Abstract
Background: The government of Nepal aims to improve the health of mothers and newborns by providing quality safe motherhood services. Increasing access and utilization of antenatal care (ANC) services are the first steps towards improving maternal and neonatal health outcomes, particularly those of the marginalized communities.Objective: The aim of this study is to assess the prevalence and factors associated with the antenatal care visits among the marginalized community of Nepal.Methods: A mixed-method study was conducted among 202 reproductive aged females of marginalized community in Nepal having childbirth during the last 2 years. Pre-tested semi-structured questionnaires and key informant interview guidelines were used for the collection of data. Bivariate and multiple regression analysis were carried out to find out the factors associated with the antenatal care visits. For qualitative data, thematic analysis was done. Results: More than half (56.9%) of the participants had completed four or more antenatal care visits. Mothers with primary level of education were 2.7 times more likely to complete four or more ANC visits (AOR: 2.7, CI: 1.09-7.07). Age at marriage (AOR: 2.3, CI: 1.08-5.22), women who took decisions alone for their health (AOR: 2.9, CI: 1.22-6.96),exposure to FCHV (AOR:2.5, CI: 1.1-5.9), knowledge about safe delivery incentive program (AOR: 3.6, CI: 1.46-9.0) and perception of “good quality” ANC service(AOR:7.5, CI: 3.3-17.1)were significantly associated with the number of ANC visits. Conclusion: The overall utilization of antenatal health services was low. So, there is a need of different community based maternal health programs especially targeting the marginalized females.
Highlights
Maternal health is one of the most important health indicators, and it indicates the overall health status of a country.1Although maternal mortality has decreased by 38% between 2000 to 2017, maternal mortality is still unacceptably high
In Nepal, the proportion of women who had four or more antenatal care (ANC) visits has increased from 9 % in 1996 to 69% in 2016.3Those women who had better socio-economic and educational status and those living in urban area were more likely to visit skilled care personnel for ANC visits compared to those with low socio-economic status, less education and those living in rural areas
A further analysis of Nepal demographic and health survey revealed that those belonging to high caste had more ANC visits compared to the women from marginalized communities.8Marginalized communities in Nepal are suffering from inequality in economic, social and political rights, opportunities and benefits.9Thus the study was conducted to assess the prevalence and factors associated with ANCvisitsamong the marginalized community of Nepal
Summary
Maternal health is one of the most important health indicators, and it indicates the overall health status of a country.1Although maternal mortality has decreased by 38% between 2000 to 2017, maternal mortality is still unacceptably high. A further analysis of Nepal demographic and health survey revealed that those belonging to high caste had more ANC visits compared to the women from marginalized communities.8Marginalized communities in Nepal are suffering from inequality in economic, social and political rights, opportunities and benefits.9Thus the study was conducted to assess the prevalence and factors associated with ANCvisitsamong the marginalized community of Nepal. Increasing access and utilization of antenatal care (ANC) services are the first steps towards improving maternal and neonatal health outcomes, those of the marginalized communities. Objective: The aim of this study is to assess the prevalence and factors associated with the antenatal care visits among the marginalized community of Nepal. There is a need of different community based maternal health programs especially targeting the marginalized females
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