Women’s enlightenment and early antenatal care initiation are determining factors for the use of eight or more antenatal visits in Benin: further analysis of the Demographic and Health Survey

Abstract

Background: Within the continuum of reproductive health care, antenatal care (ANC) provides a platform for vital health care functions, such as disease prevention, health promotion, screening, and diagnosis. It has been widely confirmed that by implementing appropriate evidence-based practices, ANC can save lives. Previous studies investigated the utilization of ANC based on the four visits model. The new guidelines set by the World Health Organization 2016 recommended increasing contacts with health providers from four to eight contacts. The present study aims to determine the frequency, determinants, and socioeconomic inequalities of ANC utilization based on the eight or more contacts in Benin. This will provide information for policy makers to improve ANC utilization. Methods: We used a population-based cross-sectional data from Benin Demographic and Health Survey (BDHS)-2017-2018. The outcome variable considered for this study was coverage of ≥ 8 ANC contacts. About 1094 women of reproductive age who became pregnant after the new guideline of ≥ 8 ANC contacts was endorsed were included in this study. The determinants for ≥ 8 ANC contacts were measured using multivariable logistic regression. Concentration (Conc.) Index and Lorenz curves were used to estimate the socioeconomic inequalities of ≥ 8 ANC contacts. The level of significance was set at P < 0.05. Results: The coverage of ≥ 8 ANC contacts was 8.0%; 95%CI 6.5%, 9.7%. The results of timing of antenatal care initiation showed that women who had late booking (after 1st trimester) had 97% reduction in ≥ 8 ANC contacts compared with women who initiated ANC contacts within the first trimester (adjusted odds ratio (AOR) = 0.03; 95% CI 0.00, 0.21). In addition, women with medium or high enlightenment were 4.55 and 5.49 as more likely to have ≥ 8 ANC contacts, compared with women having low enlightenment (AOR = 4.55; 95% CI 1.41, 14.69 and AOR = 5.49; 95% CI 1.77, 17.00, respectively). Conc. Index for the household wealth-related factor was 0.33; p < 0.001 for urban women and 0.37; p < 0.001 for the total sample. Similarly, Conc. Index for maternal education was 0.18; p = 0.006 for urban women and 0.21; p < 0.001 for the total sample.

Individual-, household-, and community-level factors associated with eight or more antenatal care contacts in Nigeria: Evidence from Demographic and Health Survey

“…This shows that compliance with the updated recommendation is low, probably because it may not have been adopted as a national policy. This study reported a higher prevalence than a previous study conducted using Benin population-based data which also examined the coverage of eight or more ANC visits [ 36 ]. Similarly, the observed prevalence is slightly higher than results from a previous multi-country study that revealed 15.3% of mothers had eight or more antenatal contacts; with the first contact in the first trimester of pregnancy.…”

“…This underscores the importance of social and behavioural change communication to increase awareness and create demand for the use of maternal health services [12]. Similarly, the findings from previous studies showed that women enlightenment and early ANC initiation were significantly associated with eight or more ANC contacts [36,61]. There is no doubt, that early booking for ANC would result in optimal number of ANC contacts during pregnancy as those who start early will have higher possibility of achieving optimal ANC visits.…”

Dimensions of women’s empowerment on access to antenatal care in Uganda: a further analysis of the Uganda demographic health survey 2016

“…Decision making included women's ability to be involved in making decisions regarding; their own health; large household purchases; visits to their family and control over their earnings 5 . Re-coding to the responses was done to have two categories (1 = woman involved in decision making alone or with partner, 0 = woman not involved in decision making).…”

“…Globally, over half of maternal mortalities are due to pregnancy-related complications and over 90% of these deaths are from low and middle income countries 5 . Majority of these maternal deaths are preventable through skilled birth attendance and increased antenatal care (ANC) contacts 5 . Focused antenatal care has been shown to increase the likelihood of skilled birth attendance 1,6 and also gives health workers an opportunity to advise pregnant women on essential pregnancy care to reduce malnutrition, stillbirths, maternal mortality and morbidity, and neonatal deaths 5,7 .…”

“…Proper access to ANC has been shown to reduce maternal mortality by up to 8 per 1000 live births 5 .…”