended eight ANC contacts. Nearly one-third (29.5%) of parous women reported at least one adverse pregnancy or neonatal outcome, with self-reported stillbirths the most frequently cited outcome (45 per 1000 births). While 97% of women reported using iron-folic acid supplements during pregnancy, initiation was commonly delayed, and no intake was reported as occurring during the critical peri-conception period. Knowledge of iron and folate/folic acid was low overall (19%), but significantly higher among women interviewed in close proximity to grassroots community-based health promotion centres.
CONCLUSIONS:
Findings highlight persistent inequities in ANC engagement, maternal nutrition education, and adverse pregnancy outcomes in this Pacific LMIC context. Strengthening inclusive community-based health promotion, improving health literacy, and adherence to WHO ANC recommendations is essential to advance equitable maternal health outcomes. This study demonstrates the value of locally co-designed, women-centred research in developing targeted interventions with relevance for other geographically constrained low resource settings across the globe.
Maternal and neonatal health outcomes in Pacific low- and middle-income countries (LMIC) such as Vanuatu are shaped by geographic isolation, health system capacity, and sociocultural factors. Despite national priorities to improve maternal health, inequities in antenatal care (ANC) engagement and maternal nutrition persist, contributing to adverse pregnancy and neonatal outcomes (1–3). Drawing on Ni-Vanuatu women’s reported experiences, this study examines how intersections between health access, health education, and community-based support influence maternal and neonatal health outcomes across diverse regions of Vanuatu.
METHODS:
A cross-sectional study was co-designed with local stakeholders using a women-centred inclusive research approach. Structured surveys were conducted in Bislama (lingua franca of Vanuatu) with 586 women across 27 communities using targeted snowball sampling in women-centric locations. Data were analysed using descriptive and inferential statistics to explore associations between ANC engagement, supplement use, health knowledge and self-reported birth outcomes
RESULTS:
Only 10% of women met WHO-recommended eight ANC contacts. Nearly one-third (29.5%) of parous women reported at least one adverse pregnancy or neonatal outcome, with self-reported stillbirths the most frequently cited outcome (45 per 1000 births). While 97% of women reported using iron-folic acid supplements during pregnancy, initiation was commonly delayed, and no intake was reported as occurring during the critical peri-conception period. Knowledge of iron and folate/folic acid was low overall (19%), but significantly higher among women interviewed in close proximity to grassroots community-based health promotion centres.
CONCLUSIONS:
Findings highlight persistent inequities in ANC engagement, maternal nutrition education, and adverse pregnancy outcomes in this Pacific LMIC context. Strengthening inclusive community-based health promotion, improving health literacy, and adherence to WHO ANC recommendations is essential to advance equitable maternal health outcomes. This study demonstrates the value of locally co-designed, women-centred research in developing targeted interventions with relevance for other geographically constrained low resource settings across the globe.
| eISSN: | 2654-1459 |
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