Utilization Of Prenatal Care Services Research Articles

Prevalence and Factors Associated with Anaemia among Pregnant Women Attending Antenatal Clinic in Mbaitoli L.G.A Imo State

Anemia during pregnancy continues to be a major health concern in Imo State and Nigeria. Globally, 41.8% - 60.0% of pregnant women experience anemia, and Nigeria has a prevalence rate of 55.1%. This cross-sectional study was conducted from September 2022 to May 2023 and involved 250 pregnant women who attended antenatal care at Nwaorieubi Comprehensive Health Center in Mbaitoli LGA, Imo State. The objective of this study was to gain insights into factors related to anemia, as well as prevention and control measures within the context of antenatal care. Data was collected through a structured questionnaire and by examining hemoglobin measurements from health records. Descriptive analysis was performed to determine means, frequencies, and proportions, while regression analysis (p<0.05) with odds ratios and a 95% confidence interval was used to explore associations. The prevalence of anemia during pregnancy was found to be 61%. The analysis revealed various factors contributing to anemia, including inadequate intake of vitamins, financial constraints, limited availability of antenatal care, lack of utilization of prenatal care services, gaps in awareness, cultural and social barriers, genetic conditions, and the occurrence of multiple pregnancies. Regression analysis highlighted significant correlations (p < 0.05) between inadequate intake of vitamins, underutilization of prenatal care, cultural and social barriers, genetic conditions, and multiple pregnancies. In terms of participant demographics, the descriptive analysis categorized participants into the following age groups: 15-22 (39 participants), 23-30 (90 participants), 31-39 (103 participants, 41%), and 40-49 (18 participants, 7%). It is worth noting that all participants in this study were married and identified as Christian. In order to raise awareness about the risk of developing anemia in late pregnancy, it is recommended that reproductive advice and education be provided to all women of reproductive age. Interventions such as mass media campaigns, outreach education, and life skills programs should be implemented to educate women on the importance of actively participating in antenatal care, adhering to prescribed medications, consuming a diverse range of nutritious meals, and incorporating iron-rich foods into their diets during pregnancy.

Factors Affecting Women’s Utilization of Prenatal Care Services in Gumuz Community

Underutilization of prenatal care services is one of the major hindrances which contribute for poor maternal health situations in Ethiopia. Studies with detailed investigation of factors influencing the prenatal care services especially in those remotely located communities in the country are limited. Therefore, the very purpose of this study was to explore factors affecting women in utilizing antenatal care services in Gumuz community. Moreover, making statistical measures on some identified variables to support the qualitative findings was another purpose. To attain these objectives, the study used Sequential Exploratory Mixed Method design. In-depth interview, focus group discussion, key informant interview and Survey questionnaires were used to gather data, thematic analysis was used for the qualitative data and descriptive, bivariate and multivariate analysis was used for the quantitative data. The findings showed that lack of knowledge about the services and negative attitude towards prenatal care services were identified as factors affecting women’s utilization of prenatal care services. Besides, women’s commitment to traditional ways of life, use of Gafias (local Magicians) treatments, using the local food taboo as a treatment and religious influences were identified as socio-cultural factors affecting women in using modern health care services. The results of the bivariate and multivariate analysis supported that knowledge and attitude have associations and significant effect on the service utilization. The study concludes that lack of knowledge, negative attitude, women’s commitments to traditional ways of life, Gafias treatments, local food taboo, religious influences, are the major factors affecting Gumuz women in using modern health care services. The finding of this study has important implications for further research, practice and policy and they are indicated in the paper.

Factors Affecting Women’s Utilization of Prenatal Care Services in Gumuz Community

Underutilization of prenatal care services is one of the major hindrances which contribute for poor maternal health situations in Ethiopia. Studies with detailed investigation of factors influencing the prenatal care services especially in those remotely located communities in the country are limited. Therefore, the very purpose of this study was to explore factors affecting women in utilizing antenatal care services in Gumuz community. Moreover, making statistical measures on some identified variables to support the qualitative findings was another purpose. To attain these objectives, the study used Sequential Exploratory Mixed Method design. In-depth interview, focus group discussion, key informant interview and Survey questionnaires were used to gather data, thematic analysis was used for the qualitative data and descriptive, bivariate and multivariate analysis was used for the quantitative data. The findings showed that lack of knowledge about the services and negative attitude towards prenatal care services were identified as factors affecting women’s utilization of prenatal care services. Besides, women’s commitment to traditional ways of life, use of Gafias (local Magicians) treatments, using the local food taboo as a treatment and religious influences were identified as socio-cultural factors affecting women in using modern health care services. The results of the bivariate and multivariate analysis supported that knowledge and attitude have associations and significant effect on the service utilization. The study concludes that lack of knowledge, negative attitude, women’s commitments to traditional ways of life, Gafias treatments, local food taboo, religious influences, are the major factors affecting Gumuz women in using modern health care services. The finding of this study has important implications for further research, practice and policy and they are indicated in the paper.

Factors Influencing the Utilization of Antenatal Services among Women of Childbearing Age in South Africa

Access to quality care before, during, and after childbirth remains an effective means of reducing maternal and neonatal mortality. Therefore, the study identified factors influencing the utilization of prenatal care services among women of childbearing age in South Africa. This is a retrospective study based on secondary data from the South African Demographic Health Survey (DHS) conducted from 1998 to 2016. In South Africa, 21.0% of mothers had used ANC services. Higher odds of seeking prenatal care were found in women aged 35 years and older (cOR = 1.26, 95% CI; 1.08–1.47, p = 0.003), married or cohabiting (cOR = 1.13, 95% CI; 1.004–1.27) observed, p = 0.043), higher level of education (tertiary education: cOR = 0.55, p = 0.001), female residents in urban areas (cOR = 1.35, 95% CI; 1.20–1.52, p = 0.001), higher wealth index (cOR = 1.32, 95% CI; 1.15–1.51, p = 0.001), employed (cOR = 1.48, 95% CI; 1.29–1.70, p = 0.001) and media exposure (cOR = 1.27, 95% CI; 1.12–1.44), p = 0.001). The findings of this study provide insight into the need to make maternal health services more accessible, more widely used, and of a higher quality. This requires effective strategic policies that promote patronage to reduce maternal mortality and improve newborn outcomes in South Africa.

Changes in Maternal Care During the Healthcare Reforms in the Republic of Georgia

Since 1991, the health system of the Republic of Georgia has passed through several phases of reform. Privatization and marketization of the healthcare system are among the major reforms. The aim of this study was to analyze the changes in the utilization of, and access to maternal care services during the period 1999–2010. Secondary analysis was done using data from three national reproductive health surveys (RHS). From three RHSs we selected 7,684 women who experienced childbirth/s during 5-years prior to each survey. We analyzed data on pregnancy outcome, type of childbirth, access and utilization of prenatal, natal and immediate postnatal care, and looked at associations with maternal age, ethnicity, educational level, employment status, residence, religion, and economic status. Binary and multinomial regressions were the main statistical models used along with descriptive statistics. We found that the overall utilization of prenatal care services was quite high; in the first wave, it was 92.1% then increased to 95.1% and 98.1% in the second wave and in the third wave respectively. However, utilization of postnatal services was quite low. According to RHS 1999–2000 only 10.7% of mothers utilized postnatal services, which increased to 23.3% in 2010. Women of age group 30–34 were more likely not to use prenatal care services than the other age groups. Rural dwellers, women with lower education level, and women with lower income were less likely to utilize prenatal check-ups. According to the findings from the survey, there were improvements in access to prenatal and natal care as well as utilization of maternal care services over the years. Overall, the use of maternal care has improved during the reforms.

Inadequate Utilization of Prenatal Care Services, Socioeconomic Status, and Educational Attainment Are Associated with Low Birth Weight in Zimbabwe.

Globally, low birth weight (LBW) remains a leading cause of neonatal and infant mortality and poses significant challenges toward the progress of achieving infant mortality-related goals. Experience from developed countries shows that two major causes of LBW (premature delivery and intrauterine growth restriction) can be averted to a great extent by adequate utilization of maternal health-care services, during pregnancy. In this study, we attempt to measure the prevalence of LBW in Zimbabwe and explore the association between adequate utilization of prenatal care (PNC) services and LBW in Zimbabwe. We also explore other possible associations with LBW. This study was based on nationally representative, cross-sectional data from Multiple Indicator Cluster Survey round 5, conducted in 2014. Participants included 3,221 mothers from both rural and urban areas. The participants were selected regardless of their current pregnancy status. Sample characteristics were presented using descriptive statistics. Association between utilization status of ANC and LBW was measured by chi-square (bivariate) test and logistic regression methods. Prevalence of LBW was 12.8%. There was 11% reduction in the odds of having LBW babies for participants from urban area when compared with rural area (AOR = 0.897; 95% CI = 0.707-1.138). When compared to women with higher education, those having primary/below primary and secondary level qualification had higher odds of experiencing LBW babies by 73 and 56%, respectively. Participants who had less than four PNC/ANC visits had 34% higher odds (AOR = 1.340; 95% CI = 1.065-1.685) than those with at least four visits, and those who had given birth more than once, had 38% lower odds (AOR = 0.620; 95% CI = 0.493-0.780) of giving birth to LBW babies when compared to those who had given birth only once. The findings of this study have programmatic and policy implications for low-resource nations and suggest that promoting access to ANC services especially in the rural areas is likely to reduce prevalence of LBW in Zimbabwe. This is important as LBW babies consume lot of health resources per se and not only in terms of hospitalization but also in terms of outpatient and physician visits during the first year of their life.

Access to and utilization of prenatal care services in the Unified Health System of the city of Rio de Janeiro, Brazil.

Prenatal care consists of practices considered to be effective for the reduction of adverse perinatal outcomes. However, studies have demonstrated inequities in pregnant women's access to prenatal care, with worse outcomes among those with lower socioeconomic status. The objective of this study is to evaluate access to and utilization of prenatal services in the Sistema Único de Saúde (SUS - Unified Health System) in the city of Rio de Janeiro and to verify its association with the characteristics of pregnant women and health services. A cross-sectional study was conducted in 2007-2008, using interviews and the analysis of prenatal care cards of 2.353 pregnant women attending low risk prenatal care services of the SUS. A descriptive analysis of the reasons mentioned by women for the late start of prenatal care and hierarchical logistic regression for the identification of the factors associated with prenatal care use were performed. The absence of a diagnosis of pregnancy and poor access to services were the reasons most often reported for the late start of prenatal care. Earlier access was found among white pregnant women, who had a higher level of education, were primiparous and lived with a partner. The late start of prenatal care was the factor most associated with the inadequate number of consultations, also observed in pregnant adolescents. Black women had a lower level of adequacy of tests performed as well as a lower overall adequacy of prenatal care, considering the Programa de Humanização do Pré-Natal e Nascimento (PHPN - Prenatal and Delivery Humanization Program) recommendations. Strategies for the identification of pregnant women at a higher reproductive risk, reduction in organizational barriers to services and increase in access to family planning and early diagnosis of pregnancy should be prioritized.

672: Does health care system distrust influence utilization of prenatal care services?

672: Does health care system distrust influence utilization of prenatal care services?

Adaptación del modelo de Andersen al contexto mexicano: acceso a la atención prenatal

The aim of this work was to propose an adjustment to the Model of Andersen who answers better to the social inequality of the population in the Mexico City and allows to evaluate the effect of socioeconomic factors in the access to the prenatal care of a sample stratified according to degree of marginalization. The data come from a study of 663 women, randomly selected from a framework sample of 21,421 homes in Mexico City. This work collects information about factors that affect utilization of health services, as well as predisposing factors (age and socioeconomic level), as enabling factors (education, social support, entitlement, pay out of pocket and opinion of health services), and need factors. The sample was ranked according to exclusion variables into three stratums. The data were analyzed through the technique of path analysis. The results indicate that socioeconomic level takes part like predisposed variable for utilization of prenatal care services into three stratums. Otherwise, education and social support were the most important enabling variables for utilization of prenatal care services in the same three groups. In regard to low stratum, the most important enabling variables were education and entitlement. For high stratum the principal enabling variables were pay out of pocket and social support. The medium stratum shows atypical behavior which it was difficult to explain and understand. There was not mediating role with need variable in three models. This indicated absence of equality in all stratums. However, the most correlations in high stratum perhaps indicate less inequitable conditions regarding other stratums.

Barriers to utilization of prenatal care services in Turkey.

To identify barriers to utilization of prenatal care services in Turkey, including pregnant women's attitudes toward pregnancy and prenatal care. Descriptive. The population was Turkish women who lived in Erzurum and had delivered their infants but were still hospitalised. The sample of 446 women had or had not received prenatal care, had no complications during pregnancy, carried their pregnancies to term, and were considered to have normal deliveries. Attitudes toward pregnancy and prenatal care and barriers to prenatal care services were measured by use of a questionnaire. Low education of pregnant women and unwanted pregnancy were barriers to use of prenatal care services. Additional barriers were negative attitudes toward pregnancy and attitudes toward prenatal care. These barriers decreased frequency of use and delayed early initiation of prenatal care. The most important barrier reported by the women was being too busy at home to seek care. Although this sample was limited, the findings indicate barriers for attention by health care providers to ensure appropriate prenatal care and maternal and infant health.

Factors associated with inadequacy of prenatal care utilization

To identify factors associated with inadequacy of prenatal care utilization in urban community. A cross-sectional study of a systematic sample stratified by maternity hospital, consisting of hospital births in the municipality of São Luís, Brazil, was carried out from March 1997 to February 1998. Socioeconomic and demographic factors, reproductive health, morbidity during pregnancy, and utilization of prenatal care services were studied. Mothers answered a standardized questionnaire before hospital discharge. The adequacy of prenatal care utilization was analyzed by means of two indexes: APNCU (Adequacy of Prenatal Care Utilization) and a new index based on the recommendations of the Brazilian Ministry of Health. There were interviewed 2,831 women who delivered at 10 public and private maternity hospitals. The inadequacy of prenatal care utilization was 49.2% according to the APNCU index and 24.5% when determined by the Brazilian index. Prenatal care at public services, low maternal schooling, low income, having no partner, and absence of maternal diseases during pregnancy were associated with inadequacy of prenatal care use according to both indexes. High parity and maternal age of 35 years or more were also associated with inadequacy, whereas primiparity, morbidity, and young maternal age (<20 years) seemed to protect from inadequacy when the Brazilian index was used. Prenatal care showed low coverage in the municipality of São Luís. The inadequacy of prenatal care utilization was associated with several factors linked to social inequality.

La atención prenatal en la ciudad fronteriza de Tijuana, México

This study was intended to explore the conditions under which prenatal care is delivered in the border city of Tijuana, Baja California, Mexico, and to assess the possible associations between that care and neonatal results in terms of birthweight, health of the neonate, and prematurity. Seven hospitals serving persons from different socioeconomic strata were chosen, and between December 1993 and March 1994 interviews were conducted with 279 women who were in the first 24 to 48 hours of puerperium. During the interviews data were collected on socioeconomic level; the mothers' knowledge, attitudes, and practices concerning obstetric health; the mothers' perceptions of access to prenatal care; the quality of prenatal care visits (evaluated in terms of having blood and urine tested and weight and blood pressure measured); and the gynecological and obstetric and health history of the mother. A database was created using the SPSS statistics software package. Possible associations were explored, with prenatal care as the independent variable and various dependent variables, by means of contingency tables and a two-tailed Fisher's exact test. None of the neonates was premature, ill, or had a birthweight of < or = 2,500 g. For this reason it was decided to divide the variable corresponding to birthweight into two groupings, < or = 3,000 g and > 3,000 g. A significant (P < 0.00038) relationship was found between a lack of prenatal care and low birthweight. In addition, a lack of prenatal care was associated with: low family income; the mother's financial dependence on the father; the mother being in an unmarried relationship; little communication with the partner; having no medical insurance; an unwanted pregnancy; and giving delivery at the General Hospital. Out of the total sample of 279 women, 15 (5.4%) had received no prenatal care. None of these 15 women reported they had encountered difficulties that prevented them from obtaining prenatal care, but only 7 of those women answered that question. The prenatal care was of good quality in 190 of the cases (68%). Both the number and the timing of the prenatal visits were adequate in 142 of the cases (50%). The mother's having worked during pregnancy or before had a positive predictive value in terms of utilization of prenatal care services. Additional studies are needed to evaluate the possible relationship between domestic violence and the lack of prenatal care or a delay in seeking such care.

Determinants of pregnancy outcomes and targeting of maternal health services in Jamaica

Detailed nationally representative population level data were used to investigate the pre-natal care and delivery experiences of pregnant women in Jamaica. The results of this study show that : (a) demographic criteria (particularly first births) and self-reported clinical pregnancy complications are valid predictors of deleterious maternal health outcomes and can be used to stratify mothers into risk groups. (b) There appears to be a significant problem of under and inappropriate utilization of pre-natal care services by all women and in particular by demographically ‘high risk’ women, i.e. young, first time mothers. Significant proportions of the latter group report either no pre-natal care visits at all or visits which are later than the first trimester. The problems of delayed initiation of pre-natal care are specially exacerbated for poor, teenage mothers who happen to be living in the Kingston Metropolitan Area. (c) In terms of the content and quality of pre-natal care services the message is somewhat mixed. On the positive side the pre-natal care system is doing a moderately satisfactory job with regard to diagnostic tests and educational advice. On the negative side however, the fact that once women enter the health care system they all receive the same moderately adequate care (in terms of diagnostic evaluations and educational advice) with no attempt to focus particular attention on high risk mothers is troublesome. (d) With regard to appropriate delivery venues for pregnant women, pre-natal care visits do not appear to significantly influence the choice of delivery venues. Moreover, rich urban women are much more likely to deliver in a hospital than their rural peers. In conclusion, the study discusses the social and behavioral context of these results, addresses the policy implications and makes some recommendations to improve maternal health services.

Prenatal Care Utilization and Persistence Patterns in a Developing Nation

Utilization of prenatal care services is an important public health issue, in that lack of utilization is associated with poor pregnancy outcomes, particularly among socially and economically high-risk women. This investigation explored factors associated with utilization of prenatal care services in a sample of 185 urban Jamaican women. Data were collected at an initial prenatal care clinic visit, follow-up interviews with those who failed to persist, and from medical records. Findings indicated that the two most important factors in late initiation of prenatal care, and in failure to persist, were cost of service and susceptibility to poor pregnancy outcome.