Trends in antenatal care visits and associated factors in Ghana from 2006 to 2018

Abstract

Introduction Given that maternal mortality is a major global health concern, multiple measures including antenatal care visits have been promoted by the global community. However, most pregnant women in Ghana and other sub-Saharan African countries do not attain the recommended timelines, in addition to a slower progress towards meeting the required minimum of eight visits stipulated by the World Health Organization. Therefore, this study explored the trends in antenatal care visits and the associated factors in Ghana from 2006 to 2018 using the Multiple Indicator Cluster Surveys. Methods The study used women datasets (N = 7795) aged 15 to 49 years from three waves (2006, 2011, and 2017-2018) of the Ghana Multiple Indicator Cluster Surveys (GMICS). STATA version 14 was used for data analyses. Univariable analyses, bivariable analyses with chi-square test of independence, and multivariable analyses with robust multinomial logistic regression models were fitted. Results The study found a consistent increase in the proportion of women having adequate and optimal antenatal attendance from 2006 to 2018 across the women’s sociodemographic segments. For instance, the proportion of mothers achieving adequate antenatal care (4 to 7 antenatal care visits) increased from 49.3% in 2006 to 49.98% in 2011 to 58.61% in 2017-2018. In the multivariable model, women with upward attainment of formal education, health insurance coverage, increasing household wealth, and residing in the Upper East Region were consistently associated with a higher likelihood of adequate and/or optimal antenatal care attendance from 2006 to 2018. Conclusion Women who are less likely to achieve optimal antenatal care visits should be targeted by policies towards reducing maternal mortalities and other birth complications. Poverty-reduction policies, promoting maternal and girl-child education, improving general livelihood in rural settings, expanding health insurance coverage and infrastructural access, harnessing community-level structures, and innovative measures such as telehealth and telemedicine are required to increase antenatal care utilization.

Factors Affecting Nonadherence to WHO’s Recommended Antenatal Care Visits among Women in Pastoral Community, Northeastern Ethiopia: A Community-Based Cross-Sectional Study

“…This finding was in agreement with the results of the studies in Ethiopia [ 12 , 14 , 18 ], Ghana [ 20 ], East Africa [ 9 ], and Sub-Saharan Africa [ 10 , 38 ] that reported women's education as an enabling factor for attending four or more ANC visits. This finding was also supported by other previous studies [ 9 , 13 , 28 , 39 , 40 ]. This could be explained by the fact that educated women might have a better awareness of the benefits of adequate ANC attendance [ 41 ] and thus more likely to adhere to the recommended visits.…”

Correlates of late initiation and underutilisation of the recommended eight or more antenatal care visits among women of reproductive age: insights from the 2019 Ghana Malaria Indicator Survey

“…Yet, some women in Ghana are unable to attain this recommendation due to barriers such as financial constraints and poor road infrastructure. 15–17 Despite the institutionalisation of the FANC model in Ghana for over a decade, the maternal mortality ratio remains high (343 per 100 000 live births). 18 This raises concerns about the implementation of the latest recommendation of eight or more ANC visits during pregnancy.…”

What has recommended Antenatal Care utilisation got to do with optimal intake of IPTp-SP among rural women aged 15-49 in Nigeria?: A population-based surveys

“…Therefore, during the survey, women who gave birth two years before the data collection were asked the number of times they attended ANC, "How many times did you receive antenatal care during this pregnancy?". To be consistent with the literature (41,42), all women who mentioned that they had less than four ANC visits were classi ed as "not recommended" while those who made four or more visits were classi ed as "recommended". We recoded "not recommended" as "0" and recommended as "1".…”

“…Recommended ANC visits served as the study's main explanatory variable. To conceptualise recommended ANC visits in accordance with prior studies' conceptualization of recommended ANC visits and the WHO recommendation on minimum ANC visits for expecting mothers (41)(42)(43), our de nition of recommended ANC visits included four or more ANC visits. The NDHS asks women about their past pregnancies as well as other vital examinations that are important for maternal and child health, like ANC visits.…”