Determinants of prenatal care use and HIV testing during pregnancy: a population-based, cross-sectional study of 7080 women of reproductive age in Mozambique

Abstract

Background:In low-income countries with poor coverage of healthcare services such as Mozambique, antenatal care serves as a vital tool for providing life-saving and cost-effective services for pregnant mothers. Nonetheless, many countries in Africa, including Mozambique, are struggling to attain an optimum level of antenatal care (at least 4 visits) utilisation among pregnant women. In the present study, we aimed to assess the sociodemographic and economic factors associated with antenatal care use in Mozambique. Methods: Cross-sectional data from the latest round of Mozambique Demographic and Health Survey (2011) on women aged 15-49 years (n = 7080) were analysed. The outcome measures were early and adequate antenatal visit and HIV tests during the last pregnancy. Data were analysed using descriptive and multivariate regression methods. The predictor variables included various demographic (e.g. age, parity), empowerment (e.g. type of employment, household wealth status) and sociocultural factors (e.g. ethnicity, religion). Results: Of the 7080 women whose data was analyzed, 15.3 and 60.1% had early and adequate ANC visits respectively while 75.4% received HIV test during ANC visits. The odds of early ANC visits were higher [OR = 1.300, 95%CI = 1.062, 1.592] among women in the rural areas compared with those in the urban areas. However, participants in rural areas had lower odds [OR = 0.788, 0.687,0.902] of receiving HIV tests during ANC visits. Women in the urban areas with secondary [OR = 1.296, 95%CI = 1.007,1.666] and higher [OR = 1.663, 95%CI = 1.052,2.628] education had higher odds of having early ANC visit. Those in the higher wealth quintiles also had significantly increased odds of using all three types of ANC indicators, particularly for rural women in the highest wealth quintile [OR = 4.776, 95%CI = 1.250,18.24]. Being within the higher wealth quintiles was found to significantly increase the odds of using all three types of ANC indicators, particularly women from rural areas with highest wealth quintile [OR = 4.776, 95%CI = 1.250,18.24]. Conclusion: About two-fifth of the women in Mozambique are not using adequate antenatal care and about and a quarter do not take HIV tests during pregnancy. The sources of low and unequal use of these vital health services might be rooted in women's socioeconomic status and cultural issues that require special policy and research attention.

Determinants of HIV testing among Filipino women: Results from the 2013 Philippine National Demographic and Health Survey

“…Given the importance of HIV testing among women, studies identifying its determinants have been carried out before. These determinants can be classified into socio-demographic determinants (e.g., age, educational attainment, address, religion, marital status, socio-economic status, employment, media exposure, and number of children) or HIV-related determinants (e.g., sexual behaviors, knowledge on HIV, perceptions on HIV testing, consumption of intoxicants, and having talked to mother or female guardian about HIV) [16][17][18][19][20][21]. Other determinants of HIV testing include having a dysfunctional relationship with their spouse/partner, tolerance of domestic violence, experiencing stigma, media exposure, number of lifetime sexual partners, having talked to mother/female guardian regarding HIV testing, ever pregnant, and exposure to public health interventions regarding HIV [16,17,22].…”

Prevalence of child marriage and its impact on fertility outcomes in 34 sub-Saharan African countries

“…In addition, DHS used multistage probabilistic sampling methodology to select clusters and households from geographic-based sampling frames that cover the entire territory of participating countries, a design that translates into naturally occurring population hierarchies. However, this study was based on self-reported data which is subject to recall bias and social desirability [51, 52]; for example, there might be errors in reporting respondents’ age at marriage due to the fact that registration of age system is not documented. In addition, the variable for pregnancy termination did not differentiate between miscarriages and abortion and thus blur the true association that exists between the forms of pregnancy termination and child marriage.…”

Antenatal visits are positively associated with uptake of tetanus toxoid and intermittent preventive treatment in pregnancy in Ivory Coast

“…Firstly, the study was based on secondary data from a cross sectional survey. Hence, it cannot be used to infer causality but only to show association between variables [64, 65]. Secondly, the data was collected three years ago, and although the disparity in taking IPTp-SP drugs and TT immunization still exists, the underlying causes may have changed.…”