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. 2023 Jan 30:11:1035759.
doi: 10.3389/fpubh.2023.1035759. eCollection 2023.

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

Dagmawi Chilot  1   2 , Daniel Gashaneh Belay  3   4 , Tigist Andargie Ferede  4 , Kegnie Shitu  5 , Melaku Hunie Asratie  6 , Sintayehu Ambachew  7 , Yadelew Yimer Shibabaw  8 , Demiss Mulatu Geberu  9 , Melkamu Deresse  10 , Adugnaw Zeleke Alem  4
Affiliations

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

Dagmawi Chilot et al. Front Public Health. .

Abstract

Background: Complications 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.

Methods: Secondary 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.

Result: The 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 recommendations: Optimal 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.

Keywords: antenatal care; low- and middle-income countries; maternal mortality; reproductive-age women; women.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
The pooled prevalence of optimal ANC in countries with high maternal mortality.
See this image and copyright information in PMC

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