Abstract

BackgroundGood quality antenatal care visits are crucial to reduce maternal mortality and improve overall maternal and neonatal health outcomes. A previous study on antenatal care visits analyzed the nationally representative data of 2011; however, no studies have been conducted recently in Nepal. Therefore, we analyzed the sociodemographic correlates of the frequency and quality of antenatal care among Nepalese women from the nationally representative data of 2016.MethodsWe analyzed data obtained from the Nepal Demography Health Survey (2016) on antenatal care for 2761 women who had one or more births in the past three years. Our study defined ‘good quality antenatal care’ as at least a 75% score on a composite metric which was obtained by adding the weighted scores assigned to the twelve recommended components of antenatal care. We analyzed the factors associated with the frequency and quality of antenatal care by using multiple Poisson regression and multiple logistic regression.ResultsWhile 70% of the Nepalese women surveyed had at least four antenatal care visits, only 21% of these women received good-quality antenatal care. We found that the educated women (APR: 1.12; CI: 1.05–1.19) and the women of rich wealth index (APR: 1.27; CI: 1.18–1.37) were more likely to receive a higher number of antenatal visits. In contrast, women living in rural areas (APR: 0.92; CI: 0.87–0.98), and those who had more than two children (APR: 0.88; CI: 0.83–0.93) were less likely to receive a higher number of antenatal visits. Regarding the quality of antenatal care, educated women (AOR: 1.51; CI: 1.09–2.08), women who had educated husbands (AOR: 2.11; CI: 1.38–3.22), women of rich wealth index (AOR: 1.58; CI: 1.13–2.20) and women who had intended pregnancy (APR: 1.69; CI: 1.23–2.34), were more likely to receive good-quality antenatal care.ConclusionsObserving a wide variation in the coverage of different components of antenatal care, concerned stakeholders could tailor the interventions by focusing on components with lower use. Because we found an association of myriad sociodemographic factors with the frequency and quality of antenatal care, targeted interventions are necessary.

Highlights

  • Good quality antenatal care visits are crucial to reduce maternal mortality and improve overall maternal and neonatal health outcomes

  • Those women who had literate husbands were more likely to have a greater number of Antenatal Care (ANC) visits compared to those who had an illiterate husband (APR: 1.09, confidence intervals (CI): 1.02–1.17)

  • Women of rich wealth index (APR: 1.27, CI: 1.18–1.37) and middle wealth index (APR: 1.16, CI: 1.09–1.23) were expected to have a greater number of ANC visits compared to women who were categorized under poor wealth index

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Summary

Introduction

Good quality antenatal care visits are crucial to reduce maternal mortality and improve overall maternal and neonatal health outcomes. We analyzed the sociodemographic correlates of the frequency and quality of antenatal care among Nepalese women from the nationally representative data of 2016. As evidenced by systematic reviews and meta-analyses, ANC encourages pregnant women to deliver at the health facility, reduces maternal mortality [5], and improves neonatal outcomes [6]. It promotes a positive pregnancy experience in which every woman maintains a healthy pregnancy along with physical and sociocultural normality, self-esteem, competence, and autonomy [7]

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