Determinants of Antenatal Health Care Utilization in Egypt (2000-2014) Using Binary and Count Outcomes

Hassan H M Zaky,Dina M Armanious,Mohamed Ali Hussein

doi:10.4236/health.2019.111004

Hassan H M Zaky, Dina M Armanious + Show 1 more

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https://doi.org/10.4236/health.2019.111004

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Abstract

Aim: This study seeks to investigate the factors determining the utilization of antenatal care services, the frequency of that use, and the timing of receiving antenatal care among Egyptian women utilizing a national representative data from Egypt Demographic and Health Surveys (EDHS) in 2000 and 2014. Methods: The paper estimates the logistic regression model, zero-inflated negative binomial model (ZINB), and negative binomial regression model (NB) to identify the most important determinants of antenatal health care utilization. Results: The findings indicate that the period 2000-2014 has experienced a significant increase in the use of antenatal health care services. The use of the public sector antenatal care services relative to that of the private sector has been decreasing over time. Moreover, wealth index, women’s education and quality of health services play significant roles in increasing accessibility of antenatal health care services. On the other hand, women’s empowerment has shown a positive effect in 2000 only. Conclusion: The study highlights the most vulnerable groups that are less likely to have access to antenatal health care services, mainly women who are less educated, poor and living in rural areas especially Upper Egypt. This certainly requires a more targeted health strategy with an equity lens.

Highlights

Complications resulting from pregnancy and childbirth are still the most important reasons of death and morbidity among women of reproductive age in developing countries more than any other single health problem [1]
The results show that women received regular antenatal care (4 visits or more) for 39 percent of last births in the five years period before the survey in 2000, compared to about 83 percent in 2014
The findings show that there has been a sharp rise in the utilization of antenatal health care services from 2000 to 2014

Summary

Introduction

Complications resulting from pregnancy and childbirth are still the most important reasons of death and morbidity among women of reproductive age in developing countries more than any other single health problem [1]. About 830 women around the world die from causes related to pregnancy and delivery and the majority are concentrated in low-income countries. These deaths could have been circumvented through an effective and efficient antenatal health care system [2]. A strategy that encourages universal access to antenatal health care will assist in decreasing maternal and neonatal mortality [4]. Egypt has started its health sector reform program since mid-2000s. Throughout these years, the program has continued to develop with varying degrees of success and failure. The main objective was to improve access and provide quality services at the primary level through a basic benefit package that included maternal services

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