Abstract
BackgroundAntenatal care (ANC) is crucial for the health of the mother and unborn child as it delivers highly effective health interventions that can prevent maternal and newborn morbidity and mortality. In 2002, the World Health Organization (WHO) recommended a minimum of four ANC visits for a pregnant woman with a positive pregnancy during the entire gestational period. Tanzania has sub-optimal adequate (four or more) ANC visits, and the trend has been fluctuating over time. An understanding of the factors that have been contributing to the fluctuating trend over years is pivotal in increasing the proportions of pregnant women attaining adequate ANC visits in Tanzania.MethodsThe study used secondary data from Tanzania Demographic Health Survey (TDHS) from 2004 to 2016. The study included 17976 women aged 15-49 years. Data were analyzed using Stata version 14. Categorical and continuous variables were summarized using descriptive statistics and weighted proportions. A Poisson regression analysis was done to determine factors associated with adequate ANC visits. To determine factors associated with changes in adequate ANC visits among pregnant women in Tanzania from 2004 to 2016, multivariable Poisson decomposition analysis was done.ResultsThe overall proportion of women who had adequate ANC visits in 2004/05, 2010 and 2015/16 was 62, 43 and 51% respectively. The increase in the proportion of women attaining adequate ANC from 2010 to 2015/16 was mainly, 66.2% due to changes in population structure, thus an improvement in health behavior. While 33.8% was due to changes in the mother’s characteristics. Early initiation of first ANC visit had contributed 51% of the overall changes in adequate ANC attendance in TDHS 2015/16 survey.ConclusionEarly ANC initiation has greatly contributed to the increased proportion of pregnant women who attain four or more ANC visits overtime. Interventions on initiating the first ANC visit within the first twelve weeks of pregnancy should be a priority to increase proportion of women with adequate ANC visit.
Highlights
Antenatal care (ANC) is crucial for the health of the mother and unborn child as it delivers highly effective health interventions that can prevent maternal and newborn morbidity and mortality
The World Health Organization (WHO) 2002 Focus Antenatal Care (FANC) model recommends a minimum of four ANC visits for a woman with an uncomplicated pregnancy, with the first visit occurring during the first twelve weeks of pregnancy, currently there is an 8-contact model in place [9, 10]
This was a Crossectional study that used data from the Tanzania Demographic Health Survey (TDHS), Further details of the survey are available elsewhere [13], but in brief this is a national representative survey done after five years with the objective to obtain the current and reliable information on demographic and health indicators about family planning, fertility levels and preferences, maternal mortality, infant and child mortality, nutritional status of mothers and children, ANC, delivery care, and childhood immunizations and diseases
Summary
Antenatal care (ANC) is crucial for the health of the mother and unborn child as it delivers highly effective health interventions that can prevent maternal and newborn morbidity and mortality. An understanding of the factors that have been contributing to the fluctuating trend over years is pivotal in increasing the proportions of pregnant women attaining adequate ANC visits in Tanzania. Adequate and quality antenatal care (ANC) is effective at promoting better health outcomes for both mother and child during pregnancy [1, 2]. The WHO 2002 Focus Antenatal Care (FANC) model recommends a minimum of four ANC visits for a woman with an uncomplicated pregnancy, with the first visit occurring during the first twelve weeks of pregnancy, currently there is an 8-contact model in place [9, 10]. Despite high ANC coverage, adequate (four or more) ANC visits are still suboptimal and could partly explain the unacceptably high neonatal mortality and stillbirth rates in Tanzania, with 25 deaths/1000 live births and 39 deaths/1000 pregnancies, respectively [13]
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