Prevalence and factors associated with underutilization of antenatal care services in Nigeria: A comparative study of rural and urban residences based on the 2013 Nigeria demographic and health survey

Adewuyi, Emmanuel O; Auta, Asa; Khanal, Vishnu; Bamidele, Olasunkanmi David; Akuoko, Cynthia Pomaa; Adefemi, Kazeem; Tapshak, Samson Joseph; Zhao, Yun

doi:10.1371/journal.pone.0197324

Cited by 141 publications

(232 citation statements)

References 32 publications

(77 reference statements)

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“…The analysis shows that there is no difference between urban and rural areas in ANC utilization in Indonesia. This condition is different from the findings in Nigeria [23], Ethiopia [24], Pakistan [25] and several other countries [26], which found disparities between urban and rural areas.…”

Section: Discussioncontrasting

confidence: 96%

Regional Disparities of Antenatal Care Utilization in Indonesia

Laksono

Rukmini

Wulandari

2019

Preprint

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Introduction:The main strategy for decreasing maternal morbidity and mortality with antenatal care (ANC). ANC aims to monitor and maintain the health and safety of the mother and fetus, detect all complications of pregnancy and take the necessary actions, respond to complaints, prepare for birth, and promote healthy living behavior. The study aims to analyze inter-regional disparities in ≥4 ANC visits during pregnancy in Indonesia. Methods: Data sources from 2017 Indonesian Demographic and Health Survey (IDHS). With an analysis unit of women aged 15-49 years old, a sample of 15,351 women was obtained. Besides 2 ANC as the dependent variable, other variables analyzed were place of residence, age, husband/partner, education, parity, wealth status, and health insurance. Analysis using Binary Logistic Regression for the final test to determine disparity. Results: All regions show a gap with the Papua region as a reference, except the Maluku region which was not significant shows differences in the use of ANC compared to the Papua. Women in the Nusa Tenggara have 4,365 chances of making ≥4 ANC visits compared to the Papua region.Women in Java-Bali have 3,607 times more chances to make ≥4 ANC visits than women in the Papua region. Women in Sumatra have 1,370 chances of making ≥4 ANC visits compared to women in the Papua region. Women in Kalimantan have 2.232 times made ≥4 ANC visits compared to women in the Papua region. Women in Sulawesi have 1,980 times more than AN4ANC visits compared to women in the Papua region. In addition to the region category, other variables found to contribute to the predictor were age, husband/partner, education, parity, wealth and insurance.Conclusion: There were disparities between regions in the ANC utilization in Indonesia.Keyword: antenatal care, the barrier of utilization, mother health

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Section: Discussioncontrasting

confidence: 96%

Regional Disparities of Antenatal Care Utilization in Indonesia

Laksono

Rukmini

Wulandari

2019

Preprint

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“…The odds of optimal ANC utilization was reduced by 41% among rural women as compared to women residing in urban areas. This finding is supported by studies done in Indonesia [12], Nigeria [13], and Ethiopia [14]. This is due to the socioeconomic inequalities and differences in health services access between urban and rural areas in the country [15].…”

Section: Discussionsupporting

confidence: 56%

Spatial distribution and determinants of an optimal ANC visit among pregnant women in Ethiopia: further analysis of 2016 Ethiopia demographic health survey

Tessema

Animut

2020

BMC Pregnancy Childbirth

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Background: Antenatal care (ANC) is essential to improve maternal and newborn health and wellbeing. Antenatal care coverage is improving in Africa since over two-thirds of pregnant women have at least one ANC contact. However, to realize the complete life-saving potential that ANC guarantees for mothers and babies, at least four visits providing essential evidence-based interventions are required.. Therefore, this study was conducted to identify determinants of an optimal ANC visit and its spatial distribution in Ethiopia. Methods: This study is a secondary data analysis of the 2016 Ethiopian Demographic and Health Survey (EDHS). A total of 8025 women who had a live birth in the five years preceding the survey were included in this study. STATA 14 software and ArcGIS10.7 software were used for analysis. The generalized estimating equation (GEE) model was fitted to identify factors associated with an optimal ANC visit. Crude and Adjusted odds ratio with a 95% CI computed to assess the strength of association between explanatory and outcome variables.Results: This study revealed that rural residence (AOR = 0.59, 95%CI: 0.45-0.77),male partners educational status [secondary school (AOR = 1.33, 95%CI: 1.05-1.67)], distance to the health institutions [not a big problem (AOR = 1.21, 95%CI: 1.04-1.39)], community-level literacy (AOR = 1.07, 95%CI: 1.03-1.12), and community level service utilization (AOR = 2.67,95%CI:2.21-3.24) were significantly associated with optimal ANC visits. From the spatial analysis result, an Optimal ANC visit was observed in Addis Ababa, Tigray, Harari, and Dire Dawa regions whereas areas with no optimal ANC visit were Afar, Amhara, Oromia Benishangul, SNNP, and Somalia regions. Conclusion: Living in peripheral regions of the country and in rural areas, lower educational status of male partners and distance to health institutions were prohibiting factors for an adequate number of visits. In this study, community-level literacy and community level service utilizations were were also affect womens' ANC utilization which implies community-level interventions should be considered for improving antenatal care utilization and better health outcomes. The government should give special attention to the regions like Afar, Amhara, Oromia, Benishangul, SNNP, and Somalia which had low optimal ANC visits.

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“…As modeling is the common approach in assessing the relationship between health variables and their determinants, modeling URAC for the two years of 1995 and 2014 was carried out. The modeling of URAC con rmed the ndings in previous literature on developing countries, and on Egypt [11][12][13][14][15][16][17][18][19][20][21]: both social and health needs were signi cant in determining URAC. On the social side, women's age at birth, their education level, their husbands' education level, the household standard of living/wealth, and the region, were signi cant determinants of URAC.…”

Section: Discussionsupporting

confidence: 77%

“…Some research efforts have focused on understanding the main determinants of any use or of regular use of antenatal care. As in the literature on determinants of antenatal care use in developing countries [11][12][13][14][15][16], research in Egypt has con rmed the importance of both social and health needs as determinants of antenatal care. On the social side, women's age or age at birth, their education, their husbands' education level, the women's work status, the household standard of living/wealth, and place of residence, assessed in terms of regional level or by rural/urban differentiation, were identi ed as signi cant determinants of antenatal care [17][18][19][20].…”

Section: Determinants and Inequality Of Antenatal Care In Egyptmentioning

confidence: 99%

Monitoring the decomposition of wealth-related inequality in the use of regular antenatal care in Egypt (1995-2014)

Khadr¹

2020

Preprint

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Background Between 1995 and 2014 Egypt successfully increased the use of regular antenatal care (URAC) among women from 30.4% to 82.9%. The same period saw a decrease in the wealth-based inequality in URAC, with significant decline in its prevalence among the richest and poorest wealth quintiles. This paper investigates the changes in the main determinants contributing to the wealth-based inequality in URAC for the two years of 1995 and 2014, and the determinants that underlined the declines in this inequality. Methods The secondary analysis was based on data from the 1995 and 2014 rounds of the Egypt Demographic and Health Survey. Logistic regression was implemented to model URAC for those two years and inequality was measured using the concentration index. Decomposition of the concentration index and Blinder -Oaxaca decomposition were implemented to assess the contribution of the URAC determinants to its inequality and the changes between 1995 and 2014. Results Decomposition of inequalities in URAC in 1995 and 2014 showed that social determinants were the main contributors to these inequalities. More than 90% of the inequalities were explained by the determinants of living in rural Upper Egypt, women and their husbands having attained higher education, the household standard of living, and birth order. These same determinants were also responsible for more than 76% of the decline in the inequality in URAC between 1995 and 2014. Findings show that high concentration of poverty in rural Upper Egypt contributes significantly to the inequality in URAC. There was a relatively smaller change in the relationship between education and URAC, whereby women and their husbands who have secondary or higher education maintain their higher odds of URAC. These findings highlight the importance of the health system and the social determinants to achieve equality in URAC. Conclusion Decomposition of inequality can support prioritization of interventions and can lead to effective and efficient use of the limited resources available in any society. Decomposition of the changes in inequality can aid the assessment of the effectiveness and the monitoring of the impact of these interventions and help identify new policies and interventions needed to tackle these inequalities.

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Prevalence and factors associated with underutilization of antenatal care services in Nigeria: A comparative study of rural and urban residences based on the 2013 Nigeria demographic and health survey

Cited by 141 publications

References 32 publications

Regional Disparities of Antenatal Care Utilization in Indonesia

Regional Disparities of Antenatal Care Utilization in Indonesia

Spatial distribution and determinants of an optimal ANC visit among pregnant women in Ethiopia: further analysis of 2016 Ethiopia demographic health survey

Monitoring the decomposition of wealth-related inequality in the use of regular antenatal care in Egypt (1995-2014)

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