Antenatal care utilization and its associated factors in Somalia: a cross-sectional study

Abstract

Background WHO recommends attending minimum four ANC consultations during pregnancy to ensure early detection of complications. The objective of this study was to quantify ANC attendance and factors associated with it. Methods Participants were randomly selected using the WHO Cluster survey methodology in Southern and Central Somalia. A paper-print questionnaire was used to collect all data. Outcomes of interest were: access to at least one ANC consultation, completion of at least four ANC consultations, initiation of breastfeeding and place of delivery, while exposures included factors related to the latest pregnancy and demographic characteristics. Associations were assessed through logistic regression. Results Seven hundred ninety-two women answered the questionnaire; 85% attended at least one and 23% at least four ANC consultations, 95% started breastfeeding and 51% had an institutional delivery. Encouragement to attend ANC increased the odds of attending at least one consultation (aOR = 8.22, 95%CI 4.36–15.49), while negative attitude of husband or family decreased the odds (aOR = 0.33, 95%CI 0.16–0.69). Knowing there is a midwife increased the odds of at least four visits (aOR = 1.87, 95%CI 1.03–3.41). Attending at least four consultations increased the odds of delivering in a health structure (aOR = 1.50, 95%CI 1.01–2.24), and attending at least one consultation was associated with higher odds of initiating breastfeeding (aOR = 2.69, 95%CI 1.07–6.74). Conclusions Family has a strong influence in women’s ANC attendance, which increases the likelihood of institutional delivery and initiating breastfeeding. Women and families need to have access to information about benefits and availability of services; potential solutions can include health education and outreach interventions.

Effect of pregnancy intention at conception on the continuity of care in maternal healthcare services use in Somalia: Evidence from first national health and demographic survey

“…Responses were then categorized as "wanted" (if they responded "yes" to the initial question), "mistimed" (if they answered "later" to the subsequent inquiry), and "unwanted" (if they indicated "no more" in the follow-up question). The reliability and validity of this data collection and categorization method have been consistently demonstrated across various regions, including Asian and African countries (11,15,17,18).…”

“…The higher rates of maternal and child mortality in Somalia reflect broader challenges related to maternal healthcare access, infrastructure, and socioeconomic disparities (1, 9, 10). Limited access to maternal healthcare services is a significant concern, with recent data indicating that only 23% of Somali mothers receive at least four ANC consultations, a significant drop from the 85% who receive at least one ANC (1,11). Additionally, only around half of deliveries occur in hospitals, with a mere 10% receiving PNC (1,11).…”

“…Limited access to maternal healthcare services is a significant concern, with recent data indicating that only 23% of Somali mothers receive at least four ANC consultations, a significant drop from the 85% who receive at least one ANC (1,11). Additionally, only around half of deliveries occur in hospitals, with a mere 10% receiving PNC (1,11). These statistics reveal that a majority of mothers in Somalia lack access to maternal healthcare services, and among those who do, there is inadequate continuity of care (CoC), increasing vulnerability to complications for both mothers and newborns.…”