Abstract
BackgroundIn African countries, including Angola, antenatal care (ANC) coverage is suboptimal and maternal mortality is still high due to pregnancy and childbirth-related complications. There is evidence of disparities in the uptake of ANC services, however, little is known about both the socio-economic and geographic-based disparity in the use of ANC services in Angola. The aim of this study was to assess the extent of socio-economic, urban-rural and subnational inequality in ANC coverage in Angola.MethodsWe analyzed data from the 2015 Angola Demographic and Health Survey (ADHS) using the World Health Organization (WHO) Health Equity Assessment Toolkit (HEAT) software. The analysis consisted of disaggregated ANC coverage rates using four equity stratifiers (economic status, education, residence, and region) and four summary measures (Difference, Population Attributable Risk, Ratio and Population Attributable Fraction). To measure statistical significance, an uncertainty interval (UI) of 95% was constructed around point estimates.ResultsThe study showed both absolute and relative inequalities in coverage of ANC services in Angola. More specifically, inequality favored women who were rich (D = 54.2, 95% UI; 49.59, 58.70, PAF = 43.5, 95% UI; 40.12, 46.92), educated (PAR = 19.9, 95% UI; 18.14, 21.64, R = 2.14, 95% UI; 1.96, 2.32), living in regions such as Luanda (D = 51.7, 95% UI; 43.56, 59.85, R = 2.64, 95% UI; 2.01, 3.26) and residing in urban dwellings (PAF = 20, 95% UI; 17.70, 22.38, PAR = 12.3, 95% UI; 10.88, 13.75).ConclusionThe uptake of ANC services were lower among poor, uneducated, and rural residents as well as women from the Cuanza Sul region. Government policy makers must consider vulnerable subpopulations when designing needed interventions to improve ANC coverage in Angola to achieve the 2030 Sustainable Development Goal of reducing global maternal mortality ratio to 70 deaths per 100,000 live births.
Highlights
In African countries, including Angola, antenatal care (ANC) coverage is suboptimal and maternal mortality is still high due to pregnancy and childbirth-related complications
ANC coverage remains an essential indicator of access and use of health care during pregnancy; it is measured as the number of women aged 15–49 with a live birth in a given period that received ANC, four or more times during pregnancy, as a percentage of the women aged 15–49 who had a live birth in the same period [5]
Disparities in the use of ANC services have been to the detriment of poor and uneducated women, as well as women residing in rural areas or specific regions of Angola
Summary
In African countries, including Angola, antenatal care (ANC) coverage is suboptimal and maternal mortality is still high due to pregnancy and childbirth-related complications. ANC coverage is a measure of access and utilization of health care during pregnancy [4] It provides an opportunity for pregnant women to use services that contribute to a “positive pregnancy experience” [3]. ANC coverage remains an essential indicator of access and use of health care during pregnancy; it is measured as the number of women aged 15–49 with a live birth in a given period that received ANC, four or more times during pregnancy, as a percentage of the women aged 15–49 who had a live birth in the same period [5]. Numerous studies have shown positive effects of antenatal care on infant birth weight [6, 7], early detection of diseases or risks and fetal abnormalities including the diagnosis of growth retardation [8,9,10] and reductions in maternal and neonatal morbidity and mortality [11, 12]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
