Antenatal Care Utilization Research Articles

Reducing waiting time among pregnant women attending antenatal care clinic at Alexandria University Hospital, Egypt: quality improvement project

ABSTRACT Introduction Antenatal Care (ANC) is crucial for preventing maternal morbidity and death. WHO guidelines published in 2016 recommended that women should attend eight ANC visits as a minimum throughout pregnancy. This research aims at boosting pregnant women satisfaction with the ANC in a public health care facility and thus their willingness to comply with treatment and care. Objectives of this study were to assess the current state of ANC visits system inside Alexandria Main University Hospital (AMUH) and to examine the outcome of appointment scheduling approach on waiting time and utilization of ANC. Methods A prospective survey with pre & post intervention (quasi-experimental study). The study took place between Jan 2023 and April 2023. All expectant mothers who showed up for their regularly scheduled antenatal appointment were advised and invited to take part in the study. The study enrolled pregnant females who were eligible and gave their verbal consent. Pregnant women seeking emergency medical attention and pregnant women who refused to participate in the study were among the exclusion criteria. A purposive sampling technique was used to enroll pregnant women. When they arrived at the clinic, pregnant women who were eligible for the study were recognized and given counseling regarding the study’s goals and the extent of their participation. Prior to enrollment in the study, oral informed permission was obtained from each participant. Results The findings of the study imply that patient experience is a crucial factor in and of itself, and that it may significantly influence utilization patterns. Discussion By practically applying QI tools a sound effective outcomes can be reached. However, patient engagement & effective communication with stakeholders are cornerstones for sustainability of any project and to ensure continuous commitment and leadership support.

Rural-Urban Disparity in Maternal Health Care Service Utilization in Four Regions of Ethiopia: Ecological and Decomposition Analysis

Background: Maternal healthcare services utilization is very low in Ethiopia with a disparity among regions. Therefore, this study aimed to assess rural-urban disparity in maternal healthcare service utilization in four regions of Ethiopia. Method: This study used 2016 Ethiopian Demographic and Health Survey data. 2563 and 1555 women who delivered in 5-years and in 2-years prior to the survey from 220 clusters respectively included as respondents of the study. Partial ecological approach used a mixture of individual level and ecological variables (group level). Multivariable logistic regression, Blinder Oaxaca decomposition and Moran’s index were used during data analysis. Result: This study found; Media exposure in rural-urban, and wealth-index in rural areas as predictors of antenatalcare utilization. Wealth-index in rural, husband education level in urban, women autonomy for own healthcare and antenatal-care utilizations in rural and urban areas as predictors of place of delivery. Wealth-index in rural, antenatalcare utilization in urban; and place of delivery in both urban and rural areas predict postnatal-care utilization. Moreover; geographic clustering observed in the utilization of ANC (Moran’s I = 0.185031, p = 0.011056), health-facility delivery (Moran’s I = 0.271865, p = 0.000209), and PNC (Moran’s I = 0.315410, p = 0.000015). The study also revealed huge rural-urban disparities in utilization of maternal healthcare services in those four regions. Conclusion: Significant rural-urban inequalities in utilization of maternal healthcare services found in four regions of Ethiopia. Therefore, policymakers and concerned stakeholders needs to develop relevant strategies that will enhance maternal healthcare utilization in those marginalized regions.

Utilization of Antenatal Care and Skilled Birth Delivery Services in Sub-Saharan Africa: A Systematic Scoping Review.

Daily, the number of women who die around the world reaches an average of 800; these deaths are a result of obstetric complications in pregnancy and childbirth, and 99% of these deaths occur in low- and middle-income countries. This review probes the use of antenatal care (ANC) and skilled birth delivery (SBD) services in sub-Saharan Africa (SSA) and highlights research gaps using Arksey and O'Malley's methodological approach. The screening of abstracts and full text was carried out by two independent authors who ensured the eligibility of data extraction from the included articles. An exploration of the data was undertaken with descriptive analyses. In total, 350 potentially eligible articles were screened, and 137 studies were included for data extraction and analysis. From the 137 included studies, the majority were from Ethiopia (n = 40, 29.2%), followed by Nigeria (n = 30, 21.9%). Most of the studies were published between 2019 and 2023 (n = 84, 61%). Significant trends and challenges with ANC and SBD services emerged from the studies. It is revealed that there are wide gaps in the utilization of ANC and SBD services. Policy attention, intervention strategies to improve access, resources, rural-urban disparity, and women's literacy are recommended to improve the utilization of ANC and SBD services in SSA countries.

Utilization of Antenatal Care Services Within the Context of COVID-19, Security Challenges, and an Unstable Healthcare System at Primary Health Care Centers.

Utilizing antenatal care (ANC) is vital for maternal and neonatal well-being, especially in low-resource settings with healthcare challenges. Identifying factors impacting antenatal care this context, t of current situation in Sudan is crucial for developing strategies to improve maternal care. This study explores ANC utilization amidst COVID-19, security issues, and healthcare instability in primary health care centers in a resource-constrained environment, aiming to enhance maternal care access and quality. This is a mixed-methods study. Quantitative data were collected through a retrospective analysis of ANC attendance records before and during the pandemic. Demographic variables were analyzed for their association with ANC utilization. In-depth interviews were conducted to collect qualitative data from pregnant women and healthcare providers. These interviews focused on capturing the experiences, perceptions, and obstacles associated with antenatal care services during the pandemic and within the healthcare system challenges. Preliminary quantitative analysis revealed a significant decline in ANC utilization during the pandemic. Fear of COVID-19 infection, disrupted transportation, and resource constraints have emerged as significant barriers to ANC attendance. The qualitative findings highlighted the impact of security challenges on healthcare access and the adaptation strategies employed, including mobile ANC clinics and telehealth consultations. This study illuminates the intricate landscape of ANC utilization in the face of a pandemic, security instability, and healthcare system vulnerability. Policymakers and stakeholders should collaborate to strengthen healthcare systems and ensure the continued provision of essential maternal health services during challenging times.

Factors Associated with Delayed Utilization of Antenatal Care Services among Pregnant Women: A Case Study at Jinja Regional Referral Hospital, Uganda

In Uganda, despite the critical benefits of early initiation of Antenatal Care (ANC) within the first trimester of pregnancy, a significant proportion of women exhibit poor attendance during this period. This study aimed to identify the factors contributing to delayed utilization of ANC services among pregnant women at Jinja Regional Referral Hospital (JRRH). A cross-sectional descriptive study was conducted, employing quantitative methods. Data were collected from 93 pregnant women who had missed their first trimester ANC visit between March 1st and April 15th, 2023, using a pretested questionnaire. The study revealed various maternal, socioeconomic, and health facility-related factors contributing to delayed ANC utilization. Maternal factors such as young age, unplanned pregnancies, and primiparity were associated with delayed ANC attendance. Socioeconomic factors including financial constraints for transport and negative sociocultural beliefs also hindered timely ANC visits. Health facility-related factors such as long distances, extended waiting times, and high service costs further contributed to delayed utilization. The findings underscore the need for targeted interventions addressing these multifaceted barriers to ensure timely access to ANC services, thereby reducing maternal and infant morbidity and mortality in Uganda. Efforts should focus on improving awareness, enhancing accessibility, and addressing sociocultural norms to promote early ANC initiation and utilization among pregnant women.

IJCM_47A: A hospital based study to assess the utilization of ANC services among married women of reproductive age group in the sub District Hospital, West Delhi, India

Background: Antenatal Services provided by government and its timely utilization are vital for the health outcomes of the mother as well as of child. Objective: To study the current pattern of utilization of antenatal services. To assess the factors influencing utilization of antenatal services. Methodology: A facility based cross-sectional descriptive study was conducted at immunization clinic of sub district hospital from Aug 2022 to Oct 2022 among 230 randomly selected mothers whose child was less than one year. A pre-test self-administrative questionnaire was applied to collect the data and complied. Appropriate statistics was be applied to achieve desired results. Results: Mean age of the participants were 27.88 ±4.6 years. More than half of the participants were identified as Hindu by religion. Most of them were classified under a lower socio-economic status. All participants were literate. Out of the total, 63 (27.4%) were primigravida, and rest were multigravida. While three-fourths of the women registered their pregnancies early, 74.3% attended at least four antenatal care (ANC) visits. Moreover, 87.4% received two doses or one booster dose of Td vaccination, and 83.9% took a minimum of 100 Iron Folic Acid tablets. However, only 66.5% of the participants reported having fully utilized Anti natal care services. Conclusion: Females of young age with primary education and those belonging to the Muslim religion were found to have inadequate utilization of complete antenatal care (ANC), despite the presence of government-funded primary care services.

Evaluation of antenatal care utilization and its effects on obstetric and newborn outcomes at a public and private hospital of Karnataka: A comparative study.

Neonatal outcomes and perinatal mortality are directly and significantly impacted by the use of appropriate antenatal care (ANC) during pregnancy. The objective of this study is to evaluate the association between the use of prenatal services and maternal and newborn outcomes in both public and private healthcare settings. This study was carried out in two tertiary healthcare setups in Mangaluru, Karnataka: Government Lady Goschen Hospital (LGH) and Kasturba Medical College Hospital (KMCH) Attavar. Data were collected from 150 women who were a part of the study. Microsoft Excel was used to compile the data, and SPSS version 25 was used to analyze it. We found that 58 out of 90 women admitted to LGH went for ANC check-ups at least four times during their gestation period and the rest of them went eight times or more, compared to just 3 out of the 60 women admitted at KMCH who went at least four times, whereas the rest went eight or more. The number of checks the mother takes appears to affect the term of the gestation with fewer preterm seen in patients who have come for a minimum of eight ANC visits, a higher risk of abnormal weight gain during pregnancy, and a lower risk of giving birth to preterm babies. The study reveals that private healthcare setups offer more antenatal services, including hospital visits, routine testing, supplements, and doctor advice. The number of antenatal visits is a significant difference between public and private healthcare setups. The public setup requires a minimum of four antenatal care visits, while the updated 2016 version requires eight. The number of antenatal visits affects both mother's and neonatal outcomes. A higher number of visits leads to fewer preterm births and a higher risk of abnormal weight gain. Education also influences the frequency of antenatal visits. The study suggests increasing the frequency of prenatal care visits and improving public education on this matter.

Factor Analysis of Antenatal Care in Women of Fertilizing Age in Nepal

<div><table cellspacing="0" cellpadding="0" align="left"><tbody><tr><td align="left" valign="top"><p><em>The high maternal and infant mortality rate in Nepal is a global problem. Antenatal Care (ANC) services are an effort to reduce maternal and infant mortality rates. This study aims to analyze factors in the utilization of antenatal care among women of childbearing age in Nepal. This research method The Nepal Demographic and Health Survey (NDHS) was carried out in the new era with official approval from the Ministry of Health and Population (MoHP), and the data collection period lasted from January 5 to June 22, 2022. The study population was women aged 15 to 49 years. who have given birth or experienced a stillbirth in the previous two years and have attended at least one antenatal care (ANC) visit. Data collection using questionnaires interviewed after they were discharged from the facility that provides delivery services. Data analysis using the JASP version 18 application to see the influence of the independent variable on the dependent variable. Bivariate data will be analyzed using chi-square analysis, and multivariate data will be analyzed using the logistic regression test. The research results showed that there was a relationship between age (p<0.001), place of residence (p<0.001), zone of residence (p<0.001), economy (p<0.001), education (p<0.001), number of children (p<0.001) women of childbearing age in Nepal with ANC visits. These factors greatly influence women of childbearing age in utilizing ANC services. Therefore, it is necessary to strengthen ANC service policies and remind women of childbearing age to make at least 4 ANC visits during pregnancy so that examinations and visits for pregnant women can be carried out completely.</em></p><p><em> </em></p></td></tr></tbody></table></div><strong><em>Keywords : Antenatal Care, Women of childbearing age, Nepal</em></strong>

Inequality in opportunity of access to antenatal care in Cameroon: multilevel modelling, spatial analysis and decomposition methods

AbstractIn Cameroon, major inequalities exist in women’s access to antenatal care (ANC), yet underlying circumstance drivers remain understudied. Using recently available Demographic and Health Survey data, we conducted multilevel model and spatial analyses to identify circumstance factors driving ANC disparities across the country's diverse regions. Drawing on a novel integration of theoretical frameworks, we evaluated how circumstances like geographic, economic and educational barriers combined to shape inequities. Both Shapley and Fields decomposition techniques apportioned contributors to ongoing inequality. Results from our study provide the first direct comparison of these approaches in Cameroon, finding a strong positive correlation between methods. Our findings show that ANC utilization overall was suboptimal, varying substantially between urban and rural areas. Key circumstance factors which disproportionately constrained disadvantaged groups’ opportunities for care included household wealth, level of education of the woman and spouse, and place of residence. Policy-relevant insights emerge from disentangling multifaceted opportunity gaps. Targeted interventions should address modifiable barriers facing underserved populations to promote more equal maternal health nationwide. Our multidisciplinary analytical approach offers lessons for analysing complex health disparities in diverse low-resource settings. Graphical abstract

Determinants of unintended pregnancy and induced abortion among adolescent women in Ethiopia: Evidence from multilevel mixed-effects decomposition analysis of 2000-2016 Ethiopian demographic and health survey data.

Adolescents are highly at risk of unintended pregnancy due to physiological, sexual, social and psychological growth. The pregnancy may end with early childbirth, induced abortion and its complications. Although, the trends of unintended pregnancy and induced abortion have declined over time in Ethiopia, evidence is limited on key determinants for decline in order to propose vital areas of interventions. The current study aimed to identify the determinants of unintended pregnancy and induced abortion among adolescents over the decades. Trends in the prevalence of unintended pregnancy and induced abortion among adolescent women aged 15-19 years were investigated based using a series of the Ethiopia Demographic and Health Surveys (EDHS) data for the years 2000, 2005, 2011, and 2016. Sub-sample of adolescent women data was extracted from each survey. The combined datasets for unintended pregnancy and induced abortion over the study period (2000-2016) was analyzed. The percentage changes of trends of unintended pregnancy and induced abortion with its corresponding 95% CI for each variable were calculated. Multilevel mixed-effects decomposition analysis was applied to identify factors significantly associated with trends of unintended pregnancy and induced abortion among adolescents. The trends of unintended pregnancy and induced abortion significantly declined during the study period. Unintended pregnancy among Ethiopian adolescents aged 15-19 years significantly decreased from 307 (41.4%) (95% CI: 35.7, 47.2%, p<0.001) in 2000 to 120 (25.1%) (95% CI: 18.9, 31.4%) in 2016. On the other hand, induced abortion significantly decreased from 62 (8.3%) (95% CI: 5.2, 11.4%) in 2000 to 20 (4.1%) (95% CI: 1.3, 6.9%, p = 0.004) in 2016. Age older than 18 years (Coeff = -0.41, 95%CI, -0.64, -0.18, p<0.001), living in Somali regional state (Coeff = -2.21, 95%CI, -3.27, -1.15, p<0.001) and exposure to media (Coeff = -0.60, 95%CI, -0.87, -0.33, p<0.001) showed a significance association with decline in unintended pregnancy whereas; living in Benshangul-Gumuz regional state (Coeff = -0.17, 95%CI, -0.32, -0.19, p = 0.03) and ANC service utilization history (Coeff = -0.81, 95%CI, -1.45, -0.17, p = 0.01) showed significance association with decline in induced abortion. The trends of unintended pregnancy and induced abortion significantly declined over the past decades in Ethiopia. Adolescent girls aged 17 years and above, exposure to media and living in Somali showed significant association with decline in unintended pregnancy whereas; living in Benshangul-Gumuz and ANC service utilization history showed significant decline with induced abortion. Exposure to media and utilization of Antenatal care (ANC) services may improve adolescent girls' reproductive health uptake.

Antenatal care service utilization disparities between urban and rural communities in Ethiopia: A negative binomial Poisson regression of 2019 Ethiopian Demography Health Survey.

Although there have been consistent improvements in maternal mortality, it remains high in developing countries due to unequal access to healthcare services during pregnancy and childbirth. Thus, this study aimed to further analyze the variations in the number of antenatal care utilizations and associated factors among pregnant women in urban and rural Ethiopia. A total of 3962 pregnant women were included in the analysis of 2019 Ethiopian Demographic and Health Survey data. A negative binomial Poisson regression statistical model was used to analyze the data using STATA version 14.0. An incident rate ratio with a 95% confidence interval was used to show the significantly associated variables. Of the 3962 (weighted 3916.67) pregnant women, about 155 (15.21%) lived in urban and 848 (29.29%) rural residences and did not use antenatal care services in 2019. Women age group 20-24 (IRR = 1.30, 95%CI:1.05-1.61), 25-29 (IRR = 1.56, 95%CI:1.27-1.92), 30-34 (IRR = 1.65, 95%CI:1.33-2.05), and 35-39 years old (IRR = 1.55, 95%CI:1.18-2.03), attending primary, secondary, and higher education (IRR = 1.18, 95%CI:1.07-1.30), (IRR = 1.26, 95%CI:1.13-1.42) and (IRR = 1.25, 95%CI:1.11-1.41) respectively, reside in middle household wealth (IRR = 1.31, 95%CI:1.13-1.52), richer (IRR = 1.45, 95%CI:1.26-1.66) and richest (IRR = 1.68, 95%CI:1.46-1.93) increases the number of antenatal care utilization among urban residences. While attending primary (IRR = 1.34, 95%CI:1.24-1.45), secondary (IRR = 1.54, 95%CI:1.34-1.76) and higher education (IRR = 1.58, 95%CI:1.28-1.95), following Protestant (IRR = 0.76, 95%CI:0.69-0.83), Muslim (IRR = 0.79, 95%CI:0.73-0.85) and Others (IRR = 0.56, 95%CI:0.43-0.71) religions, reside in poorer, middle, richer, and richest household wealth (IRR = 1.51, 95%CI:1.37-1.67), (IRR = 1.66, 95%CI:1.50-1.83), (IRR = 1.71, 95%CI:1.55-1.91) and (IRR = 1.89, 95%CI:1.72-2.09) respectively, being married and widowed/separated (IRR = 1.85, 95%CI:1.19-2.86), and (IRR = 1.95, 95%CI:1.24-3.07) respectively were significantly associated with the number of antenatal care utilization among rural residences. The utilization of antenatal care is low among rural residents than among urban residents. To increase the frequency of antenatal care utilization, health extension workers and supporting actors should give special attention to pregnant women with low socioeconomic and educational levels through a safety-net lens.

Awareness and Utilization of Antenatal Care Services among Women in Northern Nigeria

Background: Utilization of antenatal care is paramount in achieving the MDG goal, and is a resultant effect of knowledge, and attitude of the women to the services [20-25]. There are expedient factors that have been reported in literatures as affecting the utilization of ANC such as religion, education, cultures and traditions of the people, cost etc. Lack of antenatal care and its underuse can result in a variety of unfavorable pregnancy outcomes, including intrauterine growth restriction, low birth weight, and mother and infant death. This study was done to determine the awareness and utilization of ANC in Sokoto State, Nigeria as part of an effort to achieving the millennium development goal. Materials and Methods: This was a descriptive cross-sectional study, adopting the simple random sampling technique and an interviewer administered semi-structured questionnaire. Results and Discussions: The study finds, after assessment, the percentage of Good utilization, Good knowledge and Good Attitude towards ANC services as 52.3%, 72.6% and 67.0% respectively. Crude percentage of utilization of ANC services was 87.0%. Factors influencing utilization identified were marital status and income, with odds ratio of 6.2 (95%CI: 0.88 – 43.39) and 5.4 (95%CI: 1.60 – 18.30) respectively and having p-values of 0.068 and 0.007. Although the women in Sokoto have knowledge of ANC services, their utilization of ANC services is relatively poor. Conclusion: Out of the 87.0% of uptake of ANC, only 52.3% were assessed to have Good utilization score. There is need for interventions to improve utilization of ANC services among women in Sokoto.

Adolescent girls' and young mothers' knowledge and use of antenatal care in the Ahafo Region, Ghana: A cross-sectional study.

Antenatal care (ANC) is crucial to reducing maternal and neonatal deaths, but few studies examined adolescent girls' and young women's ANC utilisation and knowledge in Ghana. To assess adolescents' and young mothers' knowledge of ANC, utilisation and factors influencing its use in Ghana. Tano North Municipality, Ahafo Region. This community-based, cross-sectional study involved 440 adolescent and young mothers (between 10 and 24 years). A structured questionnaire was employed to collect data face-to-face. Descriptive and statistical analyses were performed, andp 0.05 was considered statistically significant. Of the 440 respondents, most were aged 20-24 years (61.2%), married (30.0%), Christians (78.2%), completed junior high school (JHS) (47.8%) and traders (38.9%). Postnatal mothers were 71.6% (315), and all had utilised ANC services. Antenatal care knowledge was good among 75% (330) respondents, with no significant variation by age. Religion influenced knowledge, with Muslims having lower knowledge. Antenatal care utilisation was high ( 50%) among those aged 15-19 years, married, Christians, JHS graduates and traders. Age, marital status and employment type significantly influenced ANC utilisation. Individuals in the age group 15-19 years and married women demonstrated higher odds of utilising ANC services. Casual workers and unemployed respondents were found to have lower odds of utilising ANC services compared to traders. Age, marital status, and employment type influenced ANC utilisation in the Ahafo Region. Adolescent mothers under 15 years had lower rates, requiring targeted interventions to improve pregnancy outcomes.Contribution:This study highlights the knowledge and factors influencing ANC use in Ahafo Region and adds to the existing research evidence on ANC.

Good while it lasted? Estimating the long-term and withdrawal effects of results-based financing in Malawi on maternal care utilisation using routine data

ObjectivesThis study aimed to evaluate the effect of introduction and subsequent withdrawal of the Results-based Financing for Maternal and Newborn Health Initiative (RBF4MNH) in Malawi on utilisation of facility-based childbirths,...

Antenatal Care Practices: A Population-Based Multicenter Study from Saudi Arabia.

Antenatal care (ANC) is the care women receive during pregnancy before birth and represents a cornerstone of maternal and child health. Previously, Saudi women faced various barriers to practicing ANC, including challenges related to transportation, low maternal education, poor communication with healthcare centers, and incorrect maternal beliefs. In line with Saudi Vision 2030, this multicenter cross-sectional study aimed to investigate the timing of ANC contact, coverage of service utilization in public hospitals among Saudi mothers, sociodemographic factors and antenatal health care utilization, and beliefs about prenatal vitamins, and supplement use among pregnant Saudi women. Data was collected from 1230 pregnant women across 11 Ministry of Health (MOH) facilities. The study assessed the timing of ANC initiation, beliefs about prenatal vitamins, and the use of folic acid, calcium, and iron during pregnancy. Chi-square tests were employed to analyze associations between variables. The findings revealed that 14.55% of participants initiated ANC within the first 8 weeks of pregnancy, with 85.44% starting later. However, the majority 88.78% received prenatal care during pregnancy, regardless of the timing of ANC initiation. Beliefs about prenatal vitamins varied, with 20.08% agreeing that prenatal vitamins were only indicated for malnourished mothers, 72.35% disagreeing, and 7.56% uncertain. Moreover, 51.30% believed ANC should begin before pregnancy, 29.83% after pregnancy confirmation, and 13.57% during the first trimester, with no significant correlation between beliefs and ANC timing. Regarding prenatal care, 95.20% would recommend starting prenatal care with every pregnancy, regardless of the timing of their own ANC initiation. This study offers a comprehensive analysis of factors impacting late ANC contact and inadequate ANC contacts among pregnant Saudi women. These findings contribute to the broader understanding of ANC practices among Saudi women and underscore the importance of considering various determinants for tailored interventions and health education programs.

FACTORS CONTRIBUTING TO HIGH RATES OF CEASERIAN SECTION

The increasing rate of caesarean deliveries is a major concern for public health experts worldwide. A study was conducted from January to September 2022 at the civil hospital Khairpur Mir to determine the rates of C-sections compared to normal vaginal deliveries and to evaluate the factors contributing to their increased rate in women. The study included 354 pregnant women aged 20 to 40 years who were surveyed using a pre-tested, structured questionnaire. The data was then analysed using SPSS version 16. Out of the 354 participants, 129 (36.4%) were aged between 31 to 35 years, 211 (59.6%) were uneducated, and 174 (49.2%) belonged to the middle socio-economic status. Furthermore, 103 (42.9%) women delivered by C-section, while 71 (62.3%) had a normal delivery. 54 (15.3%) participants had a parity of three, of which 19 (7.9%) women delivered by C-section, and 35 (30.7%) delivered by normal vaginal delivery. The study found that factors such as maternal age, mother's education, pregnancy complications, utilization of antenatal care, place of birth, area of residence, wealth profiles of mothers, and the number of exercises performed in the last semester were all linked to C-section. The study shows that these factors were the major contributors and strongly associated with higher C-section rates than normal deliveries. Additionally, educational status, occupation, economic status parity, place of C-section, place of ANC visit, and number of ANC visits were also found to be linked to C-section. The p-value was found to be 0.05. In conclusion, this study highlights the need for increased awareness and education on the factors contributing to the high rate of C-section deliveries, and the importance of normal vaginal deliveries for the health and well-being of both mother and child.

Exploring the interplay between food security and antenatal care utilization among pregnant women in Southern Ethiopia: Insights from an institution-based cross-sectional study

BackgroundEnsuring the satisfaction of pregnant women with antenatal care is crucial for positive pregnancy outcomes and their engagement with emerging technologies and alternative care models. Maintaining high satisfaction during the antenatal period significantly impacts the well-being of both the expectant mother and the unborn child. Despite the recognized importance of antenatal care satisfaction, comprehensive information on satisfaction levels and influencing factors in the specific study area is lacking. Therefore, this study aims to assess antenatal care service satisfaction and associated factors among pregnant women in Arba Minch town, southern Ethiopia. MethodsWe conducted an institution-based cross-sectional study among 418 pregnant women from December 2022 to January 30, 2023, using a systematic sampling method. Data were collected using the Kobo Toolbox and analyzed with SPSS Version 26. The threshold for statistical significance was set at a p-value of less than 0.05. ResultsOut of 418 participants, 54.3% (95% CI=49.4–60.4) expressed satisfaction with antenatal care services. Factors significantly associated with women's satisfaction included: being unable to read and write (AOR=2.37; 95% CI: 1.97–3.80), being aged 25–29 years (AOR=3.20; 95% CI: 1.65–6.22), receiving antenatal care at a hospital (AOR=1.81; 95% CI: 1.05–3.12), having a previous history of antenatal visits (AOR=2.59; 95% CI: 1.26–5.30), a monthly income of 2500–5000 ETB (AOR=1.44; 95% CI: 1.21–3.94), waiting times of less than 30 min (AOR=2.59; 95% CI: 1.52–4.41), maintaining a positive attitude towards antenatal care (AOR=2.50; 95% CI: 1.05–3.65), and having a secure food source (AOR=2.06; 95% CI: 1.13–3.78). ConclusionOver 54% of participants were satisfied with antenatal care services. To improve satisfaction levels, recommended strategies include enhancing healthcare infrastructure, establishing maternity waiting areas, reducing waiting times, and expanding services to remote areas.

Regional disparities in antenatal care utilization among pregnant women and its determinants in Ethiopia.

Antenatal care primarily focuses on health care checkups, the provision of advice on healthy behaviors, and the delivery of psychological, social, and emotional support for women with pregnancy. The national target set by the Ethiopian government is to achieve 95% of at least four ANC visits. Nevertheless, 43.11% of women had four or more checkups, according to the 2019 Ethiopian Demographic and Health Survey. Despite this achievement, antenatal care visits differ significantly between Ethiopian regions. Consequently, the purpose of this study was to assess regional disparities in pregnant women's utilization of antenatal care and its determinants in Ethiopia. We have used 2019 intermediate Ethiopian Demographic and Health Survey data for analysis. The analysis comprised a total of 3,917 weighted women age 15-49 who had a live birth in the 5 years preceding the survey. Poisson regression analysis was done using SAS software version 9.4. To show the strength and direction of the association, an incidence rate ratio with a 95% confidence interval was used. Variables with a p-value <0.05 were declared as significant factors associated with the number of ANC visits. In Ethiopia, the number of ANC visits differs between regions. With a mean of 4.74 (95% CI: 4.49, 4.99), Addis Ababa reported the highest percentage of ANC visits (82.7%), while the Somali Region reported the lowest percentage (11.3%) with a mean of 0.73 (95% CI: 0.57, 0.88). Maternal age, educational level, religion, household wealth index, place of delivery, and household size show significant associations with the number of antenatal care visits. In Ethiopia, there is the highest regional disparity in the number of ANC visits. The number of ANC visits was influenced by the mother's age, education, religion, household wealth index, place of delivery, and household size. Regarding the ANC visits, there should be initiatives that address the demands of pastoralist and agro-pastoralist communities to increase ANC utilization. As with many other health outcomes, education and low socio-economic status were associated with low ANC visit but these are tied to the overall social development of a country and are not immediately amenable to public health interventions.

The effect of limited access to antenatal care on pregnancy experiences and outcomes among undocumented migrant women in Europe: a systematic review.

Women who are undocumented migrants in Europe encounter a variety of challenges while trying to access health services, including restricted access to antenatal care (ANC) despite the importance of ANC to the well-being of mothers and their infants. This study's aim was to examine the effect that limited access to antenatal care has on the pregnancy experiences and outcomes of undocumented migrant (UM) women in Europe. Systematic searches were done on PubMed, Ovid MEDLINE, Ovid EMBASE, EBSCO CINAHL Plus, and BioMed Central. From the search results, only primary research articles that reported on the pregnancy outcomes and experiences of undocumented migrants were selected. A meta-analysis was not possible because this review included information from both qualitative and quantitative studies. The data that was taken from the included publications was organised, analysed, using the Microsoft Excel programme, and then meta-synthesised. Twelve papers from seven different European nations-Belgium, France, Sweden, Denmark, Norway, Finland, and England-were included in this systematic review. Eight of the studies aimed to explore the access to and utilization of ANC by undocumented migrant women and the related pregnancy outcomes. Two of the included studies examined the pregnancy experiences of UMs and two examined the perinatal risks associated with living as a migrant with no legal status. Although heterogeneous in their specific findings most of the studies showed undocumented immigrants are more likely to experience unfavourable pregnancy outcomes and experience greater anxiety and worries due to a variety of factors than documented migrants and registered citizens. This review's conclusions demonstrate the pressing need for policy modifications and healthcare reforms in Europe to address the problems associated with undocumented migrants' restricted access to antenatal care. It also highlights the urgent need for structural changes that will give this vulnerable population's health and well-being a higher priority. It is not just an issue of health equality but also a humanitarian obligation to address the many obstacles and difficulties undocumented migrant women endure during pregnancy.

Navigating antenatal care: The lived experiences of adolescent girls and young women and caregiver perspectives in Zambia.

Adolescent pregnancy remains a global concern, especially in low- and middle-income countries. Sub-Saharan African nations, including Zambia, bear a disproportionate burden of adolescent pregnancies, contributing to high rates of maternal and child mortality. Despite efforts to improve antenatal care (ANC) services, utilization rates remain suboptimal, especially among adolescent girls and young women (AGYW). To explore the barriers and facilitators to ANC services among AGYW and how these factors might differ by age and HIV status. This qualitative study employs a combination of in-depth interviews (IDIs) and focus group discussions (FGDs) to gather comprehensive insights into the experiences of AGYW regarding ANC services. The study design follows a socio-ecological framework (SEF) to identify multiple levels of influence on ANC utilization. We conducted 40 IDIs with AGYW aged 15-24; and 2 FGDs with caregivers of AGYW (n = 16). IDIs explored AGYWs barriers and facilitators to accessing and utilizing healthcare services during pregnancy, as well as social support and HIV treatment and prevention. FGD topics included social support, barriers and facilitators to ANC, and HIV services. We developed a codebook based on the SEF and coded transcripts using Dedoose software. Results showed that early pregnancy knowledge did not always translate to AGYW seeking ANC services right away or within the first trimester. More than half of the AGYW did not initiate ANC until well into the second trimester. Factors including lack of motivation, denial of pregnancy, desires to terminate pregnancies, social norms, policies, clinic environment, and financial constraints contributed to delays in ANC initiation. Social support from family, partners, peers, and the community were crucial motivators for early ANC. Lastly, challenges to ANC continuation included lack of transportation, long clinic waiting times, perceived provider indifference, and stigma at both community and clinic levels. In conclusion, gaining insights from qualitative data is essential for comprehensively understanding the barriers and challenges to accessing ANC among this specific age group. By identifying and addressing these barriers while enhancing facilitators, effective programs can be developed and implemented to improve the health and well-being of young mothers and their children.