Utilization Of Antenatal Care Services Research Articles

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.

IJCM_92A: Pregnancy outcomes associated with antenatal care service utilization & barriers and enablers affecting the utilization of antenatal care services in South-East Delhi: A community-based cross-sectional study

Background: Antenatal care provides preventive health care, through which women can learn from skilled health personnel. Women who don’t consume Iron Folic Acid Supplements as prescribed would experience iron and folic acid (IFA) deficiency anemia. Iron deficiency has negative effects on mothers and newborns while folic acid deficiency in pregnancy causes pre-eclampsia, preterm delivery, neural tube defects, fetal malformation, type 2 diabetes, and obesity in the newborn. Comprehensive antenatal care is early registration of pregnancy (within 12 weeks), at least four ANC visits at a health facility, two doses of tetanus toxoid, and at least 100 days of IFAS consumption. Objectives: 1-To assess pregnancy outcomes associated with antenatal care service utilization in participants aged 18-49 years residing in the field practice areas of a Medical College in South-East Delhi. 2-To determine the barriers and enablers affecting the utilization of antenatal care services in the given population. Methodology: It is a community-based cross-sectional study conducted in South-East Delhi. The sample size was calculated as 300 considering a 5% absolute error for a 95% confidence interval and 10% non-response rate. Out of 300, the current data of 200 participants will be depicted here. Stratified systematic random sampling with the Probability Proportional to Size technique was applied to the population registered at RHTC & UHTC. Households were selected by systematic random sampling. Pregnant women aged between 18-49 years were selected from the household. A self-designed, pre-tested, validated structured questionnaire was used. Results: Out of the total number of participants, 66.0% had knowledge regarding early registration of pregnancy. 80.0 % had permission to attend a health facility, 70.5 % had an accompanying person, 62.5 % of participants had been residing more than 6 km away from the health facility. 58.0 % of participants could meet the expenses of health care services. Out of all newborns, 90.0 % had normal birth weights, 10% had low birth weights, 81.0% participants had NVDs, and 19% were caesarean sections. Conclusion: Enablers are knowledge regarding early registration, presence of accompanying person. Permission for health visits, expenses for health care services & distance to health facility were barriers.

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.

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.

Health professionals’ perspectives on the role of obstetric ultrasonography in maternity care in rural eastern Ethiopia: a qualitative descriptive study

ObjectiveThe purpose of this exploratory study was to assess healthcare providers’ perspectives on maternity care following the introduction of ultrasound services in the area.DesignThe qualitative descriptive study.Study settingThis study was...

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.

Utilization of Antenatal Care Services among Patients Presenting in Ayub Teaching Hospital

Regular use of antenatal care services during pregnancy has a positive impact on maternal and fetal health and serves as a tool to reduce maternal morbidity and mortality. Objective: To assess the utilization of antenatal care services among pregnant women at Ayub Teaching Hospital in Abbottabad, Pakistan. Methods: This descriptive study was conducted in Ayub Teaching Hospital in Abbottabad, KPK province, Pakistan. Data were collected on paper-based questionnaires and analyzed using SPSS. A total of 208 patients participated. Results: Key findings from the study indicated that the average age of participants was 28 years. The majority of women came from lower-middle-class backgrounds. The study also revealed a wide range of educational backgrounds among participants. Most women had prior pregnancy experience. The study found that a significant percentage of women initiated antenatal visits during the first trimester with drop in visits during the third trimester. Understanding the reasons for seeking care is crucial, with various medical concerns and routine check-ups cited. Barriers to utilization included lack of awareness, family issues, and geographical distance. Additionally, only 72% of women reported taking recommended supplements during pregnancy. Conclusions: The study identified that women from middle income group with previous experience of pregnancy seek antenatal care in first trimester with various pregnancy problems but visits were not consistent. Major reason for non-utilization of services was unawareness about the services.

Has the Gratuité policy reduced inequities in geographic access to antenatal care in Burkina Faso? Evidence from facility-based data from 2014 to 2022.

Evidence shows that user fee exemption policies improve the use of maternal, newborn, and child health (MNCH) services. However, addressing the cost of care is only one barrier to accessing MNCH services. Poor geographic accessibility relating to distance is another. Our objective in this study was to assess the effect of a user fee exemption policy in Burkina Faso (Gratuité) on antenatal care (ANC) use, considering distance to health facilities. We conducted a cross-sectional study with sub-analysis by intervention period to compare utilization of ANC services (outcome of interest) in pregnant women who used the service in the context of the Gratuité user fee exemption policy and those who did not, in Manga district, Burkina Faso. Dependent variables included were socio-demographic characteristics, obstetric history, and distance to the lower-level health facility (known as Centre de Santé et Promotion Sociale) in which care was sort. Univariate, bivariate, and multivariate analyses were performed across the entire population, within those who used ANC before the policy and after its inception. For women who used services before the Gratuité policy was introduced, those living 5-9 km were almost twice (OR = 1.94; 95% CI: 1.17-3.21) more likely to have their first ANC visit (ANC1) in the first trimester compared to those living <5 km of the nearest health facility. After the policy was introduced, women living 5-9 km and >10 km from the nearest facility were almost twice (OR = 1.86; 95% CI: 1.14-3.05) and over twice (OR = 2.04; 95% CI: 1.20-3.48) more likely respectively to use ANC1 in the first trimester compared to those living within 5 km of the nearest health facility. Also, women living over 10 km from the nearest facility were 1.29 times (OR = 1.29; 95% CI: 1.00-1.66) more likely to have 4+ ANC than those living less than 5 km from the nearest health facility. Insofar as the financial barrier to ANC has been lifted and the geographical barrier reduced for the populations that live farther away from services through the Gratuité policy, then the Burkinabé government must make efforts to sustain the policy and ensure that benefits of the policy reach the targeted and its gains maximized.

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.

Factors Influencing Antenatal Care Service Utilization among Pregnant Mothers: A Study at Kampala International University Teaching Hospital, Bushenyi District

Antenatal care (ANC) services play a crucial role in ensuring the well-being of pregnant women and their unborn children, yet disparities exist in their utilization globally. This study investigates the factors influencing ANC service utilization among pregnant mothers attending Kampala International University Teaching Hospital in Bushenyi District. A cross-sectional study involving 138 participants was conducted, employing descriptive analysis and logistic regression. Results revealed that only 40.6% of mothers had good ANC service utilization, with factors such as post-primary education, manageable cost of services, and knowledge of ANC services significantly associated with higher utilization rates. Conversely, lack of awareness about when to start ANC services and inadequate knowledge of ANC services were barriers to utilization. Additionally, multiparous women and those with a primary education level were less likely to utilize ANC services optimally. These findings underscore the importance of targeted interventions, including education outreach programs and improved accessibility to ANC services, to enhance maternal and fetal health outcomes. Keywords: Antenatal care, Utilisation, Hospital, maternal mortality, Pregnant mother.

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.

Determinants of Exclusive Breastfeeding Among Mothers of Infants Less Than Six Months of Age in Mogadishu: A Facility-Based Cross-Sectional Study

Background Breastfeeding is a vital practice for infant health and well-being, with exclusive breastfeeding (EBF) during the first six months being particularly crucial. Despite its benefits, EBF is sub-optimally practiced in many low-to-middle income countries. This study focuses on Somalia, a country with historical political instability and poor health indicators, aiming to identify the prevalence and determinants of exclusive breastfeeding among women with infants under six months attending SOS Mother and Child Hospital in Mogadishu. Methods A hospital-based cross-sectional design was used, and data were collected through a structured questionnaire. The study sample consisted of 345 mothers, selected using a systematic sampling technique. Descriptive, bivariate, and multivariate analyses were conducted to assess breastfeeding practices and determine factors influencing exclusive breastfeeding prevalence. Result The study found that the prevalence of exclusive breastfeeding among the study population in Somalia was 44%, influenced by factors such as maternal education, employment, and utilization of antenatal and postnatal care services. Male infants and younger infants had higher odds of being exclusively breastfed. Conclusion and recommendations The study emphasizes the importance of promoting exclusive breastfeeding as the optimal feeding practice for infants in Somalia, highlighting the need for comprehensive health education during antenatal care visits and postnatal counseling. It recommends the development of supportive policies, such as maternity leave and workplace accommodations, along with community-based initiatives and support groups to facilitate and encourage exclusive breastfeeding practices.

To leave no one behind: Assessing utilization of maternal newborn and child health services by all the 13 particularly vulnerable tribal groups (PVTGs) of Odisha, India.

Indigenous tribal people experience lower coverage of maternal, newborn and child healthcare (MNCH) services worldwide, including in India. Meanwhile, Indian tribal people comprise a special sub-population who are even more isolated, marginalized and underserved, designated as particularly vulnerable tribal groups (PVTGs). However, there is an extreme paucity of evidence on how this most vulnerable sub-population utilizes health services. Therefore, we aimed to estimate MNCH service utilization by all the 13 PVTGs of the eastern Indian state of Odisha and compare that with state and national rates. A total of 1186 eligible mothers who gave birth to a live child in last 5years, were interviewed using a validated questionnaire. The weighted MNCH service utilization rates were estimated for antenatal care (ANC), intranatal care (INC), postnatal care (PNC) and immunization (for 12-23-month-old children). The same rates were estimated for state (n = 7144) and nationally representative samples (n = 176843) from National Family Health Survey-5. The ANC service utilization among PVTGs were considerably higher than national average except for early pregnancy registration (PVTGs 67% versus national 79.9%), and 5 ANC components (80.8% versus 82.3%). However, their institutional delivery rates (77.9%) were lower than averages for Odisha (93.1%) and India (90.1%). The PNC and immunization rates were substantially higher than the national averages. Furthermore, the main reasons behind greater home delivery in the PVTGs were accessibility issues (29.9%) and cultural barriers (23.1%). Ours was the first study of MNCH service utilization by PVTGs of an Indian state. It is very pleasantly surprising to note that the most vulnerable subpopulation of India, the PVTGs, have achieved comparable or often greater utilization rates than the national average, which may be attributable to overall significantly better performance by the Odisha state. However, PVTGs have underperformed in terms of timely pregnancy registration and institutional delivery, which should be urgently addressed.

A study on utilization of ANC services and Psychological status of mothers during Covid–19 pandemic in five adopted villages of KSRDPR University, Gadag, Karnataka

Antenatal care is also known as prenatal care is a type of preventive and primitive health care during the period of whole pregnancy to ensure a better birthing outcome for mother and baby. Improving the utilization of maternal health care services is a global challenge for the health system in low and middle-income countries. The goal set by the United Nations, Millennium Developmental goals to reduce the maternal mortality ratio by three quarters during the period 1990-2015. WHO's new SMART guidelines approach, which includes the ANC Digital Adaptation Kit and WHO digital ANC module to support countries through the process of adapting and applying. With the emergence of the COVID - 19 outbreak, it is not impossible that access to quality antenatal care services in the region will be further compromised due to competition for limited health care services. COVID -19 pandemic affects routine service delivery, which may have an impact on antenatal care (ANC) utilization among pregnant women.To assess the utilization of Antenatal Check-ups before to and during the Covid -19 Pandemic period.After obtaining permission from the District Health Office and the appropriate officer in the health force, a community-based cross-sectional study was conducted. To select study participants who are both convenient and cooperative, the purposive sampling technique was used. A semi-structured questionnaire was used to collect data, information about mothers' socio-demographic details, Antenatal service utilization before and during the Covid - 19 pandemic, An interview schedule was developed in order to identify the Antenatal Care utilization Gap in the eyes of prospective pregnant mothers and the challenges faced by health workers in providing Antenatal services. The data was entered into an excel sheet, and the results were expressed as frequency, percentage.The study included 360 pregnant and delivered mothers aged 18 to 45 years. The majority of mothers (68.33 percent) are between the ages of 18 and 25. Half of the mothers are Primi (51.94%), a quarter of the mothers are Para 1 (33.61%), and more than one-fourth of the mothers are mildly anemic (38.06%). Few mothers have high blood pressure (8.89 percent), the majority of spouses supported their wives' Antenatal natal services visits (93.89 percent), and the majority of mothers received ANC services at no cost (99.44 percent).The current study discovered that due to the COVID - 19 pandemics, antenatal care utilization was lower than before the pandemic period.

Does women's decision-making autonomy matter in utilization of antenatal care services in India? An analysis from nationally representative survey.

The primary goal is to examine the association between women's decision-making autonomy and utilization of antenatal care services among ever-married women in India. The entire study has been accomplished with the help of secondary data composed from the latest round of the National Family Health Survey (NFHS-5) conducted during 2019-21. A total of 34,618 ever-married women aged 15-49 with at least one live birth preceding five years of the survey have been taken into consideration in this study. Bivariate and multivariate analyses were conducted for proper illustration of the outcome. A sizable proportion of women did not fulfill the WHO-recommended criterion of obtaining ANC services. Utilization of full ANC services is found in some regions of southern, eastern, northern, and northeastern states, and in some districts of Gujarat. After adjusting the other explanatory variables, the result of multivariate analysis indicates that women's autonomy is significantly and positively associated with the utilization of full antenatal care services. Women who participate actively in decision-making are more likely to use full ANC services (AOR: 1.316, 95% CI: 1.197-1.446, p<0.05). Additionally, likelihood of utilization of full ANC services is high among women aged 25-34 years, are educated, have access to the media, come from richest wealth quintile, and are from southern, western, and eastern regions. Therefore, appropriate measures should be adopted to eliminate gender bias and promote women's empowerment for the overall improvement of maternal health as well as societal health.

Prevalence and Associated Factors of Client Satisfaction with Antenatal Care Services Among Antenatal Care Attendants in Ethiopia: A Systematic Review and Meta-Analysis.

An important indicator of the quality of antenatal care (ANC) is the satisfaction of the client. Despite this, women in Ethiopia are very dissatisfied with the quality of their ANC. In Ethiopia, a systematic review was conducted to estimate the pooled prevalence of client satisfaction (CS) with ANC services. Only articles published in English were included in this review. Medline/PubMed, Web of Science, Google Scholar, Scopus, Ethiopian University Repository Online, and the Cochrane Library are the main databases. The review included cross-sectional studies written in English that met the inclusion requirements. Using a random effects model, the overall rate of CS with prenatal care was calculated. Additionally, Egger's test and funnel plots were used to examine publication bias. STATA version 14 was used to perform all statistical analyses. This review included 20 studies involving 8447 women attending prenatal care services. In Ethiopia, the overall customer satisfaction rate with prenatal care services was 60.42% (95% CI [51.33.99, 69.51]; I2 = 98.9%, P < 0.001). Previous ANC follow-up, iron and folic acid supplementation, and the last planned pregnancy were statistically associated with CS. In Ethiopia, 60% of women are satisfied with their ANC. This shows that 40% of women are dissatisfied with the prenatal care provided by healthcare professionals. This will lead to a low utilization of ANC services throughout the country. Therefore, the Ethiopian government, especially the Ministry of Health and nongovernmental organizations (NGOs), must take measures to address this severity and improve identified factors.

Determining the Frequency and Influential Factors Impacting Antenatal Care Service Utilization Among Pregnant Women in Attendance at Mutara Health Centre III, Mitooma District, Uganda

Antenatal care (ANC) plays a pivotal role in curbing maternal mortality rates. This investigation sought to gauge the prevalence of and factors influencing antenatal care service utilization among pregnant women visiting Mutara Health Centre III's antenatal care clinic. The study involved 200 pregnant women in a cross-sectional analysis, employing an interview questionnaire to assess ANC service utilization determinants. Statistical Package for Social Sciences software was utilized for data analysis. The prevalence was determined by comparing the actual ANC attendance (from mid-July 2022 to mid-August 2022) against the projected monthly ANC attendance (300). The resulting attendance rate of 66.67% was categorized as inadequate, falling below the globally recommended coverage of 80%. Demographic findings revealed that the majority (57.5%) were peasants, while 47.5% of their partners had primary education. Alarmingly, 62.5% lacked knowledge regarding the appropriate timing for seeking ANC. Key conclusions drawn were that the attendance rate for ANC was notably low, coupled with inadequate knowledge among pregnant women about ANC and a prevalence of low socioeconomic status. Recommendations included tailored education programs for expectant mothers on ANC services by healthcare personnel at Mutara Health Centre III, public awareness campaigns by the Mitooma district health officer emphasizing the benefits of ANC attendance, governmental strategies to improve the livelihoods of those served by the health center, and a proposed study to assess maternal mortality prevalence specifically at Mutara Health Centre III. Keywords: Antenatal care, Pregnant women, maternal mortality, Healthcare workers.

Exploring Antenatal Health Care Service Utilization in Nepal: A Comprehensive Analysis

The utilization of maternal health care is one of the important factors in reducing the incidence of maternal mortality. Studies in Nepal and in developing countries shows that various demographic, socio-economic and economic factors are associated with ANC service utilization. The main objective of this study is to identify and examine socio-demographic and economic factors affecting antenatal healthcare service utilization in Nepal. This study used data from the Nepal Demographic and Health Survey 2016 and analyzed the data using logistic regression analysis. This research analyzes ANC (antenatal care) concerning dependent variables: age, birth order, religion, ethnicity, educational attainment, province, residence, and wealth indices. Maternal health has been receiving increased attention in the global health, development, and human rights agenda, representing a priority area for accelerating progress on the SDGs and sustaining the gains of the MDGs. Bivariate analysis was conducted for all variables, and some of them were statistically significant at the 5 percent significance level (since p &lt; 0.05). The dichotomous use of modern maternal healthcare utilization, namely whether a woman utilized maternal health care or not, employed dichotomous logistic regression to determine which factors best explain and predict the outcome of maternal health care utilization during pregnancy. A positive estimated value indicates that the odds favor the event and the event is likely to occur, while a negative value indicates that the event is not likely to occur. ANC visits of women decrease with birth order. Based on empirical results, the major factors for ANC services were income, awareness, access to health care services, and birth order attended. The level of awareness among women about the utilization of maternal healthcare in the study area was low. Maternal healthcare service utilization differed across various components of maternity. It would be better to increase awareness about the utilization of modern maternal healthcare for mothers and improve access to healthcare services in their villages to minimize transportation costs and waiting times from the government's side, thus increasing the utilization of maternal health care services in Nepal.

Effectiveness of Focused Obstetric Ultrasound Training to Nurses from Remote Health Posts to Improve Pregnancy Outcome and Reduce Morbidity.

A rural ultrasound program was started in Nepal in order to detect complicated pregnancies early in health post where radiologists are not available to provide their services. The study aims to investigate whether focused obstetric ultrasound trained nurses were capable of detecting high risk pregnancy at an early stage in their health post and refer them to higher centre timely so that they are taken care properly. The study site for research were health posts and hospitals where the rural ultrasound program had been conducted in districts of Sudurpashchim province. The referral centres within Sudurpashchim province were assessed for cross verification of diagnosis and pregnancy outcome of referred cases. Quantitative data was collected from health posts and hospitals ultrasound log book where women who had accessed obstetric ultrasound services during pregnancy. Qualitative data was collected from nurses who have completed training. The data was verified from log-book registered in the health post and hospitals. All the quantitative data was entered and analysed. Cross verified data revealed that focused obstetric ultrasound received nurses identified cases been verified same diagnosis in referral hospitals with 66 cases. In-depth interview with 28 nurses revealed that training received by them was effective in minimizing preventable maternal and neonatal mortality and morbidity. Focused obstetric ultrasound in rural and under-resources communities like in Nepal has the potential to improve access and quality of health care services and can result in an increased uptake of antenatal care service utilisation.