Abstract

Antenatal care is an important determinant of pregnancy and childbirth outcomes. Although the youth disproportionately experience adverse maternal complications and poor pregnancy outcomes, including maternal mortality, timely and frequent use of antenatal care services among unmarried youth in Uganda remains low. This study examines the factors that are important predictors of the use of antenatal health care services among unmarried and married youth. Binary logistic regression was conducted on the pooled data of the 2006, 2011 and 2016 Uganda Demographic and Health Surveys among youth who had given birth within five years before each survey to examine the predictors of ANC use. This analysis was among a sample of 764 unmarried, compared to 5176 married youth aged 15–24 years. Overall, married youth were more likely to have more frequent antenatal care visits (56% versus 53%) and start antenatal care early (27% versus 23%) than unmarried youth. Factors significantly associated with use of antenatal care in the first trimester were education and occupation among unmarried youth, and place of residence and access to the radio among married youth. Key predictors of ANC frequency among unmarried youth were parity, education level, pregnancy desire, age group, sex of head of household and region of residence. Among married youth, significant predictors of ANC frequency were parity, pregnancy desire, occupation, access to the radio and region of residence. These findings will help inform health-care programmers and policy makers in initiating appropriate policies and programs for ensuring optimal ANC use for all that could guarantee universal maternal health-care coverage to enable Uganda to achieve the SDG3.

Highlights

  • And frequent use of antenatal care (ANC) services among unmarried youth remains low in Uganda

  • It was higher among married youth who had at least secondary education (29% compared to 26% for primary/no education), and highest among those who resided in western region (33%), had less frequent access to the radio (30%), and had more frequent access to the television (31%)

  • Unmarried youth who had at least a secondary level of education were 36% less likely to attend ANC in the first trimester compared to those with no education or primary level education only (OR = 0.640, 95% CI = 0.421–0.972)

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Summary

Introduction

And frequent use of antenatal care (ANC) services among unmarried youth remains low in Uganda. The World Health Organisation (WHO) recommended at least four ANC visits, and the first one would be in the first three months of the pregnancy (MoH 2013, 2016; WHO 2016a). This has been reviewed overtime to at least eight visits to reduce perinatal mortality and improve women’s experience of care (WHO 2018; Lattof et al 2020). This is lower among adolescents, with a much lower proportion (14%) of the adolescents having had at least four ANC visits in 2011 (UBOS and ICF International 2012)

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