Determinants of early initiation of first antenatal care visit in Ethiopia based on the 2019 Ethiopia mini-demographic and health survey: A multilevel analysis

Abebe, Gossa Fetene; Alie, Melsew Setegn; Girma, Desalegn; Mankelkl, Gosa; Berchedi, Ashenafi Assefa; Negesse, Yilkal

doi:10.1371/journal.pone.0281038

Cited by 3 publications

(3 citation statements)

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“…Women with low levels of education are more likely to initiate ANC late than women with higher levels of education. These findings are comparable to those reported by other researchers [11,24,25,27,28,[32][33][34]36,48,50,51,53]. Three reasons may be suggested as explanations for why uneducated women are likely to initiate ANC late.…”

Section: Discussionsupporting

confidence: 89%

“…Other studies conducted in Malawi have reported regional differences in the utilization of maternal health services. In addition, studies conducted in Burkina Faso [50], Ethiopia [11,42], Ghana [22], Nigeria [27,51] and Sierra Leone [52] have reported regional differences in the initiation of ANC. Two factors could be responsible for the observed regional differences in the late initiation of ANC.…”

Section: Discussionmentioning

confidence: 99%

“…These are the number of ANC visits, the availability of ANC by a skilled professional and the place of ANC services. Studies on the number of ANC visits have focused on the timing of first antenatal visits [11], adherence to the recommended minimum number of visits [8,12,13] and the quality of care. This study focused on the timing of the first antenatal visit.…”

Section: Introductionmentioning

confidence: 99%

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Factors Associated with Late Antenatal Initiation among Women in Malawi

Palamuleni

2024

IJERPH

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Background Early initiation of antenatal care (ANC) is critical in identifying and mitigating adverse pregnancy-related complications. However, globally, a high percentage of women initiate ANC only at a late stage of their pregnancy. In view of this, the main objective of the study is to establish the prevalence and factors associated with late ANC initiation among women in Malawi. Methods The study was based on the 2015–16 Malawi Demographic and Health Survey (MDHS). The study population consisted of 13,251 women of reproductive age who had given birth during the five years preceding the survey. The data was analyzed using the chi-square test and multivariate logistic regression. Results The prevalence of late ANC initiation in Malawi was 75.6%. The logistic regression modelling revealed increased odds of late ANC initiation attendance among women residing in the Northern Region (AOR: 1.172; 95% CI: 1.021–1.345) and the Central Region (AOR: 1.178; 95% CI: 1.074–1.291), women residing in urban areas (AOR: 1.273; 95% CI: 1.108–1.463), women with no education (AOR: 1.814; 95% CI: 1.13–1.47) or with primary education (AOR: 1.697; 95% CI: 1.13–1.47), women with less than four ANC visits (AOR: 4.155; 95% CI: 4.002–4.814), unmarried women (AOR: 1.478; 95% CI: 1.111–1.985) and those whose last birth was not by caesarean section (AOR: 1.377; 95% CI: 1.179–1.607). Reduced odds of late ANC initiation among women were observed among women in the 20–24 age group (AOR: 0.634; 95% CI: 0.456–0.881), those in the 25–29 age group (AOR: 0.645; 95% CI: 0.476–0.874) and those aged 30–34 years (AOR: 0.634; 95% CI: 0.456–0.881). Conclusions The study found that ANC initiation in Malawi is often delayed, with most first visits occurring after the first trimester. Late ANC initiation is associated with region, place of residence, marital status, and the women’s age. These are significant factors to be considered when designing new or reviewing ANC policies and strategies aimed at increasing ANC utilization and encouraging early initiation of ANC. Earlier ANC initiation among Malawian women can contribute positively towards improving maternal and child health in Malawi. Therefore, government policies and interventions should target women with no or little education, those living in poor families and other modifiable risk factors, such as young unmarried women.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Factors Associated with Late Antenatal Initiation among Women in Malawi

Palamuleni

2024

IJERPH

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The Adequacy of ANC services received and associated factors among Women of Reproductive Age in Tanzania

Tibenderana,

Kessy,

Mlaponi

et al. 2024

Preprint

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Background ANC continues to be a vital and crucial component of care for expectant mothers and their unborn children, not only by lowering maternal mortality but also perinatal deaths and connecting them to postnatal treatment. There are limited information about the adequate Antenatal Care (ANC) services coverage, therefore this study aimed at examining the proportion of ANC services coverage, distribution pattern and its associated factors obtained by women of reproductive age (WRA) in Tanzania. Methods This was analytical cross-sectional study among women of reproductive age in Tanzania, utilizing data from the Demographic and Health Surveys (DHS) 2022. Analysis considered the complex survey design through application of weights, clustering and strata. Modified Poisson regression models estimated the factors associated with adequate reception of ANC services among WRA in Tanzania. All analyses were performed in STATA software version 18. Results The proportion of WRA who had received adequate ANC component coverage was 41%. Distribution of ANC contents ranged from 0.5% to 41% for none to seven services respectively. Almost all women (96.1%) had their baby’s heartbeat checked. Various factors such as education, wealth index, age, residence, number of ANC visits and birth order were significantly associated with uptake of ANC services among WRA in Tanzania. Conclusion The overall findings suggest a notable disparity in the utilization of ANC services, as fewer than half of women of reproductive age (WRA) are receiving sufficient ANC coverage. Therefore, integrated approaches involving health care facilities and communities, innovative strategies targeting young adults, and strengthening the policy of four or more ANC visits with regular monitoring and data collection are recommended to improve ANC access, utilization, and alignment with WHO guidelines.

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First trimester antenatal care contact in Africa: a systematic review and meta-analysis of prevalence and contributing factors

Abdo,

Demelash,

Seid

et al. 2023

BMC Pregnancy Childbirth

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Background Early detection, prevention, and management of diseases associated with pregnancy and pregnancy-related conditions depend on the beginning of antenatal care contact in the first trimester. Across Africa, regional and national differences are observed in the proportion of first-trimester ANC contact and the factors contributing to it. To create a suitable intervention plan, it is crucial to overcome these differences through single standard and uniform guidelines. This can be achieved through meta-analysis and systematic reviews. Therefore, this systematic review aimed to assess the pooled prevalence of first trimester ANC contact and the factors contributing to it in Africa. Methods Observational studies conducted in Africa were retrieved from PubMed, Google Scholar, EMASE, CINHAL, Cochrane Library, Hinari databases and Mednar using combinations of search terms with Boolean operators. The JBI 2020 Critical Appraisal Checklist was used to assess the methodological quality of the studies. To assess publication bias, a funnel plot and Egger’s test were used to and I-squared was used to check the heterogeneity of the included studies. Data were extracted using Microsoft Excel and exported to Stata 16 software for analysis. Results A total of 86 articles with 224,317 study participants from 19 African countries were included. The overall pooled prevalence of first-trimester ANC contact was 37.15% (95% CI: 33.3–41.0; I2 = 99.8%). The following factors were found to be significantly associated with first-trimester ANC contact: urban residence (OR = 2.2; 95% CI: 1.5–3.1; I2 = 98.5%); women under the age of 25 (OR = 1.5; 95% CI: 1.2–1.9; I2 = 94.1%);, educational status (OR = 1.8; 95% CI: 1.4–2.2; I2 = 96.1%), primiparity (OR: 1.7; 95% CI: 1.2–2.4: I2 = 97.4%), having planned pregnancies (OR: 2.1; 95% CI: 1.5–2.7; I2 = 95.5%) and employed women (OR = 1.7; 95% CI: 1.7–2.1; I2 = 94.4%). Conclusion Because so few women in Africa initiate first-trimester ANC contact, it is clear that increasing maternal healthcare service uptake is still a challenge and will require significant effort to scale up the services. When working to improve maternal health in Africa, each nation's government and nongovernmental organizations should prioritize raising women's educational levels and providing pertinent information to rural women, focusing on reducing unintended pregnancies, women who live far from health facilities, women with low socioeconomic statuses, multiparous women and older women. Trial registration PROSPERO International Prospective Register of Systematic reviews (ID: CRD42023401711).

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Determinants of early initiation of first antenatal care visit in Ethiopia based on the 2019 Ethiopia mini-demographic and health survey: A multilevel analysis

Cited by 3 publications

References 53 publications

Factors Associated with Late Antenatal Initiation among Women in Malawi

Factors Associated with Late Antenatal Initiation among Women in Malawi

The Adequacy of ANC services received and associated factors among Women of Reproductive Age in Tanzania

First trimester antenatal care contact in Africa: a systematic review and meta-analysis of prevalence and contributing factors

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