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

Author(s):  
Mastewal Arefaynie ◽  
Bereket Kefale ◽  
Melaku Yalew ◽  
Bezawit Adane ◽  
Reta Dewau ◽  
...  

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.


2020 ◽  
Author(s):  
Berhanu Woldeamanuel ◽  
Tadesse Belachew

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.



PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0255079
Author(s):  
Adane Nigusie ◽  
Telake Azale ◽  
Mezgebu Yitayal ◽  
Lemma Derseh

Introduction Institutional delivery has been considered as one of the important strategies to improve maternal and child health and significantly reduces birth-related complications. However, it is still low in developing countries though there are some improvements. Hence, the aim of this study was to assess the prevalence of institutional delivery and associated factors in the study area. Methods A community-based cross-sectional study was conducted. A multistage systematic sampling technique was used to select 1,394 study participants. We collected data from 18–48 years old women by using a structured questionnaire. Binary logistic regression was performed to identify factors at 95% confidence level. Results The mean age of respondents was 30 (±0.15). The wealth status of 33.48% respondents was poor and 33.33% rich. The prevalence of institutional delivery was 58.17% (95% CI: 55.57%, 60.77%). Multivariable logistic regression showed that demographic factors: women age (≥35years) (AOR = 1.43; 95% CI 1.04, 1.96), having a family size of less than five (AOR = 4.61; 95% CI 3.34, 6.34), having family discussion (AOR = 4.05; 95% CI 2.74, 5.97), distance from the nearby clinic (≤30min) (AOR = 2.92; 95% CI 1.53, 5.58) and decision power about place of delivery (AOR = 2.50; 95% CI 1.56, 4.01); socio-economic factors: husband’s educational status of primary school (AOR = 1.64; 95% CI 1.19, 2.24), middle level household wealth index (AOR = 1.78; 95% CI 1.25, 2.54) and rich level household wealth index (AOR = 2.01; 95% CI 1.42, 2.86); and programmatic factors: antenatal care visit during their recent pregnancy (AOR = 1.86;95% CI 1.16, 2.97) were affects institutional delivery positively. Whereas bad behavior of health workers (AOR = 0.27; 95% CI 0.19, 0.39) negatively affects institutional delivery. Conclusion Institutional delivery was low in the study area. This study implies that strengthening family discussion and up taking antenatal care services in regular ways are a few of the suggested recommendations.



2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Berhanu Teshome Woldeamanuel ◽  
Tadesse Ayele Belachew

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.



2019 ◽  
Author(s):  
Agung Dwi Laksono ◽  
Rukmini Rukmini ◽  
Ratna Dwi Wulandari

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.



BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e047835
Author(s):  
Adeniyi Francis Fagbamigbe ◽  
Olugbenga Olaseinde ◽  
Omon Stellamaris Fagbamigbe

ObjectivesTo assess the compliance of WHO guidelines on the timeliness of antenatal care (ANC) initiation in Nigeria and its associated factors and to provide subcountry analysis of disparities in the timing of the first ANC in Nigeria.DesignCross-sectional.SettingNationally representative data of most recent pregnancies between 2013 and 2018 in Nigeria.ParticipantsWomen with pregnancies within 5 years before the study.Primary and secondary outcome measuresThe outcome variable was the trimesters of the first ANC contact. Data were analysed using descriptive statistics, bivariable and multivariable multinomial logistic regression at 5% significance level.ResultsOf all the 21 785 respondents, 75% had at least one ANC contact during their most recent pregnancies within the five years preceding the data collection. Among which 24% and 63% started in the first and second trimester, respectively. The proportion who started ANC in the first trimester was highest in Benue (44.5%), Lagos (41.4%) and Nasarawa (39.3%) and lowest in Zamfara (7.6%), Kano (7.4%) and Sokoto (4.8%). Respondents aged 40–49 years were 65% (adjusted relative risk ratio (aRRR: 1.65, 95 % CI: 1.10 to 2.45) more likely to initiate ANC during the first trimester of pregnancy relative to those aged 15–19 years. Although insignificant, women who participate in their healthcare utilisation were 4% (aRRR: 1.04, 95 % CI: 0.90 to 1.20) times more likely to have early initiation of ANC. Other significant factors were respondents’ and spousal educational attainment, household wealth quintiles, region of residence, ethnicity, religion and birth order.ConclusionsOnly a quarter of pregnant women, initiated ANC contact during the first trimester with wider disparities across the states in Nigeria and across the background characteristics of the pregnant women. There are needs to enhance women’s autonomy in healthcare utilisation. Concerted efforts on awareness creation and empowerment for women by all stakeholders in maternal and child healthcare are antidotes for early ANC contact initiation.



2021 ◽  
Author(s):  
Samuel Hailegebreal ◽  
Girma Gilano ◽  
Binyam Tariku Seboka ◽  
Mohammedjud Hassen Ahmed ◽  
Atsedu Endale Simegn

Abstract Background: Antenatal care utilization key to reduces pregnant women death and preparing women for birth. In Ethiopian antenatal care utilization was still not meet health sector transformation plan. There was also regional variation of antenatal care services in the country. Therefore, current study was aimed to explore spatial distribution and associated factors of antenatal care utilization in Ethiopia based on the nationally representative EMDHS data.Methods: Secondary data analysis was done on 2019 Ethiopian mini demographic and health survey (EMDHS) data. ArcGIS 10.7 statistical software were used for spatial analysis. Bernoulli model was fitted by applying Kulldorff methods using the StatsCan 9.6.1 software to analyze the purely spatial clusters of ANC utilization. For associated factor mixed effect multilevel logistic regression was fitted. Inter class correlation (ICC), Median odds ratio (MOR), proportional change variance (PVC) and Deviance used for model comparison and fitness. Adjusted odds ratio (AOR) with 95% confidence interval (CI) was used to declare significant factors of antenatal care utilization.Results: The prevalence of antenatal care utilization in Ethiopia was 75% [95 CI: 73%, 76%] in this study. The spatial distribution of antenatal car utilization was non-random across the country with Global Moran’s Index value of 0.032, and significant P-value(p<0.05). For associated factor secondary and higher education were 4.2 and 6 time greater than that of no formal education women with AOR of 4.2(1.99-8.66) and 6 (1.62-22) respectively. The odds of richest households were 4.2 times AOR (1.08-2.3) and the odds of married, windowed, and divorced women were 6, 8 and 4.4 time more that of single women respectively in utilizing ANC. The odd of women utilizing ANC was 4.2 times AOR (6.25-10.62). Conclusion: The spatial distribution of ANC utilization in Ethiopia is non-random. Maternal education, marital status, wealth index, place of delivery, pregnancy status region and community women education were significant predicter of antenatal care utilization in Ethiopia. Government and non-governmental organization should scale up maternal health services to low-rate area(hotspot) and poorest women.



2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Teshager Weldegiorgis Abate ◽  
Biruk Getahun ◽  
Mekuriaw Mesfin Birhan ◽  
Getasew Mulatu Aknaw ◽  
Sefealem Assefa Belay ◽  
...  

Abstract Background Anemia is more prevalent among women, and it is a moderate public health problem in Ethiopia. The wealth status and place of residence of a woman have implications on the intervention of anemia. Studies that examined the relationship between women’s wealth index status and residency in Ethiopia are scarce. We aimed to identify the urban–rural differential in the association between household wealth index and anemia among women of childbearing age in Ethiopia. Method A cross-sectional design was employed with a nationally representative sample of 14,100 women aged 15–49-year-old from the Ethiopian demographic and health survey conducted in 2016. We used the two-stage sampling method to select the sample size. The primary outcome was anemia in women of childbearing age. A hemoglobin level of below 11 g/dl for pregnant women and 12 g/dl for non-pregnant women was the indicator of anemia. Using a three-level random intercept model to explore associated factors at the individual and household levels quantified the observed and unobserved variations between household wealth index and residence on anemia. Results Women belonging to a lower household wealth index category were more anemic (29.6%) than those middle and above wealth index categories. Women who lived in rural areas (25.5%) were prone to anemia than those who lived in urban areas (17.5%). The odds of anemia were significantly higher in women of the low household wealth category who living in rural compared to women of the middle and above household wealth category who living in urban (AOR = 1.37, 95% CI 1.14–1.65, P < 0.001). Conclusion In this study, anemia is more common among women who live in rural with the low house wealth category. Therefore, novel public health interventions should target women who live in rural areas with the lowest household wealth status.



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