Determinants of antenatal care attendance among women residing in highly disadvantaged communities in northern Jordan: a cross-sectional study

Abstract

BackgroundOne of the major reproductive health challenges among disadvantaged populations is to provide pregnant women with the necessary antenatal care (ANC). In this study, we suggest applying an integrated conceptual framework aimed at ascertaining the extent to which attendance at ANC clinics may be attributed to individual determinants or to the quality of the care received.MethodsUsing a cross-sectional design, data were collected from a sample of 831 women residing in nine sub-districts in three northern governorates of Jordan and designated according to national categorization as persistent poverty pockets. All of the sampled women were recruited from public maternal and child health centers and interviewed using a structured pre-tested survey. This tool covered certain predictors, ranging from the user’s attributes, including predisposing, enabling, and need factors, to the essential components of the experience of care. These components assessed the quality of ANC in terms of five elements: woman–provider relations, technical management, information exchange, continuity of care, and appropriate constellation of services. Adequate ANC content was assessed in relation to the frequency of antenatal visits and the time of each visit.ResultsThe results of multivariate logistic regression analyses show that the use of ANC facilities is affected by various factors related to the quality of service delivery. These include receiving information and education on ANC during clinic visits (OR = 9.1; 95% CI = 4.9–16.9), providing pregnant women with opportunities for dialogue and health talks (OR = 7.2; 95% CI = 4.1–12.8), having scheduled follow-up appointments (OR = 6.5; 95% CI = 3.5–12.0), and offering dignified and respectful care (OR = 5.7; 95% CI = 2.5–13.1). At the individual level, our findings have identified a woman’s education level (OR = 1.2; 95% CI = 1.1–1.3), desire for the pregnancy (OR = 1.7; 95% CI = 1.1–2.7), and living in a district served by an ANC clinic (OR = 4.3; 95% CI = 2.3–8.1) as determinants affecting ANC utilization.ConclusionTaking women’s experiences of ANC as a key metric for reporting the quality of the care is more likely to lead to increased utilization of ANC services by women in highly disadvantaged communities. Our findings suggest that the degree to which women feel that they are respected, informed, and engaged in their care has potential favorable implications for ANC.

Knowledge and Myths about Preeclampsia and Eclampsia and its influence on Antenatal Service Utilization among Expecting Couples in Mtwara Regional: A Cross Sectional Analytical Study.

“…The results of the current study 64% of the expecting mothers had adequate antenatal care service utilization. These results agree with the ndings of other study done in Jordan [ 19] in which 63.4% of the respondents had adequate ANC service utilization. It seems possible that these results might be due to an increasing number of health facilities in each village also the effort done by the government to ensure that every pregnant woman should be attended by the trained personnel as well as free services offered to pregnant women.…”

Utilization, Equity and Determinants of Full Antenatal Care in India: Analysis from the National Family Health Survey 4

“…Economic status and maternal education were highly associated with utilisation of ANC, which corroborates with previous literature [19,20,21]. Younger maternal age at conception is also common among these women.…”

Regional disparities in antenatal care utilization in Indonesia

“…ANC aims to monitor and maintain the health and safety of the mother and the fetus, detect all complications of pregnancy and take the necessary actions, respond to complaints, prepare for birth, and promote a healthy lifestyle. ANC visits are very important to detect and prevent unwanted occurrences that arise during pregnancy [8]. In developing countries, there has been an increase in the utilization of maternal health services, but it still varies among population groups.…”