Timing of first antenatal care visits and number of items of antenatal care contents received and associated factors in Ethiopia: multilevel mixed effects analysis

Abstract Background Receiving quality antenatal care (ANC) from skilled providers is essential to ensure the critical health circumstances of a pregnant woman and her child. Thus, this study attempted to assess which risk factors are significantly associated with the timing of antenatal care and the number of items of antenatal care content received from skilled providers in recent pregnancies among mothers in Ethiopia. Methods The data was extracted from the Ethiopian Demographic and Health Survey 2016. A total of 6645 mothers were included in the analysis. Multilevel mixed-effects logistic regression analysis and multilevel mixed Negative binomial models were fitted to find the factors associated with the timing and items of the content of ANC services. The 95% Confidence Interval of Odds Ratio/Incidence Rate Ratio, excluding one, was reported as significant. Results About 20% of the mothers initiated ANC within the first trimester, and only 53% received at least four items of antenatal care content. Being rural residents (IRR = 0.82; 95%CI: 0.75–0.90), wanting no more children (IRR = 0.87; 95%CI: 0.79–0.96), and the husband being the sole decision maker of health care (IRR = 0.88; 95%CI: 0.81–0.96), were associated with reduced items of ANC content received. Further, birth order of six or more (IRR = 0.74; 95%CI: 0.56–0.96), rural residence (IRR = 0.0.41; 95%CI: 0.34–0.51), and wanting no more children (IRR = 0.61; 95%CI: 0.48–0.77) were associated with delayed antenatal care utilization. Conclusions Rural residences, the poorest household wealth status, no education level of mothers or partners, unexposed to mass media, unwanted pregnancy, mothers without decision-making power, and considerable distance to the nearest health facility have a significant impact on delaying the timing of ANC visits and reducing the number of items of ANC received in Ethiopia. Mothers should start an antenatal care visit early to ensure that a mother receives all of the necessary components of ANC treatment during her pregnancy.

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Risk Factors Associated With Frequency of Antenatal Visits, Number of Items of Antenatal Care Contents Received and Timing of First Antenatal Care Visits in Ethiopia: Multilevel Mixed-Effects Analysis

10.21203/rs.3.rs-110214/v1 ◽

2020 ◽

Author(s):

Berhanu Woldeamanuel ◽

Tadesse Belachew

Keyword(s):

Risk Factors ◽

Decision Making ◽

Antenatal Care ◽

Household Wealth ◽

Mixed Effects ◽

Care Utilization ◽

Rural Residence ◽

Wealth Status ◽

Factors Associated ◽

Antenatal Care Utilization

Abstract Background: An improved quality Antenatal care (ANC) from skilled providers is essential to pregnant women so that ensure the key health circumstances for mother and child during pregnancy. Thus, this study attempted to assess which risk factors are significantly associated with the timing of antenatal care, the number of antenatal care visits, and the number of items of antenatal care contents received from skilled providers in the recent pregnancy among mothers in Ethiopia. Methods: Data was extracted from the 2016 Ethiopian Demographic and Health Survey. A total of 4,685 mothers was included in the analysis. Multilevel mixed-effects logistic regression analysis and multilevel mixed Negative binomial models were fitted to find the factors associated with antenatal care utilization. A 95% Confidence Interval of Odds ratio/Incidence rate ratio excluding one was reported as significant association with timely initiation of the ANC, numbers of ANC visits, numbers of items of antenatal care contents received and predictor variables.Results: About 20% of the mothers initiated ANC within the first trimester, 36.3% visits at least four ANCs, 3.6% have visited at least eight ANCs, and only 53% received at least four items of antenatal care contents. Rural residence (IRR = 0.81; 95%CI: 0.80-0.89), wanted no more children (IRR = 0.83; 95%CI: 0.75-0.91), mother without decision making power (IRR = 0.90; 95%CI: 0.83-0.98) associated with reduced frequency of ANC visits, while being rural residents (IRR = 0.82; 95%CI: 0.75-0.90), wanted no more children (IRR = 0.87; 95%CI: 0.79-0.96), husband alone decision maker of mothers health care (IRR = 0.88; 95%CI: 0.81-0.96) associated with reduced items of ANC content received. Further, birth order six or more (IRR = 0.74; 95%CI: 0.56-0.96), rural residence (IRR = 0.0.41; 95%CI: 0.34-0.51), wanted no more children (IRR = 0.61; 95%CI: 0.48-0.77) associated with delayed antenatal care utilization. Moreover, higher household wealth status, primary or secondary or higher education of mothers and partner, listening to the radio and watching television at least once a week, and a short distance to health facility were positively significantly associated with the frequency of antenatal care visits, numbers of items of ANC contents received and early initiation of ANC visit for the recent pregnancy during the last five years before the survey. Conclusions: Rural residence, poorest household wealth status, no education level of mothers or partners, unexposed to mass media, unwanted pregnancy, mothers without decision making power, and big distance to the nearest health facility, have a significant impact in delaying the timing of ANC visits, reducing the number of ANC visits and items of ANC received in Ethiopia. We ought to timely initiate an ANC visit for a frequent antenatal care visit during pregnancy. Educating girls and encouraging mothers to use modern contraceptives in order to prevent unwanted pregnancies are vital ingredients that should be included in all policies aiming to reduce maternal and neonatal deaths through improved quality of antenatal care utilization.

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Number of Antenatal Care Utilization and Associated Factors Among Pregnant Women in Ethiopia: Zero-Inflated Poisson Regression of 2019 Intermediate Ethiopian Demography Health Survey.

10.21203/rs.3.rs-970879/v1 ◽

2021 ◽

Author(s):

Mastewal Arefaynie ◽

Bereket Kefale ◽

Melaku Yalew ◽

Bezawit Adane ◽

Reta Dewau ◽

...

Keyword(s):

Antenatal Care ◽

Pregnant Women ◽

Poisson Regression ◽

Associated Factors ◽

Wealth Index ◽

Household Wealth ◽

Care Utilization ◽

Wealth Status ◽

Mortality And Morbidity ◽

Antenatal Care Utilization

Abstract Background The frequency of antenatal care enhances the effectiveness of the program to reduce maternal and child mortality and morbidity. The aim of the study was to determine the number of antenatal care and associated factors in Ethiopia by using 2019 intermediate EDHS. Methods Secondary data analysis was done on 2019 intermediate EDHS. A total of 3,916.6 weighted pregnant women were included in the analysis. Zero-inflated Poisson regression analysis was done by Stata version 14.0. Incident rate ratio and odds ratio with a 95% confidence interval were used to show the strength and direction of the association. Result About one thousand six hundred eighty eight (43.11%) women were attending four and more antenatal care during current pregnancy. Attending primary education (IRR= 1.115, 95% CI: 1.061, 1.172), secondary education (IRR=1.211, 95% CI: 1.131, 1.297) and higher education (IRR=1.274, 95% CI: 1.177, 1.378), reside in poorer household wealth index (IRR= 1.074, 95% CI: 1.01, 1.152), middle household wealth index (IRR= 1.095, 95% CI: 1.018, 1.178), rich household wealth index (IRR=1.129, 95% CI: 1.05, 1.212) and richer household wealth index (IRR=1.186, 95% CI: 1.089, 1.29) increases the number of antenatal care utilization. The frequency of antenatal care was less likely become zero among women attending primary (AOR=0.434, 95% CI: 0.346, 0.545), secondary (AOR=0.113, 95% CI: 0.053, 0.24), higher educational level (AOR=0.052, 95% CI: 0.007, 0.367) in the inflated part. Conclusion The number of antenatal care utilization is low in Ethiopia. Being rural, poorest household index, uneducated and single were factors associated with low number of antenatal care and not attending antenatal care at all. Improving the educational coverage and wealth status of women is important to increase coverage of antenatal care.

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Regional Disparities of Antenatal Care Utilization in Indonesia

10.1101/793802 ◽

2019 ◽

Author(s):

Agung Dwi Laksono ◽

Rukmini Rukmini ◽

Ratna Dwi Wulandari

Keyword(s):

Antenatal Care ◽

Health And Safety ◽

Binary Logistic Regression ◽

Regional Disparities ◽

Care Utilization ◽

Final Test ◽

Wealth Status ◽

Maternal Morbidity And Mortality ◽

Antenatal Care Utilization ◽

Main Strategy

AbstractIntroductionThe main strategy for decreasing maternal morbidity and mortality with antenatal care (ANC). ANC aims to monitor and maintain the health and safety of the mother and fetus, detect all complications of pregnancy and take the necessary actions, respond to complaints, prepare for birth, and promote healthy living behavior. The study aims to analyze inter-regional disparities in ≥4 ANC visits during pregnancy in Indonesia.MethodsData sources from 2017 Indonesian Demographic and Health Survey (IDHS). With an analysis unit of women aged 15-49 years old, a sample of 15,351 women was obtained. Besides ANC as the dependent variable, other variables analyzed were place of residence, age, husband/partner, education, parity, wealth status, and health insurance. Analysis using Binary Logistic Regression for the final test to determine disparity.ResultsAll regions show a gap with the Papua region as a reference, except the Maluku region which was not significant shows differences in the use of ANC compared to the Papua. Women in the Nusa Tenggara have 4,365 chances of making ≥4 ANC visits compared to the Papua region. Women in Java-Bali have 3,607 times more chances to make ≥4 ANC visits than women in the Papua region. Women in Sumatra have 1,370 chances of making ≥4 ANC visits compared to women in the Papua region. Women in Kalimantan have 2.232 times made ≥4 ANC visits compared to women in the Papua region. Women in Sulawesi have 1,980 times more than AN4 ANC visits compared to women in the Papua region. In addition to the region category, other variables found to contribute to the predictor were age, husband/partner, education, parity, wealth and insurance.ConclusionThere were disparities between regions in the ANC utilization in Indonesia.

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On the socio-economic determinants of antenatal care utilization in Azerbaijan: evidence and policy implications for reforms

Health Economics Policy and Law ◽

10.1017/s1744133110000174 ◽

2010 ◽

Vol 6 (2) ◽

pp. 175-203 ◽

Cited By ~ 20

Author(s):

Nazim N. Habibov

Keyword(s):

Antenatal Care ◽

Negative Binomial ◽

Important Determinant ◽

Policy Implications ◽

Healthcare Sector ◽

Care Utilization ◽

Economic Determinants ◽

Prenatal Health ◽

Antenatal Care Utilization

AbstractAzerbaijan is a country with one of the highest child mortality rates in the regions of Eastern Europe and the former Soviet Union. Drawing on the nationally representative Demographic and Health Survey, this study examines the utilization of antenatal care in Azerbaijan to identify the socio-economic determinants of the usage, and its frequency, timing and quality. Consequently, binomial logit, two ordered logit and negative binomial regression models are specified to estimate the effect of various socio-economic characteristics on the likelihood of utilization. Place of living is an important determinant of antenatal healthcare utilization in Azerbaijan. It is important in determining the likelihood of utilization, its timing and quality of care received, whereas it is not significant in the model predicting the frequency of antenatal utilization. Women’s education is also significant in three models out of four. Education is important in explaining the frequency and timing of utilization as well as the quality of services received, but it is not significant in predicting the likelihood of utilization. Wealth gradient is another important determinant of antenatal care utilization in Azerbaijan inasmuch as it is significant in explaining the likelihood of prenatal care utilization and its frequency. In addition, two variables, birth order and desirability of the last child or current pregnancy, are significant only in explaining the likelihood of utilization. Therefore, we confirm the findings of previous studies, which reported that the utilization of prenatal health care is a multistage process in which decisions are sequential. Although the same set of factors may affect decision-making at all stages, the effect of these factors is different at different stages. Implications for reforms in the healthcare sector to improve antenatal care utilization in Azerbaijan are provided and discussed.

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