Determinants of Time of Start of Prenatal Care and Number of Prenatal Care Visits During Pregnancy Among Nepalese Women

Abstract

This study is aimed at investigating the factors determining the timing of first prenatal care (PNC) visit and the number of PNC visits among a national representative sample of Nepali women. Data was drawn from the 2006 Nepal Demographic and Health Survey on women age 15-49 years old who had delivery within three years prior to the survey (N = 4,136). Multinomial logistic regression was used to study the association between socio-demographic variables and two outcome variables--the timing of first PNC and number of PNC visits. Most of the women (45%) started prenatal care after 3 months of pregnancy while 28% had no care. About 43% of women had 1-3 PNC visits, 29% had more than 3 visits. Age, education, parity and wealth were associated with both the timing of PNC and the number of PNC visits such that older women and those socioeconomically disadvantaged had late and fewer PNC visits compared to the younger ones and those with socioeconomic advantage, respectively. Women with higher parity and those in rural residencies were more likely to delay PNC, have fewer PNC or have no care at all. Majority of Nepali women do not attend prenatal care during the first trimester of pregnancy contrary to the WHO recommendation for women in developing countries. Programmes aimed at improving maternal health in general and participation in PNC in particular should target all Nepali women, especially those: in rural residencies, with no education, with high parity; older women and those from poor households.

Individual and local level factors and antenatal care use in Colombia: a multilevel analysis

“…However, this association lost statistical significance when we controlled for local level variables. Similar results were found in a study carried out in Nepal when controlling for sociodemographic characteristics 44 . In other studies conducted in Colombia, being employed was not a significant determinant of receiving antenatal care 12 .…”

“…Authors have found a strong association between household poverty 18 or neighborhood poverty 22 and a lower likelihood of accessing antenatal care in rural areas in Mali and Haiti. In other countries, studies revealed that mothers were less likely to receive visits or complete the minimum number of visits in rural areas 44,45 .…”

Factors associated with the use and quality of antenatal care in Nepal: a population-based study using the demographic and health survey data

“…They have also been shown to increase rates of immunisation; enhance the chances of initiating breastfeeding within one hour of birth and the maintenance of exclusive breastfeeding for more than four months [27]; and increase the use of postnatal check-ups [29,30]. An Indian study found that, compared to women who had neonatal deaths, those with a live birth had received better quality ANC which included body weight measurement, blood and urine testing, a full course of iron tablets, tetanus toxoid injections, abdominal examination and ultrasonography [24].…”

Prenatal Care Services in Bursa

“…Nepal'de yapılan bir çalışmada gebelerin %28'i, Çatak B. ve ark. | Doğum öncesi bakım hizmetlerinin sahada izlemi ve değerlendirilmesi: Bursa örneği Nijerya'da yapılan bir çalışmada %44'ü ve Zambiya'da ise %2'si hiç DÖB almamıştır [6][7][8] . Ülkemizde yapılan benzer saha çalışmalarından Burdur'da gebelerin tamamı en az bir kez DÖB almış iken, Adıyaman'da yapılan çalışmada gebelerin %1,7'sinin, İstanbul'da yapılan çalışmada %0,6'sının aile hekimi ve/veya kadın hastalıkları ve doğum uzmanından DÖB almadığı gösterilmiştir [9][10][11] .…”

“…Araştırmada 14 haftadan küçük gebelerin tamamı ilk doğum öncesi bakımını aile hekiminden almış iken, 33 hafta üzeri gebeler ve doğum yapmış annelerin %81,1'i ilk doğum öncesi bakımını 14 hafta içinde almıştır. Nepal'da yapılan çalışmada gebelerin yaklaşık yarısının gebelikten 3 ay sonra DÖB aldığı bildirilmektedir [6] . İstanbul'da doğum yapmış gebelerin %57,1'i, Karabük'te %84,3'ü ilk doğum öncesi bakımını ilk 14 hafta içinde almıştır (11,13) .…”