Sociodemographic Predictors of Initiating Antenatal Care Visits by Pregnant Women During First Trimester of Pregnancy: Findings from the Afghanistan Health Survey 2018

Abstract

Purpose Initiating antenatal care (ANC) visits by pregnant women during first trimester, known as timely initiation of ANC visits, is crucial for wellbeing of mothers and their unborn babies. We examined whether sociodemographic characteristics of pregnant women predict timely initiation of ANC visits. Patients and Methods Data collected for the Afghanistan Health Survey 2018 (AHS 2018) were analyzed. A binary outcome variable was created as women with ANC visits in 0–3 months (first trimester) vs women with ANC visits in ≥4 months of pregnancy. A multivariable generalized linear model was employed. Results A total of 6862 ever-married women, aged 14–49 years, with a history of pregnancy, including current pregnancy, were included. The prevalence of timely initiation of ANC visits was 55.8%. The likelihood (OR = odds ratio) of timely initiation of ANC visits was higher in women aged 30–39 years [OR 1.12 (95% CI: 1.00–1.25)], in women who could read and write [OR 1.12 (95% CI: 0.99–1.21)], in women who used public primary care facilities [OR 1.14 (95% CI: 1.01–1.28)], in women who received consultation on ANC from a doctor or midwife [OR 1.22 (95% CI: 0.72–2.08), OR 1.13 (95% CI: 0.67–1.92)] respectively, in women at fourth and highest quintiles of wealth status [OR 1.24 (95% CI: 1.04–1.48), OR 1.14 (95% CI: 0.92–1.40)] respectively, in women who intended to become pregnant [OR 1.56 (95% CI: 1.35–1.81)], in women who used the internet [OR 1.53 (95% CI: 1.13–2.06)], and in women who listened to radio [OR 1.16 (95% CI: 1.03–1.30)]. However, the likelihood was lower in women who had given birth at least twice [OR 0.67 (95% CI: 0.50–0.89)], and in women who lived in rural areas [OR 0.87 (95% CI: 0.75–1.00)]. Conclusion To promote timely initiation of ANC visits, healthcare interventions to increase availability of midwives and doctors, and improve accessibility to primary care clinics, especially in rural areas, need to be implemented.

Factors Associated with Late Antenatal Initiation among Women in Malawi

“…A similar observation was made in an earlier study in Malawi [61]. This is unexpected and contrary to findings from other studies [27,38,42,48,49,51,62] as urban women are expected to initiate ANC earlier than their rural counterparts. This stems from increased availability and accessibility of healthcare services and conducive characteristics of urban dwellers.…”

“…Older women tend to be more likely to initiate ANC late as compared with younger women. The importance of the participants' age was also underscored in other studies [24,25,38,42,48,49]. One plausible explanation is that young women may be better educated than older women, and, as such, they may have acquired more knowledge on the need to initiate ANC within the first semester.…”

Predictors of Mothers’ Care Seeking Behavior for Common Childhood Illnesses: Findings From the Afghanistan Health Survey 2015

“… 35 , 43 Although, our findings contradict the significant role of mothers’ access to media on care seeking behavior, recent data from Afghanistan indicate the significant effects of women’s exposure to media on care seeking behavior. 44 , 45 …”

Barriers to healthcare utilization among married women in Afghanistan: the role of asset ownership and women’s autonomy

“…Women in Afghanistan face heightened vulnerability, experiencing a greater likelihood of healthcare vulnerability and disease burden [ 12 – 14 ]. Basic health services and information related to family planning and reproductive health are often inaccessible to women in Afghanistan, with a substantial proportion of births going unattended by healthcare professionals [ 15 , 16 ]. Moreover, a significant portion of currently married women lacks essential pre and post-natal care [ 17 ].…”