Pooled prevalence and determinants of antenatal care visits in countries with high maternal mortality: A multi-country analysis

Abstract

BackgroundComplications during pregnancy and childbirth are the leading causes of maternal and child deaths and disabilities, particularly in low- and middle-income countries. Timely and frequent antenatal care prevents these burdens by promoting existing disease treatments, vaccination, iron supplementation, and HIV counseling and testing during pregnancy. Many factors could contribute to optimal ANC utilization remaining below targets in countries with high maternal mortality. This study aimed to assess the prevalence and determinants of optimal ANC utilization by using nationally representative surveys of countries with high maternal mortality.MethodsSecondary data analysis was done using recent Demographic and Health Surveys (DHS) data of 27 countries with high maternal mortality. The multilevel binary logistic regression model was fitted to identify significantly associated factors. Variables were extracted from the individual record (IR) files of from each of the 27 countries. Adjusted odds ratios (AOR) with a 95% confidence interval (CI) and p-value of ≤0.05 in the multivariable model were used to declare significant factors associated with optimal ANC utilization.ResultThe pooled prevalence of optimal ANC utilization in countries with high maternal mortality was 55.66% (95% CI: 47.48–63.85). Several determinants at the individual and community level were significantly associated with optimal ANC utilization. Mothers aged 25–34 years, mothers aged 35–49 years, mothers who had formal education, working mothers, women who are married, had media access, households of middle-wealth quintile, richest household, history of pregnancy termination, female household head, and high community education were positively associated with optimal ANC visits in countries with high maternal mortality, whereas being rural residents, unwanted pregnancy, having birth order 2–5, and birth order >5 were negatively associated.Conclusion and recommendationsOptimal ANC utilization in countries with high maternal mortality was relatively low. Both individual-level factors and community-level factors were significantly associated with ANC utilization. Policymakers, stakeholders, and health professionals should give special attention and intervene by targeting rural residents, uneducated mothers, economically poor women, and other significant factors this study revealed.

Disparities in Antenatal Care Visits between Urban and Rural Ethiopian Women

“…Similarly, pregnant women from richer households and richest households had fourteen and twenty-four percent more antenatal care visits when compared to women from poor households. The finding is similar to studies conducted in different countries [ 19 , 20 ]. The current study also showed that, compared to women from rural areas, women from urban areas had 61 percent more antenatal care visits.…”

Regional disparities in antenatal care utilization among pregnant women and its determinants in Ethiopia

“…Nationally representative data collected in Ethiopia in 2020 support this (24), a systematic review and meta-analysis carried out in Cameroon (27), the DHS of Sub-Saharan Africa (29), and East African countries (26). This might be a result of the fact that women are more likely to use healthcare services as their experience and knowledge of them grows (32,33).…”

Determinants of Infant Mortality in Assam, India: Modelling with Generalised Linear Regression Model for Count Data

“…Age: The expected count of infant deaths for mothers aged less than 19 years and more than 35 years at their first birth is 32% higher than for the reference group (19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35). Again, the risk of infant mortality is 1.27 times higher (e .242 = 1.27, P =.000) https://www.indjst.org/ for mothers aged less than 19 years and more than 35 years at the time of their first birth in the zero inflation group compared to mothers aged (19-35) years.…”

“…Also, as birth order increases, the quality of child care reduces since the mother will have to care for more children (11) . This may also be attributable to higher confidence from prior pregnancies and delivery experiences with restrictions of time and resources among women who had multiple birth orders (25) . https://www.indjst.org/…”