scholarly journals Continuum of Maternity Care in Zambia: a National Representative Survey

2021 ◽  
Author(s):  
Quraish Sserwanja ◽  
Milton W. Musaba ◽  
Linet M. Mutisya ◽  
Emmanuel Olal ◽  
David Mukunya
Keyword(s):  
Antenatal Care ◽  
Neonatal Morbidity ◽  
First Trimester ◽  
Continuum Of Care ◽  
Postnatal Period ◽  
Tertiary Level ◽  
Level Of Education ◽  
Maternity Services ◽  
First Semester ◽  
Western Province

Abstract BackgroundGlobally, over half of maternal deaths are related to pregnancy-related complications. Provision of a continuum of care during pregnancy, childbirth and the postnatal period results in reduced maternal and neonatal morbidity and mortality. Hence this study determined the prevalence of the continuum of care and its determinants among women in Zambia.MethodsWe used weighted data from the Zambian Demographic and Health Survey (ZDHS) of 2018 for 7325 women aged 15 to 49 years. Multistage stratified sampling was used to select study participants. We conducted multivariable logistic regression to explore continuum of care in Zambia. All our analyses were done using SPSS version 25. ResultsOf the 7,325 women, 38.0% (2787/7325) (95% CI: 36.9-39.1) had complete continuum of maternal healthcare (four and more antenatal care contacts, childbirth at a health facility and postnatal care). Women who had attained tertiary level of education (AOR: 1.84, 95% CI: 1.01-3.35) and whose partners had also attained tertiary level of education (AOR: 2.54, 95% CI: 1.52-4.27) were more likely to utilize the whole continuum of care compared to those who had no education. Women who initiated antenatal care (ANC) after the first trimester (AOR: 0.46, 95% CI: 0.39-0.53) were less likely to utilize the whole continuum of care compared to those who initiated in the first semester. Women with exposure to radio (AOR: 1.58, 95% CI: 1.28-1.96) were more likely to utilize the whole continuum of care compared to those who were not exposed to radio. Women residing in the Western province were less likely to utilize the entire continuum of care compared to those in the other nine provinces.ConclusionLevel of education of the women and of their partners, early timing of ANC initiation, residing in other provinces other than the Western province, and exposure to information through radio were positively associated with utilization of the entire continuum of care. Improving literacy levels and promoting maternity services through radio may improve the level of utilization of maternity services.

scholarly journals Continuum of maternity care in Zambia: a national representative survey

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Quraish Sserwanja ◽  
Milton W. Musaba ◽  
Linet M. Mutisya ◽  
Emmanuel Olal ◽  
David Mukunya
Keyword(s):  
Neonatal Morbidity ◽  
First Trimester ◽  
Continuum Of Care ◽  
Postnatal Period ◽  
Tertiary Level ◽  
Level Of Education ◽  
Maternity Services ◽  
First Semester ◽  
Western Province ◽  
Study Participants

Abstract Background Globally, over half of maternal deaths are related to pregnancy-related complications. Provision of a continuum of care during pregnancy, childbirth and the postnatal period results in reduced maternal and neonatal morbidity and mortality. Hence this study determined the prevalence of the continuum of care and its determinants among women in Zambia. Methods We used weighted data from the Zambian Demographic and Health Survey (ZDHS) of 2018 for 7325 women aged 15 to 49 years. Multistage stratified sampling was used to select study participants. Complete continuum of care was considered when a woman had; at least four antenatal care (ANC) contacts, utilized a health facility for childbirth and had at least one postnatal check-up within six weeks. We conducted multivariable logistic regression to explore continuum of care in Zambia. All our analyses were done using SPSS version 25. Results Of the 7,325 women, 38.0% (2787/7325) (95% confidence interval (CI): 36.9-39.1) had complete continuum of maternal healthcare. Women who had attained tertiary level of education (adjusted odds ratio (AOR): 1.93, 95% CI: 1.09-3.42) and whose partners had also attained tertiary level of education (AOR: 2.58, 95% CI: 1.54-4.32) were more likely to utilize the whole continuum of care compared to those who had no education. Women who initiated ANC after the first trimester (AOR: 0.46, 95% CI: 0.39-0.53) were less likely to utilize the whole continuum of care compared to those who initiated in the first semester. Women with exposure to radio (AOR: 1.58, 95% CI: 1.27-1.96) were more likely to utilize the whole continuum of care compared to those who were not exposed to radio. Women residing in the Western province were less likely to utilize the entire continuum of care compared to those in the other nine provinces. Conclusion Level of education of the women and of their partners, early timing of ANC initiation, residing in other provinces other than the Western province, and exposure to information through radio were positively associated with utilization of the entire continuum of care. Improving literacy levels and promoting maternity services through radio may improve the level of utilization of maternity services.

scholarly journals Adequacy and timeliness of antenatal care visits among Ethiopian women: a community-based panel study

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e053357
Author(s):  
Kasiye Shiferaw ◽  
Bezatu Mengistie ◽  
Tesfaye Gobena ◽  
Merga Dheresa ◽  
Assefa Seme
Keyword(s):  
Antenatal Care ◽  
Rural Areas ◽  
Primary Outcome ◽  
Panel Study ◽  
First Trimester ◽  
Background Characteristics ◽  
Community Based ◽  
Level Of Education ◽  
Tailored Interventions ◽  
Partner Involvement

ObjectivesThe purposes of the study are; (A) to identify whether Ethiopian women’s antenatal care (ANC) visits are adequate and timely and (B) to explore factors that determine these.DesignPanel study design.SettingEthiopia.ParticipantsA total of 2855 women nested within 217 enumeration areas.Primary outcome measuresAdequacy and timeliness of ANC visits.ResultsOf all the 2855 respondents, 65% had made an ANC visit once, while 26.8% initiated ANC visits in a timely way and 43.3% attended adequate ANC visits. Rural residence (adjusted OR (AOR)=0.55, 95% CI: 0.36 to 0.84), attending higher level of education (AOR=2.64, 95% CI: 1.47 to 4.77), being multipara (AOR=0.53, 95% CI: 0.32 to 0.89) and encouragement by partners to attend clinic for ANC (AOR=1.98, 95% CI: 1.14 to 3.44) were significantly associated with timeliness of ANC visit. Similarly, residing in rural areas (AOR=0.20, 95% CI: 0.12 to 0.35), attending higher level of education (AOR=2.96, 95% CI: 1.38 to 6.15), encouragement by partners to attend clinic for ANC (AOR=2.11, 95% CI: 1.31 to 3.40) and timeliness of ANC visit (AOR=4.59, 95% CI: 2.93 to 7.21) were significantly associated with adequacy of ANC visits.ConclusionsA quarter of the pregnant women started ANC visits during the first trimester and nearly half attended adequate ANC visits with wider disparities across regions of their origin and their background characteristics. Concerted efforts on tailored interventions for rural residents, female education and partner involvement are recommended for early and adequate ANC visit(s).

scholarly journals Antenatal care booking within the first trimester of pregnancy and its associated factors among pregnant women residing in an urban area: a cross-sectional study in Debre Berhan town, Ethiopia

BMJ Open ◽  
2020 ◽  
Vol 10 (6) ◽  
pp. e032960 ◽  
Author(s):  
Tufa Kolola ◽  
Wogene Morka ◽  
Bayisa Abdissa
Keyword(s):  
Secondary School ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Associated Factors ◽  
First Trimester ◽  
School Level ◽  
Cross Sectional ◽  
Level Of Education ◽  
Debre Berhan ◽  
First Trimester Of Pregnancy

ObjectiveThis study aimed to assess antenatal care (ANC) booking within the first trimester of pregnancy and its associated factors among urban dwellers of pregnant women in Debre Berhan town, Ethiopia.DesignCross-sectional.SettingPublic and private health facilities that provide ANC services in Debre Berhan town.Outcome measureFirst ANC booking within the first trimester of pregnancy.ParticipantsUrban dwellers of pregnant women in Debre Berhan town (n=384).ResultsA total of 387 pregnant women in Debre Berhan town were selected for this study, of which 384 responded giving a response rate of 99.2%. The proportion of pregnant women who had ANC booking within the first trimester of pregnancy was 156 (40.6%; 95% CI: 35.8% to 45.6%). In the multivariable analysis, the odds of first ANC booking within the first trimester was higher among pregnant women who had secondary school (adjusted OR (AOR): 1.84; 95% CI: 1.10 to 3.19) and more than secondary level of education (AOR: 2.26; 95% CI: 1.27 to 4.03) compared with those who had less than a secondary school level of education. Pregnant women who have any ill health with their current pregnancy (AOR: 1.99; 95% CI: 1.21 to 3.27) were more likely to start booking within the first trimester than their counterparts. The odds of ANC booking within the first trimester was threefold higher among women with knowledge of ANC (AOR: 3.05; 95% CI: 1.52 to 6.11) compared with their counterparts.ConclusionFirst ANC booking within the first trimester was found to be low among urban dwellers of Debre Berhan town. Secondary school and more educational level, having ill health during early pregnancy and women’s knowledge about ANC services were statistically associated with ANC booking within the first trimester of pregnancy. Therefore, improving ANC booking according to the WHO recommendation requires due attention. Further qualitative research exploring why early ANC booking remains low among urban dwellers is important to design intervention modalities.

scholarly journals Model Prediksi Berat Lahir Bayi Berdasarkan Berat Badan Ibu Hamil

2013 ◽  
Vol 7 (8) ◽  
pp. 339
Author(s):  
Maulia Sari ◽  
Trini Sudiarti
Keyword(s):  
Weight Gain ◽  
Birth Weight ◽  
Antenatal Care ◽  
First Trimester ◽  
Power Relationship ◽  
Maternal Weight ◽  
Variable Effect ◽  
First Semester ◽  
Prepregnancy Weight ◽  
Moderate Power

Berat lahir bayi kurang dari 3.000 gram berisiko untuk terjadinya penyakit jantung dan stroke serta kematian yang tiga belas persen lebih tinggi daripada berat lahir lebih dari 3000 gram. Tujuan penelitian ini yaitu untuk mendapatkan model prediksi berat lahir dan mengetahui faktor yang paling berpengaruh terhadap berat lahir bayi. Desain penelitian menggunakan cohort retrospektif. Sampel melibatkan 233 ibu hamil beserta bayi yang melakukan pemeriksaan antenatal care dan melahirkan di Rumah Sakit Citra Medika dan bidan bersalin Hj. Sumartini dari bulan Januari 2010 sampai Desember 2011 di Rantauprapat. Data dikumpulkan dari data rekam medis dan kelahiran pasien. Analisis korelasi dan regresi linier ganda digunakan untuk mengetahui kekuatan dan arah hubungan antara variabel independen dengan berat lahir. Hasil penelitian menemukan rata-rata berat lahir 3.337,8 ± 353,7 gram (95% CI= 3.292 – 3.383). Berat badan (BB) sebelum hamil, pertambahan berat badan ibu trimester pertama, kedua, dan ketiga mempunyai kekuatan hubungan yang sedang dan berpola positif. Model prediksi menunjukkan bahwa berat lahir = 1.764,133 + 0,023 (BB pra hamil) + 0,131 (pertambahan berat badan trimester 1) + 0,037 (per- tambahan berat badan trimester 2) + 0,037 (pertambahan berat badan trimester 3). Variabel yang paling berpengaruh adalah pertambahan berat badan trimester pertama.Birth weight less 3,000 gram have more risk to cause heart and stroke disease, 13% higher than birth weight < 3,000 gram. This study described about the correlation between prepregnancy weight, first trimester weight gain, second trimester weight gain, third trimester weight gain with birth weight. This study aimed to predict birth weight and find out the factors that most influence on birth weight. This study used a retrospective cohort design. Samples were 233 pregnant women and infants who perform antenatal care and deliver in Citra Medika Hospital and midwife maternity from January 2010 to December 2011. The data were collected through patient medical record and birth data. Correlation analysis and multiple linear regression were used to determine the strength and the relationship direction between independent variables and birth weight. The results revealed the averages of birth weight in the hospital and maternity midwife are 3,337.8 ± 353.72 grams (95% CI: 3,292 – 3,383). Prepregnancy weight, maternal weight gain in first, second, and third semester have a moderate power relationship and positive pattern. The prediction model of birth weight = 1,764.133 + 0.023 (pre-pregnancy weight) + 0.131 (first semester weight gain) + 0.037 (second semester weight gain) + 0.037 (third semester weight gain). The most variable effect is a first semester weight gain.

Congenital Toxoplasmosis: Missed Opportunities for Diagnosis and Prevention

2020 ◽  
Author(s):  
Raquel Aitken Soares Mueller ◽  
Ana Cristina Cisne Frota ◽  
Daniela Durão Menna Barreto ◽  
Daniela Pires Ferreira Vivacqua ◽  
Gabriela Bueno Loria ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Congenital Toxoplasmosis ◽  
First Trimester ◽  
University Hospital ◽  
Serological Testing ◽  
Missed Opportunities ◽  
Clinic Appointment ◽  
History Of ◽  
Acute Toxoplasmosis ◽  
Made In

Abstract Objectives Identify missed opportunities for the prevention and early diagnosis of congenital toxoplasmosis (CT) in infants followed up in a reference center for pediatric infectious diseases (PID) in Rio de Janeiro between January 2007 and December 2016. Methods Descriptive study including infants with CT, diagnosis established based on Brazil’s Ministry of Health’s criteria. All data regarding the infants and their mother’s prenatal care were collected from the medical records of the Instituto de Puericultura e Pediatria Martagão Gesteira (IPPMG)—a tertiary public pediatric university hospital. The study enrolled infants aged between 0 and 12 months followed up in the PID department of IPPMG and with confirmed infection by Toxoplasma gondii in the period between January 2007 and December 2016. All patients with diagnosis of CT registered in the PID database of the IPPMG and admitted in the above-mentioned period were included in the study. Patients whose records were not available, or who went to just one clinic appointment were excluded. Results The obstetric history of all 44 women, whose infants (45) were diagnosed with CT, was analyzed. Their median age was 22 years. None had undergone preconception serological testing for toxoplasmosis. Only 20 (45%) of them started antenatal care during the first trimester of gestation, a total of 24 (55%) had more than six antenatal care visits, and 16% of those did not undergo serological testing for toxoplasmosis. None were adequately informed of preventive measures. The diagnosis of acute toxoplasmosis was made in 50% of these pregnancies but 32% of the women were not treated. Only 10 children of these mothers were adequately screened and treated at birth. Conclusion Despite the existence of national recommendations, several opportunities were missed to prevent CT during the antenatal period and to diagnose and treat this condition in the neonatal period.

scholarly journals Current status of antenatal care of pregnant women—8 provinces in China, 2018

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Wenling Hu ◽  
Huanqing Hu ◽  
Wei Zhao ◽  
Aiqun Huang ◽  
Qi Yang ◽  
...  
Keyword(s):  
Health Services ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Community Health ◽  
First Trimester ◽  
Community Health Services ◽  
Current Status ◽  
Categorical Variables ◽  
Chi Square ◽  
Prenatal Care Visit

Abstract Background Antenatal care (ANC) played a crucial role in ensuring maternal and child safety and reducing the risk of complications, disability, and death in mothers and their infants. The objective of this study was to evaluate the current status of ANC emphasizing the number, timing, and content of examinations on a national scale. Methods The data was collected from maternal and newborn’s health monitoring system at 8 provinces in China. After ethical approval, all pregnant women registered in the system at their first prenatal care visit, we included 49,084 pregnant women who had delivered between January 1, 2018 and December 31, 2018. Descriptive statistics of all study variables were calculated proportions and chi-square for categorical variables. Results Of the 49,084 women included in this study, the mean number of ANC visits was 6.95 ± 3.45. By percentage, 78.79% women received ANC examinations at least five times, 39.93% of the women received ANC examinations at least eight times and 16.66% of the women received ANC examinations at least 11 times. The proportion of first ANC examination in first trimester was 61.87%. The percentage of normative ANC examinations and the percentage of qualified ANC examinations were 30.98 and 8.03% respectively. Only 49.40% of the total women received all six kinds of examination items in first ANC examination: 91.47% received a blood test, 91.62% received a urine test, 81.56% received a liver function examination, 80.52% received a renal function examination, 79.07% received a blood glucose test, and 86.66% received a HIV/HBV/syphilis tests. 50.85% women received the first ANC examination in maternal and child health care (MCH) institutions, 14.07% in a general hospital, 18.83% in a township hospital, 13.15% in a community health services center, and 3.08% in an unspecified place. The proportion of women who received each of the ANC examination items in community health services center was the highest, but that in the MCH institutions was the lowest. Conclusions There is a big difference between the results of this study and the data in official reports, this study found the current status of antenatal care is not optimal in China, findings from this study suggest that the systematization, continuity and quality of ANC examinations need to be improved.

scholarly journals The impact of antenatal care on under‐five mortality in Ethiopia: a difference‐in‐differences analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Samuel Oduse ◽  
Temesgen Zewotir ◽  
Delia North
Keyword(s):  
Antenatal Care ◽  
Child Survival ◽  
First Trimester ◽  
Sub Saharan Africa ◽  
P Value ◽  
Difference In Differences ◽  
Under Five ◽  
Care Services ◽  
Sub Saharan ◽  
The Impact

Abstract Background Sub-Saharan Africa, as opposed to other regions, has the highest under-five mortality rates yet makes the least improvement in reducing under-five mortality. Despite the decline, Ethiopia is among the top ten countries contributing the most to global under-five mortalities. This article examines the impact of the number of antenatal care and the timing of first antenatal care on child health outcomes. We specifically investigated if the utilization of antenatal care services positively affects the reduction of under-five mortality. Methods We employ a difference-in-differences design with propensity score matching to identify direct causal effects of antenatal care on under-five mortality based on the Ethiopian Demographic Health Survey data of 2011 and 2016. Our sample includes 22 295 women between the ages of 14–49 who had antenatal care visits at different times before delivery. Results The study revealed 1 481 cases of reported under-five mortality. 99.0% of that under-five mortality cases are women who had less than eight antenatal care visits, while only 1% of that is by women who had eight or more antenatal care visits. Antenatal care visit decreases the likelihood of under-five mortality in Ethiopia by 45.2% (CI = 19.2–71.3%, P-value < 0.001) while the timing of first antenatal care within the first trimester decreases the likelihood of under-five mortality by 10% (CI = 5.7–15.6%, P-value < 0.001). Conclusions To achieve a significant reduction in the under-five mortality rate, Intervention programs that encourages more antenatal care visits should be considered. This will improve child survival and help in attaining Sustainable Development Goal targets.

Migrant Voices in the Polish Classroom: Canadian Literature on the Tertiary Level of Education

2019 ◽  
Vol 67 (4) ◽  
pp. 411-427
Author(s):  
Dagmara Drewniak
Keyword(s):  
Present Article ◽  
English Language ◽  
Tertiary Level ◽  
Mutual Understanding ◽  
Teaching English ◽  
Level Of Education ◽  
Canadian Literature ◽  
Cultural Heterogeneity ◽  
English Language Literature ◽  
Language Literature

Abstract This paper explores the possibilities of introducing contemporary Canadian texts into a Polish university classroom. It contextualizes teaching English language literature in Poland as well as seeks options for promoting values such as openness and tolerance while facilitating global reading and raising students’ awareness on global conflicts and their meaning in the contemporaneous world. The paper aims at demonstrating that Canadian literature courses composed of texts concerned with immigration and multiculturalism turn out to have an enormous potential in creating valuable debates on the problem of embracing otherness, seeking bridges in mutual understanding, and promoting openness towards different identities. On the basis of close readings of three texts, M. Ondaatje’s The English Patient, A.J. Borkowski’s Copernicus Avenue, and E. Stachniak’s Necessary Lies, the present article also demonstrates how Canadian literature enriches and rescales students’ perception of cultural heterogeneity and responsibility of reading, thus offering new perspectives on the rapidly changing world.

scholarly journals Determinants of Antenatal Care Attendance among Pregnant Women Living in Endemic Malaria Settings: Experience from the Democratic Republic of Congo

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Célestin Ndosimao Nsibu ◽  
Célestin Manianga ◽  
Serge Kapanga ◽  
Esther Mona ◽  
Philippe Pululu ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Pregnant Women ◽  
Democratic Republic ◽  
Democratic Republic Of Congo ◽  
Male Partner ◽  
First Trimester ◽  
Reproductive Age ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Republic Of Congo

Background. Antenatal care (ANC) attendance helps pregnant women to benefit from preventive and curative services.Methods. Determinants for ANC attendance were identified through a cross-sectional survey in the Democratic Republic of Congo. Sociocultural bottlenecks were assessed via focus groups discussion of married men and women.Results. In this survey, 28 of the 500 interviewed pregnant women (5.6%) did not attend ANC services and 82.4% booked over the first trimester. The first visit is positively influenced by the reproductive age (OR: 0.52, 95% CI(0.28–0.95),p<0.04), the educational level (OR: 0.41,95% CI(0.17–0.97),p<0.04), the nearby health center (OR: 0.43, 95% CI(0.2–0.92),p<0.03), and the presence of a male partner (OR: 10.48, 95% CI(2.1–52.23),p<0.001). The barriers to early booking were (i) the cost of service; (ii) the appearance or individual income; (iii) the geographical inaccessibility or distance to health facilities; (iv) social and religious prohibitions; (v) the stigmatization from other women when conceiving in the late ages or young or while still lactating (parity); (vi) the time for waiting for services.Conclusion. The early ANC attendance is delayed among poor women with little education and living alone.

scholarly journals Towards stronger antenatal care: Understanding predictors of late presentation to antenatal services and implications for obstetric risk management in Rwanda

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0256415
Author(s):  
Christina N. Schmidt ◽  
Elizabeth Butrick ◽  
Sabine Musange ◽  
Nathalie Mulindahabi ◽  
Dilys Walker
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Antenatal Care ◽  
Low Birthweight ◽  
Secondary Data ◽  
Neonatal Morbidity ◽  
Late Presentation ◽  
Health Centers ◽  
Logistic Regression Models ◽  
Pregnancy Testing

Background Early antenatal care (ANC) reduces maternal and neonatal morbidity and mortality through identification of pregnancy-related complications, yet 44% of Rwandan women present to ANC after 16 weeks gestational age (GA). The objective of this study was to identify factors associated with delayed initiation of ANC and describe differences in the obstetric risks identified at the first ANC visit (ANC-1) between women presenting early and late to care. Methods This secondary data analysis included 10,231 women presenting for ANC-1 across 18 health centers in Rwanda (May 2017-December 2018). Multivariable logistic regression models were constructed using backwards elimination to identify predictors of presentation to ANC at ≥16 and ≥24 weeks GA. Logistic regression was used to examine differences in obstetric risk factors identified at ANC-1 between women presenting before and after 16- and 24-weeks GA. Results Sixty-one percent of women presented to ANC at ≥16 weeks and 24.7% at ≥24 weeks GA, with a mean (SD) GA at presentation of 18.9 (6.9) weeks. Younger age (16 weeks: OR = 1.36, 95% CI: 1.06, 1.75; 24 weeks: OR = 1.33, 95% CI: 0.95, 1.85), higher parity (16 weeks: 1–4 births, OR = 1.55, 95% CI: 1.39, 1.72; five or more births, OR = 2.57, 95% CI: 2.17, 3.04; 24 weeks: 1–4 births, OR = 1.93, 95% CI: 1.78, 2.09; five or more births, OR = 3.20, 95% CI: 2.66, 3.85), lower educational attainment (16 weeks: primary, OR = 0.75, 95% CI: 0.65, 0.86; secondary, OR = 0.60, 95% CI: 0.47,0.76; university, OR = 0.48, 95% CI: 0.33, 0.70; 24 weeks: primary, OR = 0.64, 95% CI: 0.53, 0.77; secondary, OR = 0.43, 95% CI: 0.29, 0.63; university, OR = 0.12, 95% CI: 0.04, 0.32) and contributing to household income (16 weeks: OR = 1.78, 95% CI: 1.40, 2.25; 24 weeks: OR = 1.91, 95% CI: 1.42, 2.55) were associated with delayed ANC-1 (≥16 and ≥24 weeks GA). History of a spontaneous abortion (16 weeks: OR = 0.74, 95% CI: 0.66, 0.84; 24 weeks: OR = 0.70, 95% CI: 0.58, 0.84), pregnancy testing (16 weeks: OR = 0.48, 95% CI: 0.33, 0.71; 24 weeks: OR = 0.41, 95% CI: 0.27, 0.61; 24 weeks) and residing in the same district (16 weeks: OR = 1.55, 95% CI: 1.08, 2.22; 24 weeks: OR = 1.73, 95% CI: 1.04, 2.87) or catchment area (16 weeks: OR = 1.53, 95% CI: 1.05, 2.23; 24 weeks: OR = 1.84, 95% CI: 1.28, 2.66; 24 weeks) as the health facility were protective against delayed ANC-1. Women with a prior preterm (OR, 0.71, 95% CI, 0.53, 0.95) or low birthweight delivery (OR, 0.72, 95% CI, 0.55, 0.95) were less likely to initiate ANC after 16 weeks. Women with no obstetric history were more likely to present after 16 weeks GA (OR, 1.18, 95% CI, 1.06, 1.32). Conclusion This study identified multiple predictors of delayed ANC-1. Focusing existing Community Health Worker outreach efforts on the populations at greatest risk of delaying care and expanding access to home pregnancy testing may improve early care attendance. While women presenting late to care were less likely to present without an identified obstetric risk factor, lower than expected rates were identified in the study population overall. Health centers may benefit from provider training and standardized screening protocols to improve identification of obstetric risk factors at ANC-1.

Sign in / Sign up

Export Citation Format

Share Document