Utilization and Determinants of Antenatal Care Visits in East African Countries: A Multicountry Analysis of Demographic and Health Surveys

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Zemenu Tadesse Tessema ◽  
Amare Minyihun
Keyword(s):  
Health Care ◽  
Antenatal Care ◽  
Logistic Regression Model ◽  
East African ◽  
African Countries ◽  
Wealth Status ◽  
Antenatal Care Visit ◽  
Care Visit ◽  
Planned Pregnancy ◽  
Contraceptive Utilization

Background. The health care a woman receives during pregnancy is important for her survival and baby, both at the time of delivery and shortly after that. In the context of high maternal morbidity and mortality in sub-Saharan Africa, fewer than 80% of pregnant women receive antenatal care visit services. Receiving antenatal care visits at least four times increases the likelihood of receiving effective maternal health interventions through the antenatal period. This study aimed to identify the utilization and determinants of attending at least four visits in 12 East African countries. Methods. The study used the demographic and health survey data from 12 East African countries from 2008 to 2018. The DHS program adopts standardized methods involving uniform questionnaires, manuals, and field procedures to gather information comparable across countries globally. A multivariable logistic regression model was fitted to identify the determinants of completing at least four antenatal care services. With their 95% CI obtained from the adjusted multilevel logistic regression model, the adjusted odds ratio was presented to show the magnitude of the relationship between the independent variable and completing antenatal care visits. Results. The pooled utilization of attending at least four antenatal care visit in the East African region was 52.44% (95% CI: 52.13, 52.74), with the highest attending at least four or more antenatal care visit visits in Zimbabwe (75.72%) and the lowest attending at least four or more antenatal care visit visits in Ethiopia (31.82%). The significant determinants of completing at least four ANC visits were age category (24–34 (AOR = 1.24, 95% CI: 1.18, 1.31) and 35–49 (AOR = 1.42, 95% CI: 1.32, 1.53)); being married women (AOR = 1.11, 95% CI: 1.1.05, 1.16); education levels of primary education (AOR = 1.20, 95% CI: 1.13, 1.27), secondary education (AOR = 1.24, 95% CI: 1.24, 1.47), and higher education (AOR = 1.91, 95% CI: 1.62, 2.14); birth order (2–4 (AOR = 0.75, 95% CI: 0.70, 0.79) and 5+ (AOR = 0.63, 95% CI: 0.58, 0.68)); planned pregnancy (AOR = 0.81, 95% CI: 0.75, 0.86); contraceptive utilization (AOR = 1.36, 95% CI: 1.29, 1.43); wealth status of middle (AOR = 1.11, 95% CI: 1.05, 1.17) and rich (AOR = 1.25, 95% CI: 1.18, 1.32); having no problem accessing health care (AOR = 1.0.95, 95% CI: 0.89, 0.97); and living countries. Conclusions. The coverage of completing the recommended antenatal care visit was low in the region. Age, marital status, mother’s and partner’s education, women’s occupation, birth order, planned pregnancy, contraceptive utilization, wealth status, healthcare accessibility, and living countries were the major determinants of completing recommended antenatal care visits. Therefore, intersectoral collaboration to promote female education and empowerment, improve geographical access to health care, and strengthen implementation of antenatal care policies with active community participation is recommended. In addition, creating a conducive environment in entrepreneurial activities for poor women is needed.

scholarly journals The determinant of Antenatal Care Visits among Pregnant Women in Ethiopia

2019 ◽  
Author(s):  
Setegn Muche Fenta
Keyword(s):  
Health Care ◽  
Mass Media ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Rural Women ◽  
Sub Saharan Africa ◽  
World Health ◽  
Antenatal Care Visit ◽  
Care Visit ◽  
Pregnant Mothers

Abstract Background Health care services during a pregnancy and after delivery are important for the survival and well being of both the mother and the infant. The World Health Organization recommends a minimum of four antenatal care visits during a pregnancy. In Ethiopia, only 38% of women aged 15-49 with a live birth received at least one-time antenatal care visits from a skilled provider. This value is much more below the average rates of least developed countries and Sub-Saharan Africa. This study aimed to identify the determinant factor of antenatal care service visits among pregnant women in EthiopiaMethod The national-level cross-sectional Ethiopian Demographic and Health 2016 survey data were accessed and used for the analysis. A total of 7913 pregnant women were included in the study. Zero-inflated Poisson regression models were employed to identify the determinant of antenatal care visits.Results Only 35.5% of the pregnant mothers have visited at least four times and 64.5% of the pregnant mothers have visited less than four times during their periods of pregnancy. The study revealed that rich women (IRR 1.077, 95% CI: 1.029,1.127), having access to mass media (IRR=1.086, 95% CI: 1.045, 1.128), having pregnancy complications (IRR=1.203, 95% CI: 1.165, 1.242), secondary or above-educated women (IRR=1.112, 95% CI:1.052, 1.176), husband's having secondary or above level of education (IRR=1.085, 95% CI: 1.031, 1.142), being married (IRR = 1.187; 95% CI: 1.087,1.296) and women age >30 years (IRR=1.067, 95% CI: 1.024, 1.111) were strongly positively associated with the antenatal care visit. Rural pregnant women less antenatal visits (IRR=0.884, 95% CI: 0.846, 0.924) had also a statistically significant association with antenatal care visits.Conclusion This study was revealed rural women, poor women, uneducated mothers, uneducated husbands, not having access to mass media, unmarried women, have not pregnancy a complication was significantly associated with less number of antenatal care visit. Therefore, efforts are needed to advance the socioeconomic status of women, increasing the educational level of women and their husbands. The concerned body also should be made maternal health-care programs should be stretched and intensified in rural areas.

scholarly journals Magnitudes and Determinants of Antenatal Care Utilization among Pregnant Women in East Africa: Evidence from Demographic and Health Surveys (DHS) from 2010 to 2018

2021 ◽  
Author(s):  
Temam Beshir Raru ◽  
Belay Negash ◽  
Biruk Shalmenu ◽  
Addisu Birhanu ◽  
Lemma Demissie ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Antenatal Care ◽  
East Africa ◽  
Health Surveys ◽  
Logistic Regression Model ◽  
Media Exposure ◽  
Wealth Index ◽  
Demographic And Health Surveys ◽  
East African ◽  
African Countries

Abstract Introduction: The use of antenatal care (ANC) plays a major role in minimizing maternal and child mortality through effective and appropriate screening, preventive, or treatment intervention. Despite the fact that almost all of the pregnancy-related mortalities are largely preventable through adequate use of ANC, Sub-Saharan Africa (SSA) particularly East African Countries continues to share the largest share of global maternal, and newborn mortality. Therefore, this study aimed to estimate the overall magnitude and determinants of ANC utilization in the 11 East Africa Countries from 2010 to 2018 using recent Demographic and Health Surveys (DHS)Methods: A secondary data analysis was done based on DHS from 2010 to 2018 in the 11 East African Countries. A total weighted sample of 89,991 women who gave birth in the 5 years preceding each country’s DHS survey were included in this study. Data processing and analysis were performed using STATA 15 software. Multilevel mixed effect logistic regression model was fitted. Model comparison was done based on Akaike and Bayesian Information Criteria (AIC and BIC). Variables with a p-value≤0.05 were declared as significant determinants of ANC utilization.Results: The magnitude of ANC utilization in East African Countries was 53.03% (95% CI: 52.70, 53.35) with the highest ANC utilization in Kenya (57.64%) and the lowest ANC utilization in Comoros (48.99%). In the multivariable multilevel logistic regression model; age 20-24 (Adjusted Odds Ratio (AOR) = 1.25; 95% CI; 1.17-1.34), 25-29 AOR = 1.47; 95% CI; 1.37-1.58), 30-34 (AOR = 1.58; 95% CI; 1.47-1.71), 35-39 (AOR = 1.63; 95% CI; 1.50-1.77), 40-44 (AOR = 1.64; 95% CI; 1.49-1.81), 45-49 (AOR = 1.71; 95% CI; 1.51-1.93), primary education (AOR = 1.24; 95% CI; 1.18-1.31), richest wealth index (AOR = 1.57; 95% CI; 1.47-1.67), being in rural resident (AOR = 0.93; 95% CI; 0.88,0.98), have media exposure (AOR = 1.11; 95% CI; 1.07-1.15), and being a Zimbabwe resident (AOR = 2.87; 95% CI; 2.55-3.23) were among factors that are significantly associated with ANC utilization.Conclusion: ANC utilization was low in the East Africa countries. Age, women education, wealth index, birth order, residence, media exposure and living countries were major determinants of ANC utilization. It would be useful to increase financial support strategies that enables mothers from poor households to use health services will be advantageous. To increase women’s understanding of the significance of ANC utilization, health education targeting mothers with no education is very crucial.

scholarly journals Trends and determinants of an acceptable antenatal care coverage in Ethiopia, evidence from 2005-2016 Ethiopian demographic and health survey; Multivariate decomposition analysis

2020 ◽  
Vol 78 (1) ◽  
Author(s):  
Tilahun Yemanu Birhan ◽  
Wullo Sisay Seretew
Keyword(s):  
Health Care ◽  
Educational Attainment ◽  
Antenatal Care ◽  
Health Survey ◽  
Decomposition Analysis ◽  
Health Care Facilities ◽  
Demographic And Health Survey ◽  
Reproductive Age ◽  
Antenatal Care Visit ◽  
Care Visit

Abstract Background an acceptable antenatal care (ANC4+) is defined as attending at least four antenatal care visit, received at least one dose of tetanus toxoid (TT) injections and consumed 100 iron-folic acids (IFA) tablets/syrup during the last pregnancy. Since maternal health care service utilization continues to be an essential indicator for monitoring the improvements of maternal and child health outcomes. This study aimed to analyze the trends and determinants that contributed to the change in an acceptable antenatal care visit over the last 10 years in Ethiopia. Methods Nationally representative repeated cross-sectional survey was conducted using 2005, 2011, and 2016 Ethiopian Demographic and Health Survey datasets. The data were weighted and analyzed by STATA 14.1 software. Multivariate decomposition regression analysis was used to identify factors that contribute for the change in an acceptable antenatal care visit. A p-value < 0.05 was taken to declare statistically significant predictors to acceptable antenatal care visit. Results among the reproductive age women the rate of an acceptable antenatal care visits was increased from 16% in 2005 to 35% in 2016 in Ethiopia. In the multivariate decomposition analysis, about 29% of the increase in acceptable antenatal care visit was due to a difference in composition of women (endowments) across the surveys. Residence, religion, husband educational attainment, and wealth status was the main source of compositional change factors for the improvements of an acceptable antenatal care visit. Almost two-thirds of an overall change in acceptable antenatal care visit was due to the difference in coefficients/ change in behavior of the population. Religion, educational attainment (both women and husband), and residence are significantly contributed to the change in full antenatal care visit in Ethiopia over the last decades. Conclusion Besides the relevance of receiving an acceptable antenatal care visit for pregnant women and their babies, an acceptable antenatal care visit was slightly increased over time in Ethiopia. Women’s characteristics and behavior change were significantly associated with the change in acceptable antenatal care visits. Public interventions needed to improve acceptable antenatal care coverage, women’s education, and further advancing of health care facilities in rural communities should be done to maintain the further improvements acceptable antenatal care visits.

scholarly journals Husband Support for Their Wives in Antenatal Care Visit

2018 ◽  
Vol 13 (1) ◽  
Author(s):  
Awalia Hanifah ◽  
Hadi Pratomo ◽  
Giang Hoang
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Antenatal Care ◽  
Rapid Assessment ◽  
Assessment Procedure ◽  
Antenatal Care Visit ◽  
Primary Health ◽  
Care Visit ◽  
Reinforcing Factors ◽  
Husband Support

In Cimanggis Primary Health Care, Depok City, the coverage of both the first antenatal care visit (ANC1) and the fourth antenatal care visit (ANC4) was 99.4% (2013) and 91% (2014). The husband support is one of the factors that plays an important role in mothers’ ANC visit. This study aimed to assess predisposing, enabling, and reinforcing factors of the husband support towards their wives’ ANC visit. This was a qualitative study using a Rapid Assessment Procedure. Five husbands of pregnant women and their wives were recruited as informants. Two midwives from the primary health care were the key informants. Data were analysed using matrix of qualitative data and thematic analysis technique. Results showed that those three factors, meaning that predisposing, enabling and reinforcing factors of the husband were very important in motivating their pregnant wives to do ANC during pregnancy.

scholarly journals Pregnant women’s decision-making capacity and adherence to iron supplementation in sub-Saharan Africa: a multi-country analysis of 25 countries

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Betregiorgis Zegeye ◽  
Nicholas Kofi Adjei ◽  
Comfort Z. Olorunsaiye ◽  
Bright Opoku Ahinkorah ◽  
Edward Kwabena Ameyaw ◽  
...  
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Antenatal Care ◽  
Iron Supplementation ◽  
Married Women ◽  
African Countries ◽  
Her Family ◽  
Care Visit ◽  
Large Household ◽  
Sub Saharan

Abstract Background Anaemia and related complications during pregnancy is a global problem but more prevalent in sub-Sahara Africa (SSA). Women’s decision-making power has significantly been linked with maternal health service utilization but there is inadequate evidence about adherence to iron supplementation. This study therefore assessed the association between household decision-making power and iron supplementation adherence among pregnant married women in 25 sub-Saharan African countries. Methods We used data from the Demographic and Health Surveys (DHS) of 25 sub-Saharan African countries conducted between 2010 and 2019. Women's decision-making power was measured by three parameters; own health care, making large household purchases and visits to her family or relatives. The association between women’s decision-making power and iron supplementation adherence was assessed using logistic regressions, adjusting for confounders. The results were presented as adjusted odds ratio (AOR) with 95% confidence intervals (CIs). Results Approximately 65.4% of pregnant married women had made decisions either alone or with husband in all three decisions making parameters (i.e., own health care, making large household purchases, visits to her family or relatives). The rate of adherence to iron medication during pregnancy was 51.7% (95% CI; 48.5–54.9%). Adherence to iron supplementation was found to be higher among pregnant married women who had decision-making power (AOR = 1.46, 95% CI; 1.16–1.83), secondary education (AOR = 1.45, 95% CI; 1.05–2.00) and antenatal care visit (AOR = 2.77, 95% CI; 2.19–3.51). Wealth quintiles and religion were significantly associated with adherence to iron supplementation. Conclusions Adherence to iron supplementation is high among pregnant women in SSA. Decision making power, educational status and antenatal care visit were found to be significantly associated with adherence to these supplements. These findings highlight that there is a need to design interventions that enhance women’s decision-making capacities, and empowering them through education to improve the coverage of antenatal iron supplementation.

scholarly journals Determinants of utilization of antenatal and delivery care at the community level in rural Bangladesh

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257782
Author(s):  
Jesmin Pervin ◽  
Mahima Venkateswaran ◽  
U. Tin Nu ◽  
Monjur Rahman ◽  
Brian F. O’Donnell ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Facility Delivery ◽  
Health Facilities ◽  
Community Level ◽  
Delivery Care ◽  
Multivariate Logistic Regression ◽  
Antenatal Care Visit ◽  
Care Visit

Background Timely utilization of antenatal care and delivery services supports the health of mothers and babies. Few studies exist on the utilization and determinants of timely ANC and use of different types of health facilities at the community level in Bangladesh. This study aims to assess the utilization, timeliness of, and socio-demographic determinants of antenatal and delivery care services in two sub-districts in Bangladesh. Methods This cross-sectional study used data collected through a structured questionnaire in the eRegMat cluster-randomized controlled trial, which enrolled pregnant women between October 2018-June 2020. We undertook univariate and multivariate logistic regression analysis to determine the associations of socio-demographic variables with timely first ANC, four timely ANC visits, and facility delivery. We considered the associations in the multivariate logistic regression as statistically significant if the p-value was found to be <0.05. Results are presented as adjusted odds ratios (AOR) with 95% confidence intervals (CI). Results Data were available on 3293 pregnant women. Attendance at a timely first antenatal care visit was 59%. Uptake of four timely antenatal care visits was 4.2%. About three-fourths of the women delivered in a health facility. Women from all socio-economic groups gradually shifted from using public health facilities to private hospitals as the pregnancy advanced. Timely first antenatal care visit was associated with: women over 30 years of age (AOR: 1.52, 95% CI: 1.05–2.19); nulliparity (AOR: 1.30, 95% CI: 1.04–1.62); husbands with >10 years of education (AOR: 1.40, 95% CI: 1.09–1.81) and being in the highest wealth quintile (AOR: 1.49, 95% CI: 1.18–1.89). Facility deliveries were associated with woman’s age; parity; education; the husband’s education, and wealth index. None of the available socio-demographic factors were associated with four timely antenatal care visits. Conclusions The study observed socio-demographic inequalities associated with increased utilization of timely first antenatal care visit and facility delivery. The pregnant women, irrespective of wealth shifted from public to private facilities for their antenatal care visits and delivery. To increase the health service utilization and promote good health, maternal health care programs should pay particular attention to young, multiparous women, of low socio-economic status, or with poorly educated husbands. Clinical trial registration ISRCTN69491836; https://www.isrctn.com/. Registered on December 06, 2018. Retrospectively registered.

scholarly journals Early antenatal care visit as indicator for health equity monitoring

2018 ◽  
Vol 6 (1) ◽  
pp. e35 ◽  
Author(s):  
Oliver Razum ◽  
Jürgen Breckenkamp ◽  
Theda Borde ◽  
Matthias David ◽  
Kayvan Bozorgmehr
Keyword(s):  
Antenatal Care ◽  
Health Equity ◽  
Antenatal Care Visit ◽  
Care Visit
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