scholarly journals Factors Influencing Antenatal Care Utilization in the East Akim Municipality of Ghana

2020 ◽  
Author(s):  
Richard Dickson Amoako ◽  
Innocent Kwau Doku ◽  
Juliana Yartey Enos

Abstract Background Maternal and neonatal mortality rates continue to be high in sub-Saharan African countries, including Ghana. Timely and regular antenatal care (ANC) during pregnancy are essential for early identification and management of potential risk factors associated with poor pregnancy outcomes. The purpose of this study was to investigate the uptake of ANC services in the East Akim Municipality of Ghana and identify factors influencing ANC utilization. Methods A cross-sectional study which employed stratified sampling methodology to select 310 women in their reproductive ages (15–49 years) in East Akim Municipality was conducted. A structured questionnaire was used to examine the determinants of ANC utilization among respondents. Data was managed using Microsoft Excel 2016 and analysed using Stata version 14. Descriptive, bivariate and multivariable logistic regression analyses were performed. Results ANC attendance, at least once during pregnancy, was almost universal (98.4%) with 83.5% making 4 + visits. However, only 58% of respondents made early ANC visits in the first trimester and 61% attended all regularly scheduled visits. Employment status, distance to health facility and pregnancy intention were significantly associated with regular ANC attendance. Self-employed women were 2.4 times more likely to attend ANC regularly (AOR: 2.42, 95%CI :1.20–4.88) than the unemployed; those who lived < 5 km to a health facility were 3.2 times more likely to attend ANC regularly than those who lived > 10 km (AOR: 3.24, 95%CI: 1.20, 8.72); and women with intended pregnancies were 2.5 times more likely to attend all ANC scheduled visits than those with unintended pregnancies (AOR: 2.46, 95%CI: 1.32, 4.57). Conclusion Although ANC utilization in East Akim Municipality is high, socioeconomically disadvantaged women who were unemployed; lived more than 10 km from a health facility; and those with unintended pregnancies did not attend ANC early and regularly. Interventions to ensure equitable access to quality reproductive health services at the community level for all women, irrespective of their socioeconomic background, is needed to improve timely and regular ANC utilization. These include strengthening of community-based health centers, provision of ANC through outreach services to poor women in remote, hard-to-reach locations and improvements in the socioeconomic conditions in which people live.

Author(s):  
Atkure Defar ◽  
Yemisrach B. Okwaraji ◽  
Zemene Tigabu ◽  
Lars Åke Persson ◽  
Kassahun Alemu

Abstract Background Maternal and child health (MCH) care utilization often vary with geographic location. We analyzed the geographic distribution and determinants of utilization of four or more antenatal care visits, health facility delivery, child immunization, and care utilization for common childhood illnesses across four Ethiopian regions. Methods A cross-sectional community-based study was employed with two-staged stratified cluster sampling in 46 districts of Ethiopia. A total of 6321 women (13–49 years) and 3110 children below the age of 5 years residing in 5714 households were included. We performed a cluster analysis of the selected MCH care utilization using spatial autocorrelation. We identified district-specific relationships between care coverage and selected factors using geocoded district-level data and ordinary least squares and hotspot analysis using Getis Ord Gi*. Results Of the 6321women included in the study, 714 had a live birth in the 12 months before the survey. One-third of the women (30, 95% CI 26–34) had made four or more antenatal visits and almost half of the women (47, 95% CI 43–51) had delivered their most recent child at a health facility. Nearly half of the children (48, 95% CI 40–57) with common childhood illnesses (suspected pneumonia, diarrhoea, or fever) sought care at the health facilities. The proportion of fully immunized children was 41% (95%, CI 37–45). Institutional delivery was clustered at district level (spatial autocorrelation, Moron’s I = 0.217, P < 0.01). Full immunization coverage was also spatially clustered (Moron’s I = 0.156, P-value < 0.1). Four or more antenatal visits were associated with women’s age and parity, while the clustering of institutional delivery was associated with the number of antenatal care visits. Clustering of full immunization was associated with household members owning a mobile phone. Conclusions This study showed evidence for geographic clustering in coverage of health facility deliveries and immunization at the district level, but not in the utilization of antenatal care and utilization of health services for common childhood illnesses. Identifying and improving district-level factors that influenced these outcomes may inform efforts to achieve geographical equitability and universal health coverage.


2016 ◽  
Vol 5 (2) ◽  
pp. 134-145
Author(s):  
Eshetu Bekele Worku, PhD ◽  
Selamawit Alemu Woldesenbet, PhD

Background and Objectives: In resource-limited settings, the uptake of antenatal care visits among women, especially teenage pregnant women, is disturbingly low. Factors that infl uence the uptake of ANC services among teenage women is largely understudied and poorly understood in John Taolo Gaetsewe (JTG), a predominantly rural and poor district of South Africa. The aim of this study was to determine the factors that infl uence uptake of ANC services among teenage mothers in JTG district. Methods: A cross-sectional health facility-based study utilising mixed method was conducted in all public health facilities (n=44) at JTG district. Mother-infant pairs (n=383) who brought their infants for six-week first DPT immunisation during the study period were enrolled in the study. Structured questionnaires were used to collect data on demographic, socio-economic and uptake of ANC indicators. Results: Out of 272 respondent mothers, 18.68% were adolescent mothers (13-19 years). The logistic regression analysis shows that mother’s age (OR=2.11; 95%CI = 1.04 - 4.27); distance to the nearest health facility (OR=3.38; 95%CI = 1.45-7.87); and client service satisfaction (OR=8.58; 95%CI =2.10-34.95 are significantly associated with poor uptake of ANC services. Conclusion and Global Health Implications: There is a need to improve the quality of adolescent reproductive health services tailored to their health and developmental needs. Moreover, addressing the social determinants of health that affect individual’s healthy life style and health seeking behavior is critical. Key words: Antenatal Care Visits • Teenage Pregnancy • Social Determinants of Health • John Taolo Gaetsewe Copyright © 2016 Worku and Woldesenbet. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


2021 ◽  
Vol 12 ◽  
pp. 215013272199689
Author(s):  
Shewangizaw Hailemariam ◽  
Wubetu Agegnehu ◽  
Misganaw Derese

Introduction: Evidences suggest a significant decline in maternal health service uptake following the coronavirus disease 2019 (COVID-19) pandemic in Ethiopia. However, COVID-19 related factors impacting the service uptake are not sufficiently addressed. Hence, the current study was intended to explore COVID-19 related factors influencing antenatal care service uptake in rural Ethiopia. Methods: A community-based qualitative study was conducted from September 25/2020 to November 25/2020 among selected pregnant women residing in rural districts of Bench-Sheko Zone, and healthcare providers working in the local health care facilities. Six focus group discussions and 9 in-depth interviews were made between pregnant women, and health care providers, respectively. Data was collected by health education and behavioral science professionals who also have experience in qualitative data collection procedure. Data were transcribed, translated, and analyzed thematically using Open Code 4.0 software. Result: The study revealed several COVID-19 related factors influencing the uptake of antenatal care service during the pandemic. Health facility related barriers, perceived poor quality of care during the pandemic, government measures against COVID-19, anxiety related to the pandemic, and risk minimization were the identified factors possibly influencing the current antenatal care service uptake among women in rural Bench-Sheko Zone. Conclusion: COVID-19 preventive measures, and health facility related factors and individual factors were responsible for the current decline in antenatal care service uptake. Preserving essential health care service is critical to prevent avoidable losses of maternal and child lives during the pandemic period. Hence, programs and strategies designed to maintain maternal health services particularly, antenatal care service have better take the above determinants into consideration.


2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Célestin Ndosimao Nsibu ◽  
Célestin Manianga ◽  
Serge Kapanga ◽  
Esther Mona ◽  
Philippe Pululu ◽  
...  

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.


2017 ◽  
Vol 17 (3) ◽  
pp. 1-14
Author(s):  
Seham Othman ◽  
Taha Almahbashi ◽  
Alabed Ali A. Alabed

Antenatal care is a vital part of primary healthcare that is known to improve maternal and newborn outcomes. The aim of this study was to identify the factors affecting utilization of antenatal care services for women in reproductive age in Yemen. This cross-sectional community-based study was conducted in six districts of Sana’a City, Yemen. Data were collected from 460 mothers who gave birth in the past six months via face-to-face interviews at home between September to December 2010. Only 54% of mothers were found to have made four or more antenatal care visits. Almost two third of participants made their first visit during their first trimester due to presence of health problems and did not follow up when they became healthy during pregnancy. Reasons for not receiving antenatal care services due to absence of health problems, high cost of antenatal care services, long waiting time, and poor staff attitude. Sixty percent of participants were unaware of the danger symptoms of common health problems in pregnancy. The significant factors affecting utilization of antenatal services were mother education, residence place, age at first pregnancy, gravida, parity, occurrence of pregnancy without planning, and number of live children (P<0.05). The factors affecting the number of visits were mother education, place of residence, and husband work were (P<0.05). Future healthcare activities should focus on improving women’s awareness of the importance of antenatal care even in the absence of noticeable health problems and lack of education about the common danger signs and symptoms of pregnancy.


2019 ◽  
Author(s):  
James Orwa ◽  
Michaela Mantel ◽  
Micheal Mugerwa ◽  
Sharon Brownie ◽  
Eunice Siaity Pallangyo ◽  
...  

Abstract Background: Improving maternal health by reducing maternal mortality/morbidity relates to Goal 3 of the Sustainable Development Goals. Achieving this goal is supported by antenatal care (ANC), health facility delivery, and postpartum care. This study aimed to understand levels of use and correlates of uptake of maternal healthcare services among women of reproductive age (15–49 years) in Mwanza Region, Tanzania. Methods: A cross-sectional multi-stage sampling household survey was conducted to obtain data from 1476 households in six districts of Mwanza Region. Data for the 409 women who delivered in the 2 years before the survey were analyzed for three outcomes: four or more ANC visits (ANC4+), health facility delivery, and postpartum visits. Factors associated with the three outcomes were determined using generalized estimating equations to account for clustering at the district level while adjusting for all variables. Results: Of the 409 eligible women, 58.2% attended ANC4+, 76.8% delivered in a health facility, and 43.5% attended a postpartum clinic. Women from peri-urban, island, and rural regions were less likely to have completed ANC4+ or health facility delivery compared with urban women. Education and early first antenatal visit were associated with ANC4+ and health facility delivery. Mothers from peri-urban areas and those who with health facility delivery were more likely to attend postpartum check-ups. Conclusion: Use of ANC services in early pregnancy influences the number of ANC visits, leading to higher uptake of ANC4+ and health facility delivery. Postpartum check-ups for mothers and newborns are associated with health facility delivery. Encouraging early initiation of ANC visits may increase the uptake of maternal healthcare services. Keywords: Antenatal care, health facility delivery, postpartum care, Mwanza, Tanzania


2021 ◽  
Vol 9 (01) ◽  
pp. 74-86
Author(s):  
Sharmila Pokharel ◽  
Ram Krishna Maharjan

Antenatal care is one of the most effective measures to reduce maternal mortality in Lower Middle-income Countries. The study aims to assess the utilization of antenatal care and related factors by breastfeeding mothers in Chitwan district of Nepal. A cross-sectional study was carried out in Bharatpur municipality in April 2020, among all women of the reproductive age group (15-49) who have had a birth child in the last 12 months before the survey date. A census sampling technique was used to select respondents. The vaccination period was two weeks. All the mothers who came to the vaccine center to vaccinate their children were the respondents of this study. The data were collected by using an interview schedule. The collected data were managed using SPSS Version 20. The study found that 84.31 percent of respondents attended more than four antenatal care utilization. The educational level of the respondents and the occupation of their partners were linked to the use of antenatal care. The number of pregnancies, the number of live births, the place of delivery, and the educational level and occupations of the birth attendees were also significantly linked to the use of antenatal care. Community mobilization and intensive use of community health workers are essential factors to improve the use of antenatal care.


Author(s):  
Cesar Tello-Torres ◽  
Akram Hernández-Vásquez ◽  
Karla F. Dongo ◽  
Rodrigo Vargas-Fernández ◽  
Guido Bendezu-Quispe

Abstract Objective To determine the adequacy of compliance with antenatal care (ANC) by pregnant women in Peru and to identify the associated factors. Methods An analytical cross-sectional study of data from the 2019 Peruvian Demographic and Family Health Survey (Encuesta Demográfica y de Salud Familiar, ENDES, in Spanish) was conducted. The dependent variable was adequate compliance with ANC (provided by skilled health care professionals; first ANC visit during the first trimester of pregnancy; six or more ANC visits during pregnancy; ANC visits with appropriate content) by women aged 15 to 49 years in their last delivery within the five years prior to the survey. Crude and adjusted prevalence ratios and their 95% confidence intervals were calculated using a log-binomial regression model. Results A total of 18,386 women were analyzed, 35.0% of whom adequately complied with ANC. The lowest proportion of compliance was found with the content of ANC (42.6%). Sociodemographic factors and those related to pregnancy, such as being in the age groups of 20 to 34 years and 35 to 49 years, having secondary or higher education, belonging to a wealth quintile of the population other than the poorest, being from the Amazon region, not being of native ethnicity, having a second or third pregnancy, and having a desired pregnancy, increased the probability of presenting adequate compliance with ANC. Conclusion Only 3 out of 10 women in Peru showed adequate compliance with ANC. Compliance with the content of ANC must be improved, and strategies must be developed to increase the proportion of adequate compliance with ANC.


2020 ◽  
Author(s):  
◽  
Angella Nakimera

Abstract Background: A study was carried out to identify the factors influencing the utilization of ultrasound scan services among pregnant mothers at Ndejje Health Centre IV, Wakiso District. Methodology: The study design was descriptive and cross-sectional and it employed both quantitative and qualitative data collection methods. A sample size of 30 respondents was selected using a simple random sampling procedure. An interview guide was used to collect data. Results: The study revealed various factors influencing the utilization of ultrasound scan services among pregnant mothers. For example, although all 30 (100%) had ever heard about ultrasound scan services, most 20 (66.7%) had ever used ultrasound scan services once 10 (50%) and 12 (60%) used the services in the 3rd trimester due to factors including 20 (66.7%) of ultrasound scan services, 21 (70%) having fears about using ultrasound scan services including 14 (66.7%) fear that the scan would identify bad conditions on the baby, 18 (60%) lacked partner support. The study results also revealed that respondents faced various health facility factors which influenced the utilization of ultrasound scan services. For example, most 20 (66.7%) respondents reported that Ndejje Health Centre IV was not equipped to provide ultrasound scan services due to 12 (60%) frequent breakdown and poor maintenance of equipment which led to 18 (60%) ultrasound scan services not being readily available, 12 (60%) long waiting time to receive services as most waited more than 2 hours to receive services. Conclusion and recommendations: Respondents faced various and health facility-related factors which influenced their utilization of ultrasound scan services. The key recommendations included ready availability of services through regular and timely maintenance of equipment, improving efficiency, and reducing waiting time as well as improved health education of mothers about the importance of using the services.


2019 ◽  
Author(s):  
Ruth Atuhaire

Abstract Background Maternal health care and treatment services have a bearing on maternal mortality. Direct and Indirect factors affecting Maternal health outcomes therefore require understanding to enable well targeted interventions. This study, therefore, assessed the interrelationships between early antenatal care, health facility delivery and early postnatal care.Methods We investigated Maternal Health services using utilizing Antenatal care (ANC) within three months of pregnancy, Health facility delivery and utilizing postnatal care (PNC) within 48 hours after childbirth. The 2016 Uganda Demographic and Health Survey data was used. During analysis, a Generalized Structural Equation Model using logistic link and binomial family option was used. The interrelated (Endogenous) outcomes were timely ANC, health facility delivery and timely PNC.Results Timely ANC (aOR=1.04; 95% CI=0.95-1.14) and(aOR=1.1; 95% CI=1.00-1.26) was directly related to increased odds of health facility delivery and timely PNC respectively. Factors that increased the odds of timely ANC as a mediating factor for health facility delivery and timely PNC were women age 35-39 (aOR=1.18; 95% CI=0.99-1.24) compared to women age 15-19, completing primary seven (aOR=1.68; 95% CI=1.58-1.81) compared to some primary, available health workers (aOR=1.06; 95% CI=0.97-1.18), complications (aOR=2.04; 95% CI=1.89-2.26) and desire for pregnancy(aOR=1.15; 95% CI=1.03-1.36). Factors that reduced the odds of timely ANC were being married (aOR=0.93; 95% CI=0.89-1.20), distance and cost of service being problematic (aOR=0.97; 95% CI=0.85-1.1) (aOR=0.5; 95% CI=0.37-0.82) respectively. Factors that significantly influenced health facility delivery through timely ANC were; unmarried (OR=1.03; (=1.04*0.99)), distance being problematic ((aOR=1.0; (=1.04*0.97)) and complications (aOR=2.02; (=1.04*1.94)). Factors that significantly influenced timely PNC through timely ANC were; women age 35-39 (aOR=1.3; (=1.18*1.1)) compared to 15-19, completing primary seven (aOR=1.68; (=1.68*1.1))compared to some primary and service cost being problematic (aOR=0.55; (=0.5*1.1)). Surprisingly, health facility delivery was not statistically significant as a mediator for timely PNC.Conclusion Attending antenatal care within first trimester was a mediating factor for health facility delivery and early postnatal care. Interventions in maternal health should focus on factors that increase antenatal care first trimester attendance in resource limited settings. Furthermore, Government should reduce on costs of attaining all maternal health services and emphasize girl education completion.


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