scholarly journals Determinants of Optimal Antenatal Care Visit Among Pregnant Women in Ethiopia: a Multilevel Analysis of Ethiopian Mini Demographic Health Survey 2019 Data

2021 ◽  
Author(s):  
Delelegn Emwodew Yehualashet ◽  
Binyam Tariku Seboka ◽  
Getanew Aschalew Tesfa ◽  
Tizalegn Tesfaye Mamo ◽  
Elias Seid
Keyword(s):  
Antenatal Care ◽  
Pregnant Women ◽  
Health Survey ◽  
Rural Women ◽  
Urban Areas ◽  
Formal Education ◽  
Educational Interventions ◽  
World Health ◽  
Wealth Status ◽  
Factors Associated

Abstract Background: Optimal antenatal care (ANC4 +) needs to be used throughout pregnancy to reduce pregnancy complications and maternal mortality. The World Health Organization (WHO) recommends eight ANC contacts, while Ethiopia has the lowest coverage of at least four ANC visits. Therefore, this study aimed to identify factors associated with optimal ANC visits among pregnant women in Ethiopia. Methods: This study is a secondary data analysis of the 2019 Ethiopian Mini Demographic and Health Survey (EMDHS). A multilevel logistic regression model is set up to identify factors associated with optimal ANC visits. Adjusted odds ratios (AOR) with 95% confidence intervals (CI) were calculated to estimate the strength of the association between the outcome and the predictor variables. Results: Overall, 43% of women had optimal ANC visits during their last pregnancy. Higher educated women are 3.99 times more likely (AOR = 3.99; 95% CI: 2.62-6.02) to have optimal ANC visits than women with no formal education. The wealthiest women are 2.09 times more likely (AOR = 2.09; 95% CI: 1.56-2.82) to have optimal ANC visits than women in the poorest quintile. The odds of optimal ANC visit is 42 percent lower in rural women (AOR = 0.58, 95% CI: 0.41-0.83) compared to women living in urban areas. Conclusion: Women's educational status, wealth status, mass media exposure, place of residence and region are factors that are significantly associated with optimal ANC visit. These findings help health care programmers and policymakers to introduce appropriate policies and programs to ensure optimal ANC coverage. Priority should be given to addressing economic and educational interventions.

scholarly journals Country compliance with WHO-recommended antenatal care guidelines: equity analysis of the 2015–2016 Demography and Health Survey in Myanmar

2020 ◽  
Vol 5 (12) ◽  
pp. e002169
Author(s):  
Ngatho Samuel Mugo ◽  
Kyaw Swa Mya ◽  
Camille Raynes-Greenow
Keyword(s):  
Antenatal Care ◽  
Pregnant Women ◽  
Adolescent Mothers ◽  
Health Survey ◽  
Rural Areas ◽  
Urban Areas ◽  
Multinomial Logistic Regression ◽  
Wealth Quintile ◽  
Adjusted Risk ◽  
Factors Associated

IntroductionEarly access to adequate antenatal care (ANC) from skilled providers is crucial for detecting and preventing obstetric complications of pregnancy. We aimed to assess factors associated with the utilisation of the new WHO ANC guidelines including the recommended number, on time initiation and adequate components of ANC contacts in Myanmar.MethodsWe examined data from 2943 mothers aged 15–49 years whose most recent birth occurred in the last 5 years prior to the 2015–2016 Myanmar Demographic and Health Survey. Factors associated with utilisation of the new WHO recommended ANC were explored using multinomial logistic regression and multivariate models. We used marginal standardisation methods to estimate the predicted probabilities of the factors significantly associated with the three measures of ANC.ResultsApproximately 18% of mothers met the new WHO recommended number of eight ANC contacts. About 58% of the mothers received adequate ANC components, and 47% initiated ANC within the first trimester of pregnancy. The predicted model shows that Myanmar could achieve 70% coverage of adequate components of ANC if all women were living in urban areas. Similarly, if ANC was through private health facilities, 63% would achieve adequate components of ANC. Pregnant women from urban areas (adjusted risk ratio (aRR): 4.86, 95% CI 2.44 to 9.68) were more than four times more likely to have adequate ANC components compared with women from rural areas. Pregnant women in the highest wealth quintile were three times more likely to receive eight or more ANC contacts (aRR: 3.20, 95% CI 1.61 to 6.36) relative to mothers from the lowest wealth quintile. On time initiation of the first ANC contact was fourfold for mothers aged 30–39 years relative to adolescent mothers (aRR: 4.07, 95% CI 1.53 to 10.84).ConclusionThe 2016 WHO ANC target is not yet being met by the majority of women in Myanmar. Our results highlight the need to address health access inequity for women who are from lower socioeconomic groups, or are younger, and those living in rural areas.

Prevalence and factors associated with anemia in pregnancy among women receiving antenatal care at the West Gonja District Hospital of Northern Ghana.

2020 ◽  
Vol 4 (3) ◽  
pp. 01-12
Author(s):  
Martin Malick
Keyword(s):  
Antenatal Care ◽  
Pregnant Women ◽  
Hemoglobin Concentration ◽  
World Health ◽  
Multiple Gestation ◽  
The West ◽  
Factors Associated ◽  
Folate Supplement ◽  
Anemia In Pregnancy ◽  
In Pregnancy

Background: Anemia in pregnancy is a major public health problem especially in Low and Middle-income countries (LMIC) including Ghana and is defined by the World Health Organization (WHO) as being present when the hemoglobin concentration in the peripheral blood is 11g/dl or less. In most African countries anemia in pregnancy occurs if the hemoglobin concentration falls below 10g/dl. Pregnant women are at a higher risk of developing anemia due to several factors such as hemodilution, nutritional factors, multiple gestation, socio-economic status and malaria infestation. Anemia in pregnancy is an important cause of maternal mortality and affects half of pregnant women worldwide; with 56% of West African pregnant women being anemic. The objective of this study is to assess the prevalence and identify the risk factors associated with anemia among pregnant women receiving antenatal care at the West Gonja Hospital (WGH) Methods: A cross-sectional was conducted with 136 pregnant women receiving antenatal care at the WGH between January 2017 to February 2018. Random sampling was used to select participants and data was collected using a structured questionnaire. Data was analyzed using the SPSS Version 24.0. Results: A total 71(52.2%) of the study population were anemic, while 65 (47.8%) were not anemic. 20(74.1%) of the 27 pregnant housewives were anemic, while 11(64.7%) of the pregnant farmers were anemic. 27 (96.4%) of the 28 pregnant women who took their iron/folate supplement only some few days were anemic. 12 (100%) of the 12 participants who took their iron/folate supplement a few times a week were anemic. 4 (80%) of the 5 participants who never took their iron/folate supplement were anemic. 21 (70%) of those who did not sleep under ITN were anemic. 33 (84.6%) of the 39 patients who were diagnosed with malaria were also anemic. 28 (87.5%) of the 32 participants who took only 2 meals a day were anemic. 27 (79.4%) of the 34 patients who took liver, beef, chicken and fish only twice weekly were anemic. 15 (88.2%) of the 17 patients who drank tea some days in a week were anemic. Conclusion: Although most of the pregnant women were adequately educated on the most relevant aspects of anemia in pregnancy, more than half of them were still anemic. Anemia was more prevalent among pregnant uneducated housewives with poor nutritional habits. All the pregnant sickle cell disease patients as well as those diagnosed with malaria were also anemic.

scholarly journals Predictors of home births among rural women in Ghana: analysis of data from the 2014 Ghana Demographic and Health Survey

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Eugene Budu
Keyword(s):  
Maternal Health ◽  
Health Survey ◽  
Rural Women ◽  
Rural Areas ◽  
Statistical Significance ◽  
Northern Region ◽  
Demographic And Health Survey ◽  
Wealth Status ◽  
Home Births ◽  
Factors Associated

Abstract Background Home births is one of the factors associated with maternal mortality. This study examined the predictors of home births among rural women in Ghana. Methods Data for this study was obtained from the 2014 Demographic and Health Survey (DHS) of Ghana. For the purpose of this study, a sample size of 2,101 women in the rural areas who had given birth within five years prior to the survey and had responses on variables was considered. Data processing, management and analysis were carried out using STATA version 14.0. This study carried out bivariate and multivariate analyses and results were tested at 95% confidence interval. The Adjusted odds ratios were used to present the results and the level of statistical significance was assessed using 95% confidence intervals. Results Home births was found to be high among women who resided in the Northern region compared to those in the Western region [AOR, 1.81 CI = 1.10–2.98]. Similarly, the likelihood of home birth was high among women with four or more births [AOR, 1.46 CI = 1.03–2.05] and Traditionalists [AOR, 2.50 CI = 1.54–4.06]. Conversely, giving birth at home was low among women with higher level of education [AOR = 0.58, CI = 0.43–0.78], those with rich wealth status [AOR = 0.19, CI = 0.10–0.38], those with four or more ANC visits [AOR = 0.11, CI = 0.15–0.23] and those who were covered by NHIS [AOR = 0.58, CI = 0.46–0.72]. Conclusions Over the years, there have been efforts by governments in Ghana to make maternal health services free in the country. However, a substantial proportion of women still undergo home births. To reduce the utilization of home births in Ghana, it is essential that government and non-governmental organisations make the cost of delivery services part of the free maternal health care policy and take into consideration the factors associated with the high rates of home births among rural women in Ghana.

scholarly journals What influences home delivery among women who live in urban areas? Analysis of 2014 Ghana Demographic and Health Survey data

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0244811
Author(s):  
Bright Opoku Ahinkorah ◽  
Abdul-Aziz Seidu ◽  
Eugene Budu ◽  
Ebenezer Agbaglo ◽  
Francis Appiah ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Health Survey ◽  
Rural Areas ◽  
Urban Areas ◽  
Wealth Quintile ◽  
Home Delivery ◽  
Northern Region ◽  
Demographic And Health Survey ◽  
Factors Associated ◽  
At Home

Background In Ghana, home delivery among women in urban areas is relatively low compared to rural areas. However, the few women who deliver at home in urban areas still face enormous risk of infections and death, just like those in rural areas. The present study investigated the factors associated with home delivery among women who live in urban areas in Ghana. Materials and methods Data for this study was obtained from the 2014 Ghana Demographic and Health Survey. We used data of 1,441 women who gave birth in the 5 years preceding the survey and were dwelling in urban areas. By the use of Stata version 14.2, we conducted both descriptive and multivariable logistic regression analyses. Results We found that 7.9% of women in urban areas in Ghana delivered at home. The study revealed that, compared to women who lived in the Northern region, women who lived in the Brong Ahafo region [AOR = 0.38, CI = 0.17–0.84] were less likely to deliver at home. The likelihood of home delivery was high among women in the poorest wealth quintile [AOR = 2.02, CI = 1.06–3.86], women who professed other religions [AOR = 3.45; CI = 1.53–7.81], and those who had no antenatal care visits [AOR = 7.17; 1.64–31.3]. Conversely, the likelihood of home delivery was lower among women who had attained secondary/higher education [AOR = 0.30; 0.17–0.53], compared to those with no formal education. Conclusion The study identified region of residence, wealth quintile, religion, antenatal care visits, and level of education as factors associated with home delivery among urban residents in Ghana. Therefore, health promotion programs targeted at home delivery need to focus on these factors. We also recommend that a qualitative study should be conducted to investigate the factors responsible for the differences in home delivery in terms of region, as the present study could not do so.

scholarly journals Prevalence and factors associated with late antenatal care visit among pregnant women in Lushoto, Tanzania

2017 ◽  
Vol 19 (3) ◽  
Author(s):  
Flora Njiku ◽  
Herman Wella ◽  
Adellah Sariah ◽  
Joyce Protas
Keyword(s):  
Antenatal Care ◽  
Pregnant Women ◽  
Health Care Services ◽  
First Trimester ◽  
Antenatal Clinic ◽  
World Health ◽  
P Value ◽  
Cross Sectional ◽  
Factors Associated ◽  
Care Services

Background: Adequate utilization of antenatal health care services is associated with improved maternal and neonatal health outcomes. The World Health Organization recommends pregnant women to attend antenatal care services as early as in the first trimester. However, many women due to various reasons fail to meet the recommendations. The objective of this study was to determine the prevalence and factors associated with late antenatal booking among pregnant women in Lushoto district of north-eastern Tanzania.Methods: This hospital based cross sectional study involved pregnant women and was conducted in August-September 2015. A standardized questionnaire was used to obtain participants demographic characteristics and obstetrics history. Data analysis was done using (SPSS) and relationship between outcome variables and exposure variable was done using Chi-square test. Multivariate logistic regression was used to measure the association.Results: A total of 240 participants were involved in the study.  Out of these, 169 (70.4%) participants booked late for antenatal care (ANC) services. Delayed booking was mainly associated with not being married (AOR=3.08; 95%CI 1.149-8.275; P value=0.025) and unemployment (AOR=4.28; 95% CI 2.11-8.679; p-value=0.000)Conclusion:  Late first antenatal clinic visit was high in Lushoto, and was highly associated with unmarried and unemployment status. Therefore, provision of continuous health education and community sensitization on the importance of timely seeking ANC services should be strengthened.

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 Factors Associated With Uptake of Iron Supplement During Pregnancy Among Women of Reproductive Age in Tanzania: an Analysis of Data From the 2015 to 2016 Tanzania Demographic and Health Survey and Malaria Indicators Survey

2021 ◽  
Vol 9 ◽  
Author(s):  
Fabiola Vincent Moshi ◽  
Walter C. Millanzi ◽  
Ipyana Mwampagatwa
Keyword(s):  
Pregnant Women ◽  
Health Survey ◽  
Formal Education ◽  
Reference Population ◽  
Demographic And Health Survey ◽  
Reproductive Age ◽  
Free Access ◽  
Iron Supplement ◽  
Factors Associated ◽  
Working Status

Background: Pregnant women are vulnerable to iron deficiency due to the fact that more iron is needed primarily to supply the growing fetus and placenta and to increase the maternal red cell mass. Little is known on the factors associated with uptake of iron supplement during pregnancy.Methods: The study used data from the 2015 to 2016 Tanzania Demographic and Health Survey and Malaria Indicators Survey. A total of 6,924 women of active reproductive age from 15 to 49 were included in the analysis. Both univariate and multiple regression analyses were used to determine factors associated with uptake of iron supplement during pregnancy.Results: Majority of the interviewed women 5,648 (81.6%) always took iron supplement during pregnancy, while a total of 1,276 (18.4%) women never took iron supplement during pregnancy. After controlling for confounders, the predictors for uptake of iron supplement during pregnancy were early antenatal booking (adjusted odds ratio, AOR = 1.603 at 95% CI = 1.362–1.887, p < 0.001); rural residence (AOR = 0.711 at 95% CI = 0.159–0.526, p = 0.007); wealth index [rich (AOR = 1.188 at 95% CI = 0.986–1.432, p = 0.07)]—poor was the reference population; level of education [primary education (AOR = 1.187 at 95% CI = 1.013–1.391, p = 0.034)]—no formal education was the reference population; parity [para 2 to 4 (AOR = 0.807 at 95% CI = 0.668–0.974, p = 0.026), para 5 and above (AOR = 0.75 at 95% CI = 0.592–0.95, p = 0.017)], para 1 was the reference population; zones [mainland rural (AOR = 0.593 at 95% CI = 0.389–0.905, p = 0.015) and Unguja Island AOR = 0.63 at 95% CI = 0.431–0.92, p = 0.017]—mainland urban was the reference population; and current working status [working (AOR = 0.807 at 95% CI = 0.687–0.949, p = 0.009)].Conclusion: The study revealed that, despite free access to iron supplement during pregnancy, there are women who fail to access the supplement at least once throughout the pregnancy. The likelihood to fail to access iron supplement during pregnancy was common among pregnant women who initiated antenatal visits late, were from poor families, had no formal education, reside in rural settings, had high parity, were from mainland rural, and were in working status. Interventional studies are recommended in order to come up with effective strategies to increase the uptake of iron supplement during pregnancy.

scholarly journals Factors associated with changes in adequate antenatal care visits among pregnant women aged 15-49 years in Tanzania from 2004 to 2016

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Elizabeth Kasagama ◽  
Jim Todd ◽  
Jenny Renju
Keyword(s):  
Antenatal Care ◽  
Pregnant Women ◽  
Decomposition Analysis ◽  
Secondary Data ◽  
Health Interventions ◽  
World Health ◽  
Continuous Variables ◽  
Factors Associated ◽  
Health Organization ◽  
Maternal And Newborn

Abstract Background Antenatal care (ANC) is crucial for the health of the mother and unborn child as it delivers highly effective health interventions that can prevent maternal and newborn morbidity and mortality. In 2002, the World Health Organization (WHO) recommended a minimum of four ANC visits for a pregnant woman with a positive pregnancy during the entire gestational period. Tanzania has sub-optimal adequate (four or more) ANC visits, and the trend has been fluctuating over time. An understanding of the factors that have been contributing to the fluctuating trend over years is pivotal in increasing the proportions of pregnant women attaining adequate ANC visits in Tanzania. Methods The study used secondary data from Tanzania Demographic Health Survey (TDHS) from 2004 to 2016. The study included 17976 women aged 15-49 years. Data were analyzed using Stata version 14. Categorical and continuous variables were summarized using descriptive statistics and weighted proportions. A Poisson regression analysis was done to determine factors associated with adequate ANC visits. To determine factors associated with changes in adequate ANC visits among pregnant women in Tanzania from 2004 to 2016, multivariable Poisson decomposition analysis was done. Results The overall proportion of women who had adequate ANC visits in 2004/05, 2010 and 2015/16 was 62, 43 and 51% respectively. The increase in the proportion of women attaining adequate ANC from 2010 to 2015/16 was mainly, 66.2% due to changes in population structure, thus an improvement in health behavior. While 33.8% was due to changes in the mother’s characteristics. Early initiation of first ANC visit had contributed 51% of the overall changes in adequate ANC attendance in TDHS 2015/16 survey. Conclusion Early ANC initiation has greatly contributed to the increased proportion of pregnant women who attain four or more ANC visits overtime. Interventions on initiating the first ANC visit within the first twelve weeks of pregnancy should be a priority to increase proportion of women with adequate ANC visit.

scholarly journals Factors associated with changes in adequate antenatal care visits among pregnant women aged 15-49 years in Tanzania from 2004 to 2016.

2020 ◽  
Author(s):  
ELIZABETH KASAGAMA ◽  
Jim Todd ◽  
Jenny Renju
Keyword(s):  
Population Structure ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Decomposition Analysis ◽  
Secondary Data ◽  
Wealth Quintile ◽  
First Trimester ◽  
World Health ◽  
Continuous Variables ◽  
Factors Associated

Abstract Background: Antenatal care (ANC) is crucial for the health of the mother and the unborn child as it delivers highly–effective health interventions that can prevent maternal and newborn deaths and morbidity. In 2002, the World Health Organization (WHO) recommended a minimum of four ANC visits for a pregnant woman with a positive pregnancy during the entire gestational period. Tanzania has sub-optimal adequate (four or more) ANC visits and the trend has been fluctuating over time. An understanding on the factors that have been contributing to the fluctuating trend over years is crucial in increasing the proportions of pregnant women attaining adequate ANC visits in Tanzania.Methods: The study used secondary data from Tanzania Demographic Health Survey (TDHS) from 2004 to 2016. The study included 17976 women aged 15-49 years. Data were analyzed using stata version 13. Categorical and continuous variables were summarized using descriptive statistics and using the weighted proportions. A Poisson regression analysis was done to determine factors associated with adequate antenatal. A multivariable Poisson decomposition analysis was done to determine factors associated with changes in adequate ANC visits among pregnant women in Tanzania from 2004 to 2016.Results: The overall proportion of women who had adequate ANC visits in 2004/05, 2010 and 2015/16 was 62%, 43% and 51% respectively. The identified determinants of adequate ANC visits were: early ANC initiation, zones, having more than one child, being aged 20 years and above, wanting pregnancy later, belonging to a richer and richest wealth quintile, having secondary and higher education, reporting distance to health facility not a big problem and watching TV at least once per week. Comparing 2004/05 and 2010 surveys, changes in the population structure contributed 4.2% of changes in adequate antenatal care visits while changes in coefficients contributed 95.8% of the changes. Also, comparing 2015/16 to 2010 surveys, changes in population structure and coefficients contributed 66.2% and 33.8% respectively. Conclusion: Early ANC initiation has greatly contributed to increased proportion of pregnant women who attain four or more ANC visits overtime. More effort should focus on pregnant women to initiate ANC in the first trimester in order to increase proportion of women with adequate ANC visit.

scholarly journals Factors Associated With Changes in Adequate Antenatal Care Visits Among Pregnant Women Aged 15-49 Years in Tanzania From 2004 to 2016

2020 ◽  
Author(s):  
ELIZABETH KASAGAMA ◽  
Jim Todd ◽  
Jenny Renju
Keyword(s):  
Population Structure ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Decomposition Analysis ◽  
Secondary Data ◽  
Wealth Quintile ◽  
First Trimester ◽  
World Health ◽  
Continuous Variables ◽  
Factors Associated

Abstract Background: Antenatal care (ANC) is crucial for the health of the mother and the unborn child as it delivers highly–effective health interventions that can prevent maternal and newborn deaths and morbidity. In 2002, the World Health Organization (WHO) recommended a minimum of four ANC visits for a pregnant woman with a positive pregnancy during the entire gestational period. Tanzania has sub-optimal adequate (four or more) ANC visits and the trend has been fluctuating over time. An understanding of the factors associated with changes in adequate ANC visits over years is crucial in improving the proportions of pregnant women attaining adequate ANC visits in Tanzania. Methods The study used secondary data from Tanzania Demographic Health Survey (TDHS) from 2004 to 2016. The study included 17976 women aged 15–49 years. Data were analyzed using stata version 13. Categorical and continuous variables were summarized using descriptive statistics and using the weighted proportions. A Poisson regression analysis was done to determine factors associated with adequate antenatal. A multivariable Poisson decomposition analysis was done to determine factors associated with changes in adequate ANC visits among pregnant women in Tanzania from 2004 to 2016. Results The overall proportion of women who had adequate ANC visits in 2004/05, 2010 and 2015/16 was 62%, 43% and 51% respectively. The identified determinants of adequate ANC visits were: early ANC initiation, zones, having more than one child, being aged 20 years and above, wanting pregnancy later, belonging to a richer and richest wealth quintile, having secondary and higher education, reporting distance to health facility not a big problem and watching TV at least once per week. Comparing 2004/05 and 2010 surveys, changes in the population structure contributed 4.2% of changes in adequate antenatal care visits while changes in coefficients contributed 95.8% of the changes. Also, comparing 2015/16 to 2010 surveys, changes in population structure and coefficients contributed 66.2% and 33.8% respectively. Conclusion Early ANC initiation has greatly contributed to increased proportion of pregnant women who attain four or more ANC visits overtime. More effort should focus on pregnant women to initiate ANC in the first trimester in order to increase proportion of women with adequate ANC visit.

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