Antenatal Care Services Research Articles

Utilization, satisfaction, and barriers to antenatal care among pregnant women in Gadarif State during the Sudan war: a cross-sectional study

BackgroundHealthcare services during wartime face significant challenges. Pregnant women seeking antenatal care (ANC) during the Sudan conflict encounter numerous barriers, impacting their access and satisfaction. This study assessed ANC utilization, satisfaction, and barriers faced by pregnant women in Gadarif State during the ongoing war.MethodsThis cross-sectional study was conducted at Gadarif Hospital for Obstetrics and Gynecology from September to November 2024, targeting women who had given birth at the hospital. A questionnaire with four sections assessed utilization, satisfaction, and barriers with ANC during wartime. Cross-tabulations and chi-square tests analyzed associations between categorical variables, with p-values < 0.05 considered significant.ResultsA total of 345 pregnant women participated in this study. ANC utilization was reflected in a median of 4.0 visits (IQR = 2.0), with the first visit occurring at a median of 13 weeks (IQR = 13). Overall, 90.4% of participants reported being satisfied with ANC services, although satisfaction with interpersonal communication skills was the lowest at 6.4%. Barriers to access included lack of privacy (33.3%) and irregular facility operating hours (21.4%), while the primary reasons for missing ANC visits were transport challenges and the absence of night-duty staff.ConclusionThis study revealed a surprisingly high level of satisfaction with ANC services, despite key barriers such as lack of privacy and irregular health facility operating hours. While ANC attendance was relatively good, visits tended to start later than recommended. Interventions should focus on addressing these barriers by improving service accessibility and ensuring consistent care. Enhancing early engagement with ANC is also critical to improving maternal health outcomes.

Effective coverage for maternal health: operationalising effective coverage cascades for antenatal care and nutrition interventions for pregnant women in seven low- and middle-income countries.

Efforts to improve maternal health have focused on measuring health and nutrition service coverage. Despite improvements in service coverage, maternal mortality rates remain high. This suggests that coverage indicators alone do not fully capture the quality of care and may overestimate the health benefits of a service. Effective coverage (EC) cascades have been proposed as an approach to capture service quality within population-based coverage measures, but the proposed maternal health EC cascades have not been operationalised. This study aims to operationalise the effective coverage cascades for antenatal care (ANC) and maternal nutrition services using existing data from low- and middle-income countries (LMICs). We used household surveys and health facility assessments from seven LMICs to estimate EC cascades for ANC and maternal nutrition services provided during ANC visits. We developed theoretical coverage cascades, defined health facility readiness and provision/experience of care scores and linked the facility-based scores to household survey data based on geographic domain and facility type. We then estimated the coverage cascade steps for each service by country. Service contact coverage for at least one ANC visit (ANC1) was high, ranging from 80% in Bangladesh to 99% in Sierra Leone. However, there was a substantial drop in coverage from service contact to readiness-adjusted coverage, and a further drop to quality-adjusted coverage for all countries. For ANC1, from service contact to quality-adjusted coverage, there was an average net decline of 52 percentage points. For ANC1 maternal nutrition services, there was an average net decline of 48 percentage points from service contact to quality-adjusted coverage. This pattern persisted across cascades. Further exploration revealed that gaps in service readiness including lack of provider training, and gaps in provision/experience of care such as limited nutrition counselling were core contributors to the drops in coverage observed. The cascade approach provided useful summary measures that identified major barriers to EC. However, detailed measures underlying the steps of the cascade are likely needed to support evidence-based decision-making with more actionable information. This analysis highlights the importance of understanding bottlenecks in achieving health outcomes and the inter-connectedness of service access and service quality to improve health in LMICs.

A qualitative study of abortion decision-making trajectories among pregnant women at their first antenatal care visit in Kampala, Uganda.

In Uganda, only about half of women who want to avoid pregnancy are using modern contraceptives, leading to high numbers of unintended pregnancies and elevated maternal and neonatal morbidity and mortality. In this study, we aimed to learn more about women's abortion decision-making before continuing to carry a pregnancy. We utilised a qualitative study design and interviewed 31 purposively selected single and partnered pregnant women aged ≥18 years at their first antenatal care visit at Kawempe National Referral Hospital in Kampala, Uganda. We conducted the interviews in Luganda or English, transcribed them, and then translated them into English, as needed, for analysis. We analysed the data using thematic analysis. Deductive codes were based on social networks, social support, and health behaviour theories, and inductive codes were derived from interview transcripts. Almost half of the study participants (n = 13) considered an induced abortion before deciding to continue carrying their pregnancy. The most commonly stated reasons they considered abortion included anticipated interruptions to work and education, exhaustion related to child-rearing, and lack of social support. Other participants (n = 9) reported not considering abortion due to anticipated social support for their pregnancy, concerns about abortion-related morbidity and mortality, late confirmation of pregnancy, and religious beliefs. No participants discussed Uganda's restrictive abortion policies as a reason not to consider abortion. Our results point to opportunities for continued reproductive health education and improved access to reproductive health services to allow pregnant women to meet their reproductive needs, seek out family planning, antenatal care, and safe abortion services when desired, and create support networks for pregnant women.

Factors associated with late antenatal care booking in selected health facilities of Zoba Maekel, Eritrea: a cross-sectional study

BackgroundAntenatal care is a special care provided for pregnant women with the aim of preventing, detecting, and treating health problems in both the fetus and mother. Early antenatal care attendance promotes early detection and treatment of complications which result in proper management during delivery and puerperium. However, the majority of pregnant women in Eritrea initiate their ANC booking late. The study aims to assess factors associated with late ANC booking among pregnant mothers attending selected antenatal care services in Zoba Maekel, Eritrea.MethodA health facility based cross-sectional study was conducted from February to March 2022 among 439 pregnant women. To select the study participants, a stratified two-stage cluster sampling method was employed and a predesigned and pretested questionnaire was used to collect data regarding factors associated with late antenatal booking. Binary logistic regression analysis was used to assess the association between the outcome variable and the independent variables and a P-value less than 0.05 was considered statistically significant.ResultThe prevalence of late antenatal care booking was 59% (95% CI 0.54–0.64). Those aged 20–34 years (AOR: 0.26; 95% CI: 0.15–0.44), 34 and above (AOR: 0.21; 95% CI: 0.11–0.33), and those who were unemployed (AOR: 0.45; 95% CI: 0.34–0.59) had decreased odds of late first ANV booking. Having family size of 4 and above (AOR: 2.25; 95% CI: 1.07–4.74), reside in rural areas (AOR = 2.20, 95%, CI: 1.38–3.50), from Muslim religion (AOR = 2.11, 95%, CI: 1.70–2.62), with gravida 2 to 4 (AOR = 2.11, 95%, CI: 1.70–2.62) and gravida 5 and above (AOR = 3.11, 95%, CI: 2.26–4.27) had higher odds of late antenatal care initiation. The odds of late ANC initiation was 1.62 among ANC visitors yet not accompanied by their husband to health center (AOR = 1.62, 95% CI 1.35–1.95).ConclusionThis study showed that most pregnant women did not start ANC booking earlier. Further, the study indicated that younger age, rural settlements, family size ≥ 4, from Muslim religion, employees, gravida 4 to 9, and those who did not get husband/family support to ANC follow-up, were highly likely to initiate ANC booking late. Hence, it is crucial to provide health education on the timing of ANC among women of reproductive age. The community's awareness of the importance of receiving early ANC also needs to be promoted.

Predictors of Antenatal Care Service Utilization Among Women of Reproductive Age in Ethiopia: A Systematic Review and Meta-Analysis.

Objective: This study aimed to provide pooled predictors of ANC (antenatal care) service use among women of reproductive age in Ethiopia. Methods: Studies were systematically searched using PubMed, Medline, CINAHL, EMBASE, and Google Scholar. The Newcastle-Ottawa scale (NOS) tool was utilized for quality assessment (risk of bias). All data analyses were conducted by utilizing Stata version 17. A random-effects model was used to obtain the pooled predictors of ANC use. The publication bias was checked using a funnel plot and Egger's regression test. Results: Twenty-two studies with a sample size of 25,671 were included in this review. The identified predictors of ANC service use were highest wealth rank (AOR 1.92 [95% CI: 1.53-2.31]), formal women education (AOR 2.40 [95% CI: 1.75-3.06]), formal husband education (AOR 1.49 [95% CI: 1.36-1.66]), women age ≥ 20 (AOR 1.75 [95% CI: 1.47-2.17]), mass media exposure (AOR 1.44 [95% CI: 1.21-1.66]), good maternal knowledge about the pregnancy complication (AOR 1.49 [95% CI: 1.11-1.88]), planned pregnancy (AOR 1.59 [95% CI: 1.28-1.91]), women autonomy (AOR 1.42 [95% CI: 1.23-1.62]), and positive husband attitude about the ANC service use (AOR 2.63 [95% CI: 1.47-3.79]). Conclusions: Several predictors have increased the ANC service utilization, like wealth status, women's and their husbands' education, older/increasing women's age, media exposure, maternal knowledge about pregnancy complications, planned pregnancy, women's autonomy to decide on household health care, and positive husband attitude about the ANC service utilization.

Utilization of Antenatal and Maternity Health Care Services among Nursing Mothers Attending Child Welfare Services in Epe Local Government Area, Lagos State, Nigeria

This study is to investigate the utilization of antenatal and maternity healthcare services among nursing mothers attending child welfare services in Epe Local Government Area of Lagos State, Nigeria. Three research questions and hypotheses were postulated for this study. Descriptive survey research design was adopted for the study. Multistage sampling was used to select primary health centre for the study. Simple Random sampling was used to select three primary health centres for the study in Epe Local Government, while the purposive sampling technique was used to select 150 nursing mothers for the study. The findings of the study revealed that there was significant utilization of antenatal care services among nursing mothers attending child welfare services in Epe Local Government Area, Lagos State, there was significant utilization of maternity health care services among nursing mothers attending child welfare services in Epe Local Government Area, Lagos State and significant relationship existed between utilization of antenatal care, maternity health care services, maternal and child health care among nursing mothers attending child welfare services in Epe Local Government Area, Lagos State. The study recommends that Lagos State Government and healthcare providers should work to improve access to antenatal and maternity healthcare services, particularly in rural and disadvantaged areas.

Exploring challenges in accessing primary healthcare for pregnant women in Pakistan: a qualitative descriptive study

IntroductionMaternal and newborn mortality are critical global health concerns. Achieving Sustainable Development Goal 3.8 (SDGs), which aims to improve these outcomes, is hindered by the poor quality of care in health facilities, a significant barrier to the utilization of antenatal care (ANC) services in Pakistan. This study aimed to explore the barriers to the underutilization of ANC services in Tehsil (sub-division of a district) Hazro, Punjab, Pakistan, from the perspective of pregnant women.MethodThe study employed four focus group discussions (FGDs) with 36 pregnant women who had attended at least three ANC visits. Data were collected through purposive sampling and analyzed using NVivo 12, ensuring rigor through Lincoln and Guba’s guiding principles.ResultThe findings revealed three key themes, following the three delays model: 1. Decision to Seek Care, 2. Delay in Reaching Healthcare Facilities, and 3. Delay in Acquiring Satisfactory and Appropriate Health Care. Women often made the decision to seek care with the support of their spouse, family, and lady health workers, highlighting the importance of their decision-making autonomy. Financial constraints did not significantly hinder access to healthcare services. However, long distances, travel time, and associated costs were identified as major barriers. Most importantly, the majority of women lacked awareness of danger signs and the importance of seeking timely medical help. This issue was compounded by the unavailability of healthcare personnel, negative staff attitudes, insufficient medicines and equipment, and a lack of referral services.ConclusionThis descriptive study underscores the urgent need for affordable, accessible, and responsive maternal and child healthcare. To address these barriers, stakeholders − including policymakers, public health experts, and maternal, neonatal, and child health (MNCH) providers − must prioritize MNCH initiatives and reforms. Collaborative efforts are crucial to translating MNCH policies into effective strategies at the community level.

Women’s Status and its Association with Antenatal Care Use: A Cross Sectional Study Conducted In Gilgit Baltistan

According to the WHO, more than 287,000 women died during pregnancy and after childbirth in 2020. Sub-Saharan Africa and south Asia are at high risk in maternal mortality rate. In Pakistan, the maternal mortality rate is 186 per 100,000 live births, and 49% of women still don’t visit for adequate antenatal care. Socio-cultural factors have a critical role in accessing maternal healthcare services. This study investigated the association between women’s autonomy and utilization of maternal healthcare services in Gilgit-Baltistan. In the study, a cross-sectional survey design was adopted, and multi-stage sampling techniques were employed. A total of 928 samples were selected from the four districts of the Baltistan division. The results show that women and their husband’s education strongly associated with the utilization of antenatal care services (OR, 4.230, CI: 95% 2.761-6.479 with P-value .000), Women’s involvement in decision making about reproductive health related matters also significantly associated with women receiving antenatal care services (OR 5.082, CI: 95% 3.366-7.673 with Pvalue-.000). Keeping in view the current findings it strongly recommended that state agencies and non-governmental organization should focus on female literacy and women empowerment

Trends and inequalities in women’s use of quality antenatal care, intrapartum care, and immediate postnatal care services in Ethiopia: multivariate decomposition, secondary data analyses of four demographic and health surveys over two decades (2001–2019)

ObjectiveThis study aimed to examine the trends and inequalities in women’s use of quality antenatal care (ANC), quality intrapartum care and immediate postnatal care (PNC) services, and the determinants that...

Antepartum Depression among Pregnant Women Attending Antenatal Care (ANC) Services in Tertiary Hospital of Nepal

Background: Antepartum depression is common complication of women during pregnancy, May affects the mother, child and family adversely with serious consequences like maternal suicide if it left untreated. To assess antepartum depression among pregnant women, a hospital-based cross-sectional study was conducted in Bharatpur Hospital of Chitwan. Methodology: A cross sectional study was conducted in a tertiary level government hospital using convenient sampling method. A total of 252 pregnant women were interviewed with semi structured questionnaire including Edinburg Postpartum Depression scale (Sensitivity-68.4, Specificity -93.8) to screen for antepartum depression. Data was entered on Epi-data and further analyzed using SPSS. Results: Out of 252 respondents, 16.7 % were with antepartum depression while 83.3% recorded no antepartum depression. Loneliness (AOR= 24.96, 95% CI (2.92-213.45) and self-harm (AOR= 3.39, 95%CI (1.11-10.38) had higher odds of having antepartum depression. Conclusions and Recommendations: The study indicates that feeling of self-harm thoughts and thought of loneliness are much important for reducing the problem burden of antepartum depression which affects the health of both mother and child. So, further efforts should be considered and programs targeting health related quality of pregnant women should be incorporated in developing countries like Nepal.

Integrating WHO's digital adaptation kit for antenatal care into BornFyne-PNMS: insights from Cameroon.

Digital health innovations represent unique opportunities to address maternal, newborn, and child health challenges in Sub-Saharan Africa. In 2021, the World Health Organization (WHO) launched the Digital Adaptation Kits (DAKs) for antenatal care (ANC) as part of its Standards-Based, Machine-Readable, Adaptive, Requirements-Based, and Testable (SMART) guidelines approach. DAKs are operational and software-neutral mechanisms that convert WHO guidelines into standardized formats that can be easily integrated into digital systems by various countries. This article outlines the methodology for updating and integrating WHO DAK content into the BornFyne-prenatal management system (PNMS) version 2.0. This study, which employs a participatory action research approach, is part of a larger research study for the BornFyne-PNMS project. A review of the ANC DAK operational document and data dictionaries was conducted to identify elements that were present in BornFyne-PNMS version 1.0. This was followed by a series of consultations and stakeholder meetings. Five stakeholder meetings were held to engage stakeholders across Cameroon. Some of the registration elements, among other DAK aspects of ANC service provision, were identified in BornFyne version 1.0 but required reorganizing, remodeling, and reanalyzing to align with the International Classification of Diseases codes and DAK data content as part of the expansion for BornFyne version 2.0. Up to 40% of the DAK dictionary data content existed within the BornFyne-PNMS version 1.0, including additional DAK content adapted to update BornFyne-PNMS version 2.0. The digital health ecosystem in Cameroon is in an emerging phase with an increasing demand for digital health technologies, especially in the areas of reproductive, maternal, newborn, child, and adolescent health. The digital health ecosystem in Cameroon is in an emerging phase with an increasing demand for digital health technologies, especially in the area of reproductive, maternal, newborn, child, and adolescent health. This article describes and documents the steps in operationalization of the ANC DAK content into the BornFyne-PNMS content, highlighting the DAK as an important tool for guiding and facilitating software engineers in developing and integrating recommended ANC guidelines into digital platforms to facilitate interoperability, going by the structure of the document, its workflow processes, and content mapping elements.

Consumption of Mixed Indigenous Vegetables: A solution to low hemoglobin levels among pregnant women in Babati, Tanzania

Pregnancy-related anemia is a critical health issue affecting a larger number of pregnant women in Tanzania affected. The study examined the impact of consuming locally grown indigeneous vegetables on iron intake and anemia prevention. The study utilized a cross-sectional design to investigate the impact of consuming locally grown indigenous vegetables on iron intake and anemia prevention among 340 pregnant women in Babati District, Tanzania. Participants were recruited from antenatal care services at four health facilities within the district. Dietary assessments were conducted to evaluate food consumption patterns and Dietary Diversity Scores (DDS).were calculated to determine the variety of food groups consumed. Indigenous vegetables were analyzed for the iron, vitamin C, and phytate content to assess their nutritional composition. Statistical analyses conducted included Chi2 (χ2) tests and Spearman rank correlations to evaluate the relationships between socio-demographic factors, dietary practices, and anemia prevalence. The prevalence of anemia was 45%, with a significant association between anemia and maternal age (P &lt; 0.04, χ2 = 6.43), as older women (36–49 years) were less likely to be anemic compared to younger women (≤35 years). Marital status also correlated with anemia (P &lt; 0.04, χ2 = 4.1), with married women showing a lower prevalence. Dietary diversity was limited, with only 55.6% of participants consuming five or more food groups (DDS ≥ 5). Indigenous vegetables, such as sweet potato leaves and amaranth combined with lemon juice, showed high vitamin C content (43.2 ± 0.26 mg/g), enhancing iron absorption. Hygiene practices like hand washing after toilet use were associated with reduced anemia risk (P &lt; 0.0022, χ2 = 9.352). This study highlights the importance of indigenous vegetables, dietary diversity, and good hygiene in reducing anemia among pregnant women in rural Tanzania, emphasizing the need for nutrition education and improved access to iron-rich foods.

Pengaruh Dukungan Psikososial, KIE dan Fasilitas Layanan Kesehatan terhadap Keputusan Ibu Hamil dalam Memilih ANC dan Persalinan

This study aims to analyze the role of Social Media Marketing as a moderation variable on the influence of psychosocial support, health communication, information and education (KIE), and health facilities on pregnant women's decisions in choosing Antenatal Care (ANC) and childbirth services at Petukangan General Hospital. Psychosocial support, which includes emotional and social support from family and health workers, plays an important role in lowering anxiety and improving the comfort of pregnant women. In addition, an effective KIE is able to increase the understanding of mothers-to-be regarding the risks and available health care options. Health facilities at Petukangan Hospital, including medical equipment, hygiene, and comfort of the treatment room, are also important aspects that affect the preferences of pregnant women. This study found that Social Media Marketing has a significant role as a moderation variable. With the right utilization, social media can be an effective platform to disseminate information about the quality of hospital services and facilities, so that it can influence the decision of pregnant women. The results of the analysis showed that the combination of psychosocial support, good information and education, quality health facilities, and effective marketing through social media increased the tendency of pregnant women to choose Petukangan Hospital as the place of delivery. This study underscores the importance of the right social media marketing strategy in improving hospital competitiveness in the digital era. Recommendations are given for Petukangan Hospital to strengthen digital marketing strategies to maximize the positive influence on the decisions of potential patients, especially among pregnant women.

Utilisation of eight or more antenatal care visits and its associated socio-economic-related inequalities in sub-Saharan Africa: A decomposition analysis.

Inadequate utilisation of maternal healthcare services, particularly antenatal care (ANC), poses a challenge in sub-Saharan Africa (SSA). There is a dearth of regional studies that address the socio-economic disparities in the use of ANC in SSA. Therefore, we examined the wealth and education-based inequalities in the utilisation of ANC services among women in SSA. We analysed secondary data obtained from the Demographic Health Survey conducted in fifteen countries in SSA. We estimated the degree of wealth and education-related inequalities using concentration curves, concentration indices (CIX), and decomposition analysis, which identified the factors contributing to the disparities in the utilisation of ANC. All the analyses were conducted using Stata version 17.0 (Stata Corporation, College Station, TX, USA). The results revealed a significant socio-economic gap in utilising ANC in SSA. We found positive and statistically significant wealth index-related (CIX = 0.30; p-value < 0.0001) and education-based inequalities (CIX = 0.33; p-value < 0.0001) in eight or more ANC visits. The extent of wealth index-related and education-based inequalities varied across the fifteen countries. The decomposition analysis showed that educational attainment accounted for about 21% of the inequalities in eight or more ANC visits. Wealth index contributed 12.14% of the inequalities in eight or more ANC visits. Our results further showed that women's education, wealth, parity, and place of residence significantly contributed to the utilisation of eight visits or more among women in SSA. This study shows the disparities in ANC coverage, contingent upon wealth index and educational attainment. Our study highlights the importance of adopting a holistic approach involving robust cooperation between healthcare and other social service sectors. It is crucial to prioritise the primary social factors contributing to disparities in the utilisation of ANC services, including women's education, parity, place of residence, and economic status. Policymakers and stakeholders must prioritise efforts to combat obstacles to healthcare access, including the provision of easily accessible, affordable, and culturally appropriate services.

Enhanced quality of nutrition services during antenatal care through interventions to improve maternal nutrition in Bangladesh, Burkina Faso, Ethiopia, and India.

Quality antenatal care (ANC) services are critical for maternal health and nutrition. Information on the quality of nutrition interventions during ANC is scarce in low- and middle-income countries. We examined the effects of intensified maternal nutrition interventions during ANC on service readiness, provision of care, and experience of care and assessed the inter-relationships between the dimensions of quality. We used data from impact evaluations of maternal nutrition interventions in Bangladesh, Burkina Faso, Ethiopia, and India. We calculated the quality of nutrition services during ANC using information from health facility assessments, health care provider interviews, ANC observations, and client exit interviews. We used structural equation models to examine relationships between the dimensions of quality. Health facilities in all four countries had a high service readiness component in terms of basic amenities, equipment and supplies, medicines and commodities, and guidelines (mean (x̄) = 8-10 in Bangladesh and Burkina Faso, x̄ = 7-9 in Ethiopia, and x̄ = 6-8 in India). Scores for provision of care were low across the countries but higher in intervention compared to control areas in Bangladesh (5.2 vs. 2.9) and Burkina Faso (5.6 vs. 4.8), but not significantly different in Ethiopia (range = 4.7-5.0) and India (range = 2.6-3.5). For experience of care, client satisfaction scores were high and similar between intervention and control areas in all countries (range = 8.3-9.7), but client experience scores were lower with statistically significant differences observed only in Bangladesh (x̄ = 8.2 in intervention vs. x̄ = 7.1 in control areas). The interventions had significant direct effects on service readiness in Bangladesh (β = 0.07), Burkina Faso (β = 1.20), and Ethiopia (β = 1.0), on the provision of care in Bangladesh (β = 2.27), Burkina Faso (β = 1.27), and India (β = 0.96), and experience of care in Bangladesh (β = 0.21). In this study, we provided evidence on various dimensions of service quality that may be improved by interventions to strengthen nutrition services during ANC in diverse low- and middle-income countries.

Antenatal care services utilization and their associated factors among postnatal women in Dodoma city: a cross-sectional study

BackgroundIn 2016, the World Health Organization (WHO) updated its antenatal care (ANC) guidelines to improve the quality and effectiveness of ANC services. Whether in Tanzania the services are utilized according to the WHO’s guidelines remains a subject for investigation. Thus, the aim of this study was to assess the utilization of ANC services in line with the antenatal care guidelines among postnatal women in Dodoma City, Tanzania.MethodsWe employed an analytical cross-sectional study design. A questionnaire was developed based on information from literature and the Tanzania ANC guideline of 2018 to obtain data about social demographic characteristics and ANC services utilization. A total of 426 postnatal women were sampled using a proportionate systematic random sampling procedure. Data were collected using a face-to-face interview and abstraction from the ANC card. Using SPSS software version 26, We performed descriptive and regression analyses using SPSS software version 26 to determine the utilization of services and the associated factors. Data were considered significant at a p-value < 0.05 and reported along with 96% confidence intervals.ResultsThe majority of the postnatal women (63.2%) initiated ANC visits during their first trimester. The availability of ANC support person was the key factor associated with the early initiation of ANC services. The median number of antenatal contacts was 4, with only 6.8% of postnatal women being able to meet the minimum of eight contacts as recommended by WHO. The top ANC services provided to the majority of women include education about the use of bed nets to prevent malaria during pregnancy (92.9%), Tetanus Toxoid (TT) vaccination (86.8%), Intermittent Preventive Therapy for malaria (IPTp-SP) medication (90.8%) and mebendazole medication to treat or prevent parasitic infections (90.1%).ConclusionOverall, the majority of women in Dodoma initiate ANC contacts within the first trimester, but only a small proportion complete eight contacts as recommended by WHO. The health care system should prioritize addressing the factors identified in this study, particularly by encouraging ANC support persons to increase the frequency of ANC contacts.

Impact of Covid-19 on antenatal care: evidence from Madagascar Demographic and Health Survey.

Despite the growing literature on the impact of Covid-19 on antenatal care (ANC) and maternal/neonatal and child health outcomes globally, substantial knowledge gaps remain about the population-level impact in sub-Saharan Africa (SSA). Existing evidence on the ANC impact of Covid-19 in SSA is largely based on health facility or small-scale qualitative research, which are limited in providing population-level understanding. This paper examines the extent to which Covid-19 impacted ANC service utilisation and identifies what population sub-groups were most adversely impacted. It is based on a secondary analysis of the Madagascar Demographic and Health Survey (DHS), the first DHS in SSA released following the Covid-19 pandemic. Multilevel logistic regression analysis was used to estimate the net effect of Covid-19 on ANC and identify the most at-risk population sub-groups. The findings show that all ANC measures considered (no ANC, early ANC, adequate ANC visits) were significantly affected by Covid-19 (p<0.05). On average, Covid-19 was associated with a 42% increase in the odds of having no ANC, a 22% reduction in the odds of starting early ANC during the first trimester, and a 22% reduction in the odds of receiving adequate ANC (at least four visits, starting during the first trimester). Births to older mothers and to mothers with no education were disproportionately affected during Covid-19. Although youth aged 15-24 had poorer ANC compared to older women before the pandemic, the pattern was reversed during the pandemic. Also, the protective effect of education was stronger during than before the pandemic. These findings underscore the importance of Covid-19 impact mitigation strategies targeting the most at-risk groups (e.g. older mothers). Furthermore, essential information/education during pandemics should be in formats accessible to non-literate women. This paper advances understanding of the population-level impact of Covid-19 on ANC and emphasises the need for further research to better understand the population-level impact of Covid-19 across countries of SSA.

Prevalence and Susceptibility of Trichomoniasis among Pregnant Women Attending Selected Primary Health Care Centers within Chikun Local Government Area, Kaduna State

Trichomoniasis is a disease caused by a protozoan parasite called Trichomonas vaginalis which is transmitted through sexual contact. Complications of T. vaginalis include cystitis, cervicitis, urethritis, infertility, low birth weight, neonatal morbidity, and mortality. This study, therefore, was carried out to determine the occurrence of Trichomoniasis among pregnant women attending ante-natal care services in some Primary Health Care Centers (PHC) within the Chikun Local Government Area of Kaduna State. A sample size of 360 was used in the study. High vaginal swab (HVS) samples were collected from each pregnant woman using the septic method. Wet mount preparation and culture method were used to identify T. vaginalis isolates, and the isolates were further confirmed using molecular techniques and a phylogenetic tree. The susceptibility pattern of the drug metronidazole against the isolates was determined using a standard method. The results obtained in this study revealed that 24 (6.7%) samples were positive for T. vaginalis in both wet mount and culture methods. A single 312bp product of the region was amplified in all 24 samples. Partial nucleotide sequences of T. vaginalis isolates using BLAST analysis with reference sequences in the GenBank database showed that twenty-four isolates belonged to T. vaginalis. All isolates were susceptible to the varied Minimum Inhibitory Concentration (MIC) after 24 hours of treatment with metronidazole (0.4, 0.8, 1.6, and 3.2 µg/ml) except the isolates treated with 0.1 µg/ml of metronidazole.

Mobile Application Prototype: AP3S to Prevent Stunted Babies

Stunting in toddlers is a serious concern because it can have various short and long-term adverse effects. Therefore, it is necessary to design a mobile-based system to monitor the health of pregnant women early on so that stunted babies can be prevented. This study aims to develop a prototype of an application for early detection of stunting risk in Androidbased antenatal care services. This application prototype is made in Indonesian and is called: “Aplikasi Pendampingan Percepatan Penurunan Stunting (AP3S)”/Stunting Reduction Acceleration Assistance Application. The methodology applied is the system development life cycle (SDLC), one of the primary methods for developing mobile applications in the health sector. As a result, a prototype application with a design and functionality that facilitates access for pregnant women can connect directly with health workers and monitor and consult further. As for health workers, AP3S can provide a comprehensive health analysis of antenatal care, including nutrition for pregnant women, fetal growth monitoring, and health education. AP3S has the advantage of being able to immediately display the risk of babies born stunted or babies with low birth weight so that preventive interventions can be carried out immediately. In conclusion, after conducting a literature study and prototype development, an efficient, easy-to-use, and safe application prototype was obtained to facilitate patient access to health services to prevent babies born with stunting.

Male Participation Factors in Antenatal Care for Maternal Health in Rural Areas: Systematic Review

Maternal health remains a critical global health priority, especially in rural areas where Antenatal Care (ANC) services often face significant challenges, including limited resources, low awareness, and cultural barriers. Male involvement plays a vital role in improving maternal health outcomes. This systematic review examines factors influencing male participation in ANC services in rural settings. A literature search was conducted using PubMed, ProQuest, and Scopus databases from 2019 to 2024. Keywords included "pregnant woman," "rural population," "antenatal care," "patriarchal culture," and "men involvement". After filtering, 17 relevant articles were selected based on CEBM study quality. The study included qualitative, quantitative, and mixed-method research on male participation in ANC at both community and facility levels. Only studies published in English within the specified timeframe were included, while duplicates, non-English articles, and studies outside the rural context were excluded. Among the selected studies, eight were quantitative, six qualitative, and three employed mixed methods. Findings reveal that education, social norms, economic factors, and policies significantly influence husbands' involvement in ANC, aligning with previous research. However, this review highlights key differences, particularly in the impact of social changes that promote greater male participation and the role of concrete policies in enhancing their access to ANC. To improve husband involvement, targeted interventions are necessary, including couple-based educational programs, enhanced accessibility and affordability of health services, and shifts in community attitudes toward men's roles during pregnancy. Addressing these factors is essential for improving maternal health outcomes in rural settings.