Exploring antenatal care utilization and intimate partner violence in Benin - are lives at stake?

Abstract

Background The republic of Benin ranks in the bottom third of countries recently assessed for ANC coverage and its Ministry of Family and National Solidarity (2009) reported close to 70% of Beninese women suffered abuse at least once in their lifetime. Utilization of antenatal care (ANC) services is key to positive health outcomes for both mother and infant. This study examined the impact of intimate partner violence (IPV) on the utilization of ANC services in Benin using both the basic 4 visit model (ANC-4) and the updated WHO recommended 8-visit model (ANC-8). Methods Data used for this study were collected from the nationally representative 2017–2018 Benin Demographic Health Survey (BDHS) on ever-partnered women aged 15–49 who had completed both reproductive maternal health and domestic violence modules of the survey. Descriptive statistics and multivariate logistic regression analysis were performed to determine significant factors associated with ANC utilization in Benin. Results Over 40% of the women (n = 3084) reported experience of IPV in their lifetime. Findings revealed that women who ever experienced IPV (OR 0.753, 95% CI: 0.628–0.901; p = 0.002) had 25% less odds of accessing the basic four ANC visits. IPV was not found to be a factor in accessing at least eight ANC visits. With increasing number of children, there was less likelihood of accessing at least four and at least eight visits. Being in the richest quintile (OR 5.490, 95% CI 3.907–7.714; p < 0.000 for ANC-4; OR, 5.781, 95% CI: 3.208–10.41; p < 0.000), making decisions on household and health care (OR 1.279, 95% CI: 1.042–1.569 for ANC-4; OR, 1.724; 95% CI: 1.170–2.540; p = 0.006 for ANC-8), and getting paid cash for work increased the chances of utilizing ANC-four (OR 1.451, 95% CI: 1.122–1.876; 0.005) but not for ANC-eight. Belonging to the Muslim faith decreased the odds of ANC utilization compared to all other religions. Conclusion This work revealed key areas for maternal health policy makers and service providers in Benin to appropriately plan effective policies (i.e., alleviate poverty; equitable health services access; cultural sensitivity) and necessary interventions (i.e. ANC education, IPV prevention, paid employment, alcohol cessation) to increase utilization of ANC.

What predicts delayed first antenatal care contact among primiparous women? Findings from a cross-sectional study in Nigeria

“…These were pregnancy wantedness (planned, when pregnancy was wanted at the time of occurrence or unplanned when pregnancy was not wanted at all or not wanted at the time of occurrence) and spousal violence during pregnancy (experienced or not experienced). The two variables have been identified as having significant predictive power on antenatal care utilization [49][50][51][52]. Two external environmental factors, namely, place of residence and geo-political zone were included for statistical control.…”

Association between intimate partner violence during pregnancy and risk of preterm birth

“…Infant and child mortality are growing health issues globally, particularly in sub-Saharan Africa [1][2][3]. The complications from preterm birth, including sepsis, periventricular leukomalacia, seizures, infections, feeding difficulties, cerebral palsy, visual and hearing problems and necrotising enterocolitis [1] have led to approximately 16% of all deaths and 35% of deaths of newborn babies globally [1].…”

The Association Between Early Antenatal Care and Intermittent Preventive Treatment of Malaria in Pregnancy in Sub-Saharan Africa: Effect Modification by Planned Pregnancy Status

“…Our finding on the lower prevalence of IPTp+3 among mothers who had perceived domestic violence was not surprising. Previous studies on domestic violence were negatively associated with ANC [ 26 33 ], and therefore women who perceive/experience domestic violence may not meet the required ANC contacts needed to receive IPTp+3. Our finding on the association between mothers within higher wealth quintiles more likely to receive IPTp+3 compared to those in the poorest wealth quintile aligns well with published literature [ 34 ].…”

“…The variables for our analyzes were pre-selected based on factors identified in previous literature, [ 14 25 26 ] and availability in the MICS datasets. While we used Stata 16 SE (Stata Corp, College Station, TX) to conduct the meta-analysis, SAS version 9.4 (SAS Institute, Cary, NC) was used for the descriptive statistics and regression analyzes.…”