Factors associated with late antenatal care booking: population based observations from the 2007 Zambia demographic and health survey

Abstract

IntroductionIn spite of the extreme importance of an early antenatal care visit, more than 50% of Zambian pregnant women book for antenatal care late. We aimed to determine factors associated with late antenatal care booking in Zambia.MethodsData stem from the 2007 Zambia Demographic and Health Survey where information on socio-demographic, social-economic, obstetrical characteristics and timing of the first antenatal visit were extracted on all women aged 15 to 49 years. A weighted survey analysis using STATA version 12 was applied. Firstly, we explored proportions of ANC booking at 0-3 months, 4-5 month and 6-9 months. Secondly, we investigated the association between predictor variables and late antenatal care booking using univariate and multivariate logistic regression.ResultsOverall (n= 3979), the proportion of late ANC booking (booking between 4th to 9th month) was 81% disaggregated as 56% and 19% at 4 to 5 months and 6 to 9 months respectively. Women who wanted their last child later were more likely to book late than those with wanted pregnancies then (AOR: 1.35 95% CI 1.10-1.66). Women with higher education were 55% less likely to book for ANC late compared to women with no education (AOR: 0.45 95%CI: 0.27-0.74). Women aged 20-34 years were 30% more likely to book earlier than women younger than 20 years (AOR: 0.69 95% CI 0.50-0.97).ConclusionWe found high proportion of late ANC booking associated with presence of unplanned or unwanted pregnancies in this population. The concentration of this problem in lower or no education groups may be an illustration of existing inequalities which might further explain limitations in health promotion messages meant to mitigate this challenge. There is thus urgent need to re-pack health promotion message to specifically target this and related poor groups.

Socio‐demographic predictors of unintended pregnancy and late antenatal booking in Honiara, Solomon Islands

“…Our finding that multiparity is an independent predictor of late antenatal booking is consistent with other settings where it has been documented that women view no advantages to early booking because antenatal care is seen as primarily curative and not preventative, or in places where care quality is poor or expensive . Similarly, our finding that unintended pregnancy is an independent predictor of late antenatal booking is consistent with other studies, which have shown that women with an unintended pregnancy are 2.0–4.4 times more likely to attend their booking visit late . Antenatal care in the Solomons could be strengthened by improving the quality of services provided as recommended by the WHO in their document on antenatal care for a positive pregnancy experience .…”

Prevalencia de inicio tardío de la atención prenatal. Asociación con el nivel socioeconómico de la gestante. Estudio de corte transversal. Bucaramanga, Colombia, 2014-2015

“…Un total de 116 de las 391 participantes ( [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21]9), y una razón cruda de prevalencias (RP) de 2,53 (IC 95 %: 1,64-3,91). Otros factores de riesgo asociados al inicio tardío en el análisis bivariado fueron la edad, la escolaridad menor a 12 años y la no afiliación al SGSSS.…”

“…De otro lado, tener una relación estable disminuye la probabilidad de iniciar tardíamente la APN. Contrario a nuestros hallazgos, la asociación entre unión estable e inicio tardío ha sido reportada por otros estudios (6,7).…”

“…Diversos estudios del ámbito internacional han identificado factores de la gestante asociados al inicio tardío de la APN, entre estos: no tener compañero estable (6), bajo nivel educativo, embarazo no deseado, no tener se guro de salud o institución regular de atención, ser menor de 20 años o mayor de 35, la multiparidad, el desempleo, vivir en zonas deprimidas socialmente o tener bajos niveles de ingreso (6)(7)(8)(9)(10)(11)(12)(13)(14). Al respecto, algunos autores recomiendan identificar, en cada contexto en particular, los problemas puntuales que afectan a las gestantes para orientar las estrategias de intervención (15).…”

Determinants of utilization of maternal health care services among mothers in Harare, Zimbabwe

“…Our study found out that women who had unplanned pregnancies were less likely to utilize maternal health services. Two studies in east Africa also found out that women who had unplanned pregnancies were two times more likely to book for ANC late compared to women who had planned to have a baby [40,41]. This may be attributed to the late diagnosis of the pregnancy thus, the woman may be shy visit the clinic and register the pregnancy especially in cases where the pregnant mother is very young, dependent, and not married.…”