Factors associated with the timely initiation of antenatal care: findings from a cross-sectional study in Northern Bangladesh

Abstract

ObjectiveThis paper explored the factors that influence the timely initiation of antenatal care (ANC) in Bangladesh.DesignThis was a cross-sectional survey.SettingThis study conducted in two rural subdistricts and one urban area from three Northern districts of Bangladesh from August to November 2016.ParticipantsWomen who had a live birth in the last 1 year prior to data collection were enrolled for this study. In each study area, around 900 women were interviewed, and finally, we completed 2731 interviews.Primary outcome measuresThe primary outcome was timely first ANC from a Medically Trained Provider (MTP).ResultsAbout 43% of pregnancies were detected at their earliest time. The majority of participants (82%) received at least one ANC from an MTP. Only 11% received timely first ANC from an MTP as per the WHO FANC model. The women who detected pregnancy earlier were more likely (adj.OR 1.99, 95% CI 1.31 to 3.01) to receive the timely first ANC. The urban women were more likely (adj.OR 1.78, 95% CI 1.13 to 2.80) to receive the timely first ANC from an MTP than those of the rural women. Besides, their husbands’ educational status (adj.OR 1.61, 95% CI 1.0 to 2.60) was significantly associated with the timely first ANC.ConclusionApart from sociodemographic factors, early pregnancy detection was strongly associated with the timely first ANC visit. Timely initiation of ANC is an opportunity to adhere to all the WHO recommended timely ANC visits for a pregnant woman. The findings suggest maternal, neonatal, and child health programmes to focus on the early detection of pregnancy to ensure universal ANC coverage and its timeliness.

Bivariate binary logistic regression analysis on optimal antenatal care visits and timing of antenatal care initiation among reproductive age women in Ethiopia; evidence from 2019 Ethiopian mini demographic health survey

“…Women with higher levels of education are more likely to have optimal timing for ANC initiation and optimal ANC visits. This nding is consistent with previous research [13,17,20,22,53]. This is because education improves health-care utilization and increases knowledge about speci c issues.…”

“…The independent variables that are potentially affected by optimal ANC visits and timing of ANC initiation were maternal age group, region, place of residence, mother's education level, religion, family size, sex of household head, wealth index, total children ever born, marital status, and place of delivery. The independent variable was taken from previous studies that are published worldwide [9,[12][13][14][15][16][17][18][19][20][21][22].…”

“…Only 2% of women received ANC until the eighth month of pregnancy or later. Several studies are identifying determinants of the number of ANC visits and the timing of rst antenatal care visits, such as maternal age, region, maternal education, family size, total children ever born, place of residence, place of delivery, marital status, religion, wealth index, and household sex [9,[12][13][14][15][16][17][18][19][20][21][22] Having at least four ANC visits during pregnancy promotes a healthy practice that has been shown to reduce maternal mortality and morbidity while also promoting safe motherhood with improved maternal health outcomes [23]. The World Health Organization (WHO) recommends the rst visit before 12 weeks of pregnancy, as well as the necessary contents of ANC visits, to improve women's care experience and reduce perinatal mortality [24], while four visits to Ethiopia are still pending [25].…”

Sociodemographic Predictors of Initiating Antenatal Care Visits by Pregnant Women During First Trimester of Pregnancy: Findings from the Afghanistan Health Survey 2018

“…For example, in a recent multi-country analysis of Demographic and Health Surveys from sub-Saharan Africa, it was found that the percentage of pregnant women commencing timely ANC visits ranged from 14.5% in Mozambique to 68.6% in Liberia. 24 Findings from several other LMICs reported that the prevalence of initiating timely ANC attendance was as low as 11% in a geographic region of Bangladesh, 36 and as high as 65.7% in an urban area in Ethiopia. 20 In Ethiopia, three studies from three regions of the country reported early ANC initiation of 19.5%, 37 31.5%, 17 and 57.8%.…”

“…Previous studies from LMICs reported significant associations between timely initiation of ANC attendance by pregnant women and women’s age, 17 , 18 , 20 , 22–25 , 30–32 , 37 wealth status, 18 , 24 , 25 , 31 , 33 , 37 education, 18 , 21–25 , 29 , 31 parity, 18 , 20 , 23–27 , 29 , 32 access to media, 23 , 24 , 28 , 31 , 38 pregnancy intention, 16 , 19 , 21 , 23 , 24 , 26 , 27 , 29–31 , 39 residential area, 24 , 29 , 36 family size, 17 , 29 and husband’s education. 19 , 36 Except for the statistically insignificant correlation of husband’s education with pregnant women’s timely ANC attendance, our findings on the higher odds of pregnant woman’s timely ANC attendance by age, education, wealth status, parity, pregnancy intention, residential area, and access to media were fairly consistent with previous studies. A recent study, which used data from the demographic and health survey (DHS) of 36 African countries, found strong associations of sociodemographic and contextual factors with the likelihood of timely initiation of ANC visits by pregnant women.…”