Oral Presentation ESA-SRB-ANZOS 2025 in conjunction with ENSA

Elevating Ni-Vanuatu women’s voices through research on maternal health, nutrition, and adverse birth outcomes  (128601)

Eliza Kitchener 1 2 , Rachael Thurecht 2 , Rex Turi 3 , Tominic Turi 4 , Nerida Hinge 5 , Jenny Stephen 5 , Matthew Cornish 6 , Georgia R Kafer 1 2
  1. Australian Centre for Pacific Islands Research, Moreton Bay, Queensland, Australia
  2. School of Health, The University of the Sunshine Coast, Moreton Bay, QLD, Australia
  3. Health Clinic, Wan Smolbag Theatre, Port Vila, Efate, Vanuatu
  4. Nutrition Centre, Wan Smolbag Theatre, Port Vila, Efate, Vanuatu
  5. Ministry of Health, Port Vila, Efate, Vanuatu
  6. Department of Pediatrics, Medical College of Georgia, Augusta University, Augusta, Georgia, USA

Aims

Adverse pregnancy, neonatal, and infant outcomes (APNIOs) remain a significant public health concern in Vanuatu, a Pacific lower-middle-income country (LMIC). This study aimed to support local health services by quantifying APNIO incidence, assessing antenatal care (ANC) engagement, investigating antenatal supplementation practices, and evaluating women’s knowledge of iron and folic acid in supporting healthy pregnancy outcomes.

Methods

A cross-sectional survey was conducted between July and September 2023. Snowball sampling recruited 586 Ni-Vanuatu women across 27 urban and rural communities on Efate Island. Structured interviews (delivered in Bislama) captured demographic data, pregnancy outcomes, ANC attendance, supplement use, and knowledge. Data were analysed using chi-square, Fisher’s exact, Kruskal–Wallis, Spearman’s rank correlation, and logistic regression (p<0.05).

Results

The cohort reported 1682 births. Among parous women (n=156), 29% experienced at least one APNIO, significantly associated with home region (χ², p=0.003). Stillbirths (45/1000 births), occured at higher rates in rural areas (64/1000) than urban (36/1000). No significant associations were found between stillbirth rates and education level, region, or food expenditure. ANC initiation varied by age (χ², p=0.0136), with younger women more likely to attend earlier. While 79% attended ≥4 ANC contacts, only 12% met WHO’s recommended 8 visits. Supplement uptake was high (95%), but initiation was delayed, with no women reporting use prior to or during early gestation. Knowledge of iron/folic acid was low (19%), significantly associated with interview location (Exp(B)=18.8, 95% CI [7.4–49], p<0.001).

Conclusion

High APNIO rates and suboptimal ANC and supplement practices highlight gaps in maternal health services and literacy in Vanuatu. Strengthening early ANC engagement and nutrition education may reduce APNIOs. Evidence presented here suggests that community-led health promotion is effective in improving maternal health literacy. Future research should explore scalable interventions and policy integration to enhance maternal and child health outcomes across rural and urban Vanuatu.