Exploring cooking fuel choices among Ghanaian women of reproductive age: A socio-economic analysis from a statistical mechanics perspective.

This study examined awareness and utilization of maternal and child health services among women of reproductive age in rural areas in Akwa Ibom State. Three objectives and three research questions were raise to guide this study. A descriptive survey research design was adopted and the population of this study was 303,768 females of reproductive age in the study area and a sample size of 246 women of reproductive age drawn through purposive sampling technique was used for the study. A researcher-developed questionnaire titled Awareness and Utilization of Maternal and Child Health Care Services Questionnaire with reliability coefficient of 0.73 was the instrument for data collection. The data were analyzed using frequency and percentage. The findings of the study indicated that there was a great awareness of maternal and child health services among women of reproductive age; utilization of maternal and child health services among women of reproductive age was good; there was a great level of utilization of maternal and child health services among women of reproductive age. Based on these findings, it was concluded that there was optimal awareness and utilization of maternal and child health services among women of reproductive age in rural areas in Akwa Ibom State. Based on the findings, recommendations were made that federal, states and local government areas should still need to reach out to other people who do not utilize maternal and child health care services; educating women and men about the importance of maternal and child health care services would make them to utilize the services and efforts should be made to fill health service gaps with substantial success through more community-based facilities and financial subsidies.

The rising consumption of unhealthy foods, characterized by high levels of sugar, salt, and unhealthy fats, poses significant health risks to women. Urbanization and globalization have shifted dietary patterns, leading many people to opt for processed and fast foods over traditional, nutrient-rich meals. This trend contributes to increased rates of non-communicable diseases, such as diabetes, and cardiovascular conditions, particularly among women of reproductive age. To determine the socio-demographic and economic factors associated with unhealthy food consumption among women of reproductive age in Tanzania. The study analyzed secondary data from the 2022 Tanzania Demographic and Health Survey and Malaria Indicator Survey. The study included a weighted sample of 15,254 women of reproductive age. The "svy" command in Stata was used to assign the sample weight. Multivariable logistic regression was employed to identify significant factors associated with unhealthy food consumption, with significance set at a 5% level. The overall unhealthy food consumption among women of reproductive was 14% (95% CI: 12.9, 15.2). The study found that women residing in urban areas (AOR = 1.37, 95% CI = 1.17, 1.61), women with secondary education (AOR = 1.72, 95% CI = 1.36, 2.17), higher education (AOR = 2.39, 95% CI = 1.73, 3.31), women from middle quintile (AOR = 1.35, 95% CI = 1.06, 1.73), and rich quintile (AOR = 2.42, 95% CI = 1.92, 3.05), married women (AOR = 0.87, 95% CI = 0.75, 1.00), women who listened to radio (AOR = 1.18, 95% CI = 1.04, 1.34), watching television (AOR = 1.23, 95% CI = 1.08, 1.40), having 0-2 children (AOR = 1.30, 95% CI = 1.06, 1.58) were significantly associated with unhealthy food consumption. The study found that overall unhealthy food consumption among women of reproductive age was 14%. This was associated with place of residence, education level, wealth status, listening to radio, watching television and number of children. The study recommends implementation of community-based nutritional education programs focusing on healthy eating habits, particularly targeting urban areas where unhealthy food consumption is higher as well as utilize mass media platforms to disseminate information about healthy dietary habits.

IntroductionIn the pursuit of achieving the Sustainable Development Goal targets of universal health coverage and reducing maternal mortality, many countries in sub-Saharan Africa have implemented health insurance policies over the last two decades. Given that there is a paucity of empirical literature at the sub-regional level, we examined the prevalence and factors associated with health insurance coverage among women in in sub-Saharan Africa.Materials and methodsWe analysed cross-sectional data of 307,611 reproductive-aged women from the most recent demographic and health surveys of 24 sub-Saharan African countries. Bivariable and multivariable analyses were performed using chi-square test of independence and multi-level logistic regression respectively. Results are presented as adjusted Odds Ratios (aOR) for the multilevel logistic regression analysis. Statistical significance was set at p<0.05.ResultsThe overall coverage of health insurance was 8.5%, with cross-country variations. The lowest coverage was recorded in Chad (0.9%) and the highest in Ghana (62.4%). Individual-level factors significantly associated with health insurance coverage included age, place of residence, level of formal education, frequency of reading newspaper/magazine and watching television. Wealth status and place of residence were the contextual factors significantly associated with health insurance coverage. Women with no formal education were 78% less likely to be covered by health insurance (aOR = 0.22, 95% CI = 0.21–0.24), compared with those who had higher education. Urban women, however, had higher odds of being covered by health insurance, compared with those in the rural areas [aOR = 1.20, 95%CI = 1.15–1.25].ConclusionWe found an overall relatively low prevalence of health insurance coverage among women of reproductive age in sub-Saharan Africa. As sub-Saharan African countries work toward achieving the Sustainable Development Goal targets of universal health coverage and lowering maternal mortality to less than 70 deaths per 100,000 live births, it is important that countries with low coverage of health insurance among women of reproductive age integrate measures such as free maternal healthcare into their respective development plans. Interventions aimed at expanding health insurance coverage should be directed at younger women of reproductive age, rural women, and women who do not read newspapers/magazines or watch television.

BackgroundOverweight and obesity of women is a growing concern all over the world. However, an understanding on the socio-economic inequalities in overweight and obesity of women received little attention, especially in the context of Bangladesh. Therefore, the objective of this study was to measure the inequality in overweight and obesity among women of reproductive age in Bangladesh as well as to explore the effect of various socio-economic factors on this inequality.MethodsThis study used data from the Bangladesh Demographic and Health Survey 2014 which is a nationally representative data. The concentration index of overweight and obesity was applied to measure the extent of socio-economic inequality. Finally, the concertation index was decomposed in order to understand the contribution of different socio-economic variables in inequality in overweight and obesity of women.ResultsThis study included a total of 16,624 women of reproductive age. The study found that the prevalence of overweight was about 29% and the rate of obesity was approximately 11%. The value of concentration index for overweight and obesity was 0.37 (p < 0.001). This study also observed that about 52% inequality was explained by household’s wealth status followed by watching television (25%), husband/partner’s educational status (around 7%), women’s educational status (about 5%), place of residence (approximately 4%).ConclusionsThis study found notable level of overweight and obesity among the women of Bangladesh. Various socio-economic factors like wealth status, education levels of women and partners, urban settings, women watching television predominantly contributed to the inequality in overweight and obesity among women of reproductive age. Therefore, the study suggests adopting necessary interventions targeting the women of higher socio-economic status to reduce the risk of life-threatening problems caused by overweight and obesity.

Anemia remains a global public health problem, especially in developing countries. It affects primarily children under five (CU5), women of reproductive age (WRA), and pregnant women due to their higher need for iron. The most common form of anemia is iron-deficiency anemia (IDA). IDA is estimated to cause half of all anemia cases and one million deaths per year worldwide. However, there remains a lack of well-documented and biochemically assessed prevalence of IDA based on the representative population-based samples globally and regionally. In this study, we aimed to assess the National Nutrition Survey (NNS) 2018 to identify the prevalence and risk factors of IDA in Pakistani CU5 and WRA. Secondary analysis was conducted on the NNS 2018, a cross-sectional survey, which collected data on dietary practices, malnutrition, and food insecurity. Anemia was defined as hemoglobin levels < 11.0 g/dL in children and 12.0 g/dL in women. IDA was defined as low hemoglobin and low ferritin (<12 ng/mL) levels, adjusted for inflammation using AGP and CRP biomarkers in CU5 and WRA. Univariate and multivariable logistic regressions were conducted using Stata statistical software (version 16). We also compared the IDA rates of NNS 2018 and 2011. A total of 17,814 CU5 and 22,114 WRA were included in the analysis. Of the CU5, 28.9% had IDA, while 18.4% of WRA reported to experience IDA. Among the CU5, IDA was most prevalent among male children aged 6-23 months living in rural areas and with the presence of diarrhea and fevers in the last 2 weeks. Children whose mothers had no education, were aged 20-34 years, and employed, had a higher prevalence of IDA. Married WRA, who are employed, living in rural areas, and with no education, had a higher prevalence of IDA. In the multivariable logistic regression, children aged 6-23 months (AOR = 1.19, 95% CI [1.08-1.33], p < 0.001) and with the presence of diarrhea in the last 2 weeks (AOR = 1.32, 95% CI [1.13-1.54], p < 0.001) or fever (AOR = 1.16, 95% CI [1.02-1.32], p = 0.02) had higher odds of IDA. At the household level, the odds of IDA among CU5 were higher in the poorest households (AOR = 1.27, 95% CI [1.08-1.50], p = 0.005), with ≥5 CU5 (AOR = 1.99, 95% CI [1.28-3.11], p = 0.002), and with no access to improved sanitation facilities (AOR = 1.17, 95% CI [1.02-1.34], p = 0.026). For WRA, the multivariable logistic regression found that the odds of IDA were higher among women with vitamin A deficiency (Severe: AOR = 1.26, 95% CI [1.05-1.52], p = 0.013; Mild: AOR = 1.36, 95% CI [1.23-1.51], p < 0.001), zinc deficiency (AOR = 1.42, 95% CI [1.28-1.57], p < 0.001), no education (AOR = 1.53, 95% CI [1.30-1.81], p < 0.001), and from severely food insecure households (AOR = 1.20, 95% CI [1.07-1.34], p = 0.001). The odds of IDA were lower among women whose body mass index was overweight (AOR = 0.77, 95% CI [0.69-0.86], p < 0.001) or obese (AOR = 0.71, 95% CI [0.62-0.81], p < 0.001). The child's age, presence of diarrhea or fever, place of residence, household size, wealth status, and access to sanitation facilities were significantly associated with IDA among CU5 in Pakistan. For WRA, education, body mass index, vitamin A and zinc status, household food security status, wealth status, and access to sanitation facilities were significantly associated with IDA. Large, well-established, government-funded programmes focused on micronutrient supplementation, food fortification, the diversification of food supplies, and the treatment and prevention of infectious and parasitic diseases are needed to prevent IDA and all forms of anemia among children and women in Pakistan.

The development of the information age has had a certain degree of impact on the fertility intention of women of childbearing age. There is relatively little current research on the fertility intention of women of childbearing age from the perspective of information technology. This study objectively describes the fertility intention of women of childbearing age in Hebei Province and combines past literature to explore the underlying reasons. Research has found that the current willingness to have multiple children in both urban and rural areas in this region is relatively low, with more women of childbearing age in rural areas than in cities. Compared to the beginning of this century, there may have been a degree of increase in the willingness to have multiple children due to the policy loosening. Based on the above results and combined with previous studies, this study explored how to promote the fertility willingness of women of childbearing age in Hebei Province from the perspective of informatization such as the Internet, new media, and digital economy.

Malnutrition has been persistently high in Tanzania, especially in the rural areas. Although some interventions have been implemented to reduce the rate of undernutrition, improvement is much slower than expected. Moreover, the prevalence of overweight and obesity among women of reproductive age has been on the increase. Changes in lifestyles specifically in eating habits may contribute to the observed increase trend in the prevalence of overweight and obesity. However, there are limited studies that have assessed diet quality for women. Hence, this study aimed to assess the consumption of protective and risk food groups for non-communicable diseases (NCDs) in rural areas of the Morogoro region, Tanzania. The cross-sectional study involved 512 randomly selected women of reproductive age in Mvomero district. All mothers or caretakers with children of age 6-23 months who resided in the area for over three months were eligible to participate. A structured questionnaire was used to collect demographic data and the Global Diet Quality Questionnaire was used to collect dietary intake data for women. A multivariate regression model was used to identify factors associated with consumption of diversified diets, NCD-protect, and NCD-risk food group scores. The results show that about 42% of the women had no formal education and about one in three women own a mobile phone. About 70% consumed vegetables while 33% consumed deep fried foods. Only 34% of the women met the minimum diet diversity (MDD-W) of five or more food groups. The mean NCD-protect score was 2.8 ± 1.4 and the NCD-risk score was 0.77 ± 0.97. Household income was positively associated with an increase in both protect scores and NCD-risk. Mobile phone ownership was positively associated with NCD-risk. Other factors such as age and self-employment in agriculture were positively associated NCD-protect while the number of children was negatively associated with NCD-protect score. Rural communities should be educated on the importance of food diversification starting from production to consumption and the need for multiple sources of income to increase purchasing power of the household while considering proper food choices to avoid the risk of NCDs. The Ministry of Agriculture and other stakeholders should support and promote production of bio-fortified crops and keeping small animals. The Ministry of Education should ensure that school children are aware of the NCD-risk foods and make available healthier food choices around the school environment.

Objectives: To assess the knowledge, self-reported practices on prevention of Iron deficiency anemia and to find the relationship between knowledge and practice. Materials and methods: Questionnaire on demographic proforma, knowledge and self reported practice on prevention of Iron deficiency anemia were used to collect the data. A descriptive survey design was adopted and 120 women were selected for the study using cluster sampling technique. Results: Majority of women belonged to the age group of 31-45 years (53.3%), most of them (31.7%) had the secondary level of education. Majority of participants had inadequate knowledge (55.8%) and unfavorable practices (58.3%) with regard to iron deficiency anemia and its prevention. There was a weak positive correlation between knowledge and self-reported practices of women (? = 0.275, p= 0.002). Conclusion: The women of reproductive age have inadequate knowledge on iron deficiency anemia and its prevention. Adequate knowledge may lead to better practices on prevention of iron deficiency anemia.

Although Ghana has made modest progress in the fight against HIV, the prevalence among women remains high, with 66% of people living with HIV in the country being females. Besides, approximately 71% of people with HIV in Ghana know their status compared with the global average of 85% and the WHO target of 95%. This relatively low percentage of people with HIV, knowing their status, tends to derail Ghana's attainment of SDG 3.3. Against this backdrop, this paper examines the drivers of HIV testing status among women of reproductive age in Ghana to inform policy. We analysed a nationally representative sample of 14,997 women aged 15-49 from the 2022 Ghana Demographic and Health Survey (GDHS). A pooled and disaggregated (rural vs. urban) multiple logistic regressions were estimated to examine the drivers of HIV testing uptake among women in Ghana. Approximately 54% of the sampled women had ever tested for HIV. Women residing in urban areas had a high HIV testing status (58.83%) relative to their counterparts in rural areas (48.91%). At the bivariate level, ever-married (66%) and pregnant women (69%) had a higher HIV testing uptake relative to their never-married (39%) and not-pregnant (52%) counterparts. Findings from the multivariate logistic regressions highlight significant similarities in the drivers of HIV testing among rural and urban women, albeit some of the predictors are exclusive to either rural or urban areas. HIV testing is significantly predicted by wealth status, education, age, marital status, employment, pregnancy status, and administrative region of residence. Though women in the richer and richest wealth categories were more likely to undertake HIV testing in both urban and rural areas, the positive effect was more pronounced among women residing in urban areas. Besides, the level of education predicted the HIV testing status of women in both rural and urban areas, albeit the effect was more pronounced in the rural areas. Moreover, pregnant women in the urban areas were more likely to test for HIV relative to their counterparts in the rural areas. The study demonstrated the need to target women of lower socio-economic status and those pregnant, especially in rural areas, for HIV public health education interventions. Such interventions are crucial in increasing HIV testing to avert severe HIV/AIDS morbidity through appropriate ART and thus avoid preventable deaths. The study also highlights the need to improve the availability of testing kits in rural areas to address the supply-side challenges facing public health facilities in rural areas.

Research examining the life situations of the general population of very old adults has increased during the past decade (e.g., Manton, 1986; Rosenwaike, 1985). Very old adults, for example, are found to have longer recovery time from acute health conditions; to have increased limitations of activities, length of hospitalization, institutionalization, and need for assistance; and more limitations in activities of daily living than other older adults (Rosenwaike, 1985). Relatively little research, however, has examined the characteristics and needs of adults surviving to very old age in rural areas. Information on the very old is important because of their distinct vulnerability to inadequate health and related care, especially in rural under-served areas. Approximately 25% of adults 65 years of age or older, or over 7.6 million persons, reside in rural areas (U.S. Bureau of the Census, 1992). In addition, 25% of elders 85 years of age and older live in rural areas (U.S. Bureau of the Census, 1992). Nationally, it is estimated that between 1980 and 2030, the number of adults in this very old age group will triple and by 2050 the number will have increased sevenfold (U.S. Senate Special Committee on Aging, 1991). Although the majority of very old adults will continue to reside in urban locations, a substantial number will be located in rural areas. Additionally, many of these very old rural elders, and the families caring for them, can be expected to have inadequate resources for the maintenance of their well-being. AGING IN RURAL CONTEXT For the purposes of this review, issues related to aging in rural areas have been divided into two major sections. First, information is provided regarding environmental and individual characteristics of very old persons aging in a rural context. Second, information pertinent to the prediction of very old age survival in rural areas is presented. Characteristics of Very Old Persons Elders in rural areas have been described as disadvantaged, both in terms of community and individual resources, when compared with older adults residing in metropolitan areas (e.g., Coward, 1987; Glasgow, 1988; Glasgow, Holden, McLaughlin, & Rowles, 1993; Lee & Lassey, 1980; McLaughlin & Jensen, 1993). Several community-level characteristics, including small community size, population dispersion, geographic isolation, limited public sector resources, and the concentration of economic resources in a small number of business and industry sectors, have contributed to economic hardships and inadequate social and supportive resources available for elders in rural areas (Glasgow, 1993). Glasgow (1993) noted two ways these limitations affected well-being: (a) by reducing the effective social and economic responses possible from the public sector, including adequate access to proximate health care, public transportation, and formal social services; and b) by frequently limiting older adults' access to helpers within their informal network. The life situations of older adults in rural areas have been further affected by individual-level social and economic changes during the last decade. For example, older adults residing in rural areas have become more diverse. This increased diversity has complicated the creation of viable service models. Rowles and Johansson (1993) described four types of rural elderly residents in terms of their community integration: (a) lifelong community residents who have maintained large kinship and informal networks; (b) lifelong community residents whose informal support resources have been reduced as family members have moved from the area; (c) return migrant elders who, because of their limited recent history in the area, have minimal access to informal support networks; and (d) retirees who have moved from urban areas with little or no previous social history in the area and, as a result, have limited informal social support. An individual-level economic change affecting many older rural adults is the increasing number of very old rural adults living in poverty. …

Background Spousal violence is a critical public health issue in India, with profound physical, psychological, and sexual consequences, particularly among married women of reproductive age in rural areas, where the risk is alarmingly high. The aim of the study is to assess various forms of spousal violence, its associated factors, and the pathways leading to different forms of abuse among women of reproductive age residing in the selected rural area of Chengalpattu District, Tamil Nadu. Methodology A community-based cross-sectional study was conducted on 250 married women of reproductive age. The participants were selected using systematic random sampling from a prepared line list. Data were collected from a sample of 250 women through face-to-face interviews using the Indian Family Violence and Control Scale (IFVCS), and multivariate logistic regression analysis and path analysis were performed using SPSS v25 (IBM Corp., Armonk, NY, US). Results Multivariate analysis identified regular alcohol consumption of husbands and spousal violence had the highest odds for all three forms of spousal violence: psychological violence (odds ratio (OR) = 5.15, 95% CI: 2.62-10.11), physical violence (OR = 6.6, 95% CI: 3.29-13.23), and sexual violence (OR = 2.89, 95% CI: 1.09-7.69). Other factors, such as nuclear families and lower socioeconomic status, were found to be significantly more vulnerable. Path analysis indicated that psychological violence often precedes physical and sexual violence, with alcohol consumption acting as a key trigger. Conclusion Women often face multiple interrelated forms of violence, with significant determinants including husbands' alcohol use, nuclear families, and lower socioeconomic status. Therefore, a multifaceted strategy is needed to prevent this threat.

The planning family acts to help the family to plan the pregnant and natal they want. The target of research: to knowing the factors related to the contraception use plan in women of reproductive age. Method Research: Sample of The Indonesia Demographic and Health Survey (IDHS) 2017 includes 1, 970 census blocks covering urban and rural areas. The implementation of the IDHS uses 3 types of questionnaires. Results: the planned use of contraception in women of reproductive age is mostly in rural areas and in women of reproductive age with elementary-high school education. Most women of reproductive age know more about modern contraception. Plans for use of contraception in women of reproductive age in married women. Conclusions: residence, education, knowledge of the types of contraceptive methods and marital status are related to contraception use plans in women of reproductive age.

&lt;p class="abstract"&gt;&lt;strong&gt;&lt;span lang="EN-US"&gt;Background: &lt;/span&gt;&lt;/strong&gt;Reliable data on mortality and morbidity among women of reproductive age are scarce in India. The present study is the Rajasthan component of a large multi-centric study on cause of death by verbal autopsy conducted in five states of India. The data pertaining to deaths among women of reproductive age are presented. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;&lt;span lang="EN-US"&gt;Methods: &lt;/span&gt;&lt;/strong&gt;House-to-house surveys of a representative population from rural and urban areas in six districts of Rajasthan were undertaken by Probability of Proportion to Size (PPS) sampling. Information on death was obtained from the relatives of the deceased and cause of death was assigned using the standardized algorithm prepared for the purpose. International Classification of Diseases - ICD-10 was used to code the assigned cause of death. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;&lt;span lang="EN-US"&gt;Results: &lt;/span&gt;&lt;/strong&gt;A total of 231 deaths of women of reproductive age were investigated, of which 36 (16%) were maternal deaths while 195 (84%) were non-maternal deaths. Nine out of ten maternal deaths were in rural area.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;&lt;span lang="EN-US"&gt;Conclusions: &lt;/span&gt;&lt;/strong&gt;Certain infectious and parasitic diseases; pregnancy, childbirth and the puerpurium; injury, poisoning and other consequences of external causes; and symptoms, signs and abnormal clinical and laboratory findings not elsewhere classified were found to be the major killers among the women of reproductive age. A comprehensive approach that includes in addition to reproductive health interventions, interventions addressing underlying illiteracy among women and social reforms needs to be undertaken. &lt;/p&gt;&lt;p class="keywords"&gt;&lt;strong&gt;&lt;span lang="EN-US"&gt;Keywords: &lt;/span&gt;&lt;/strong&gt;Maternal deaths, Non-maternal deaths, Women of reproductive age, Verbal autopsy&lt;/p&gt;

This study aimed to identify factors associated with the use of modern contraceptive service among rural married women of reproductive age in Myanmar. A cross-sectional quantitative study was conducted among 648 married women aged 18-49 years (4 townships with the lowest contraceptive prevalence (n=316) and 4 townships with the highest prevalence (n=332). This study found that women in townships with low prevalence of modern contraceptive use were more likely to be illiterate and manual workers or farmers, to have lower education and no regular income, other religions than Buddhism, and higher number of family members and children, compared to those with high prevalence. In addition, they responded negatively to the accessibility, availability, affordability and acceptability of contraceptive services, and lower satisfaction with the services. This study suggests that the Myanmar government should promote contraceptive services more aggressively for women of reproductive age in rural areas that reflect ethnic minority cultures.

Despite global commitment and investment in improving maternal and child health, inequities in antenatal care (ANC) persist, especially in sub-Saharan Africa (SSA), but evidence on variations in ANC initiation at the global SSA level is limited. This study analyzed variations in ANC initiation and examined the associated factors among women of reproductive age in SSA. The data were drawn from the most recent Demographic and Health Survey conducted between 2007 and 2019 in thirty-six (36) countries. The analytical sample consisted of 123,134 women who had births in the two years preceding the survey and made at least one ANC visit during the index pregnancy. The association between the timing of ANC initiation and each independent variable was examined using the Pearson chi-square test. Kaplan-Meier survivor curves were generated to examine the extent to which ANC initiation occurred over time. Event history analysis models were specified using the discrete-time logit function to examine the unadjusted and adjusted effects of each covariate on ANC initiation. The results indicate that only 36.9% of the women initiated ANC within the first trimester during the index pregnancy and a little less than 1 in 10 (8.2%) did not initiate ANC until the third trimester. The country-specific results show wide variations in the initiation of ANC. For example, ANC initiation in the first month of pregnancy was least common in Niger (0.2%) and most common in Liberia (16.6%). The time to initiation of ANC visits at any time interval was greater for women in rural areas, those with no education or primary education and women who had no exposure to mass media. Among several covariates, increased involvement of females in household decision-making and household wealth status were found to be associated with ANC initiation. Women who participated in making three and four household decisions were more likely to initiate ANC (aOR = 1.02, p < 0.05 and 1.03, p < 0.01 respectively) compared to women who did not participate in household decision-making. Women who belonged to higher wealth status categories showed higher odds of ANC initiation compared to those in the poorest category. The findings of the present study indicate that early initiation and universal coverage of ANC among women of reproductive age in SSA continues to be a challenge. Policies that target female education up to at least the secondary level and interventions that improve the socioeconomic status of women can empower women to make decisions for themselves, which could increase the chances of early and timely ANC initiation.