Determinants of optimal antenatal care visit among reproductive age women in Low and Middle Income Countries; Evidence from recent demographic health survey: application of a multilevel binary logistic regression model

Abstract

Background The evaluation of utilization and the factors influencing optimal ANC visits is critical to improving maternal and neonatal health outcomes. The goal of antenatal care is to reduce maternal and perinatal mortality and morbidity. The study's goal is to identify the factors that influence optimal ANC visits among reproductive-age women in low-income countries. Methods The study included a total weighted sample of 329,721 women who gave birth during the study period. For model fitness and comparison, the intra-class correlation coefficient, median odds ratio, proportional change in variance, AIC, BIC, and deviance were used. To identify the determinants of optimal ANC visits in LMICs, a multilevel multivariable logistic regression model was fitted. To declare significant determinants of optimal ANC visits, the adjusted odds ratio and its 95% confidence interval were used. Results The overall prevalence of optimal ANC visits was 60.1%, and this ranged from 16.8% in Afghanistan to 97.0% in the Dominican Republic. In the Multilevel multivariable logistic regression model; age 20 to 34 (AOR = 1.267; 95%CI: 1.233–1.303)), age above 34 (AOR = 1.342; 95%CI: 1.302–1.384)), primary educated women (AOR = 1.529; 95%CI: 1.496–1.563), secondary educated women (AOR = 2.626; 95%CI: 2.561–2.694), higher educated women (AOR = 4.563; 95%CI: 4.341–4.796), middle wealth index (AOR = 1.033; 95%CI: 1.015–1.052), rich wealth index (AOR = 1.340; 95%CI: 1.284–1.399), having media exposure (AOR = 1.273; 95%CI: 1.251–1.293)), employed women (AOR = 1.252; 95%CI: 1.212–1.293), and being Central America resident (AOR = 5.967; 95%CI: 5.655–6.297) were significantly associated with optimal ANC visits. Conclusion Maternal age, maternal education level, family size, number of children, sex of household head, wealth index, marital status, husband/partner education level, husband/partner occupation, maternal occupation, media exposure, place of delivery, and region were all significant predictors of optimal ANC visits in low- and middle-income countries. This discovery assists health care providers and policymakers in implementing appropriate policies and programs to ensure optimal ANC coverage. It is critical to develop strategies to improve antenatal care access and availability.

Optimal utilization of maternal health service in Indonesia: a cross-sectional study of Riskesdas 2018

“…Like our finding, a study from Ethiopia mentioned that the ANC and frequency of ANC visits were significantly associated with optimal maternal services utilization 20. However, an unpublished study showed that women delivering in a health facility have more optimal ANC services 29. Despite using better optimal care, we agreed that mothers who deliver in health facilities are more likely to have better education,4 30 live in urban areas 4 30 and be exposed more to ANC 30…”

“… 20 However, an unpublished study showed that women delivering in a health facility have more optimal ANC services. 29 Despite using better optimal care, we agreed that mothers who deliver in health facilities are more likely to have better education, 4 30 live in urban areas 4 30 and be exposed more to ANC. 30 …”