Factors Associated with Numbers of Antenatal Care Visits in Rural Ethiopia

Abstract

Melkalem Mamuye Azanaw,1 Alemayehu Digssie Gebremariam,1 Fentaw Teshome Dagnaw,1 Hiwot Yisak,1 Getaneh Atikilt,1 Binyam Minuye,2 Melaku Tadege Engidaw,1 Desalegn Tesfa,1 Edgeit Abebe Zewde,3 Sofonyas Abebaw Tiruneh1 1Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia; 2Department of Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia; 3Department of Biomedical Sciences, College of Health Sciences, Debre Tabor University, Debre Tabor, EthiopiaCorrespondence: Melkalem Mamuye Azanaw Email [email protected]: Antenatal care (ANC) is a medical care and procedure carried out for pregnant women. Data on ANC visits can help policymakers show gaps in service provision. Therefore, this study assessed the factors associated with the number of ANC visits among women in rural Ethiopia.Methods: We included a total of 6611 women who gave birth within 5 years preceding the survey from the 2016 Ethiopian Demographic and Health Survey. A multi-level negative binomial regression analysis was employed to consider the hierarchical nature of the data. In the multivariable analysis, variables with a p-value < 0.05 were considered to be significantly associated with the number of ANC visits.Results: Overall, 27.3% (95% CI: 14.63, 15.76) of women had at least four ANC visits during pregnancy in rural Ethiopia. Among individual level factors, age group 25– 29 years (adjusted incidence rate ratio (AIRR)=1.13,95% CI:1.02,1.26), household rich wealth status (AIRR=1.17, 95% CI:1.04,1.31), women’s educational status (primary, AIRR=1.19,95% CI:1.08,1.32; secondary, AIRR= 1.30,95% CI:1.08,1.55; above secondary, AIRR=1.35, 95% CI:1.07,1.71), partner educational status (primary, AIRR=1.16, 95% CI:1.05,1.28; secondary, AIRR=1.22,95% CI:1.08,1.38), and autonomy to decision to their care (AIRR=1.25,95% CI:1.10,1.42) were positively associated factors whereas having a birth order of five or more (AIRR=0.80,95% CI: 0.69,0.94) was a negative associated with number of ANC visits. Among community-level variables, being in higher community level literacy (AIRR=1.35, 95% CI: 1.14, 1.59) and higher poverty level (AIRR=0.77, 95% CI: 0.64, 0.92) were significant factors with the number of ANC visits.Conclusions and Recommendations: Women’s age, wealth status, women’s educational status, partner educational status, autonomy to decision making in health care, and birth order were determinants of the number of ANC visits. Furthermore, poverty and literacy are also important factors at the community level. Addressing economic and educational interventions for rural women should be prioritized.Keywords: antenatal care, women, rural Ethiopia, multilevel negative binomial count analysis

Keywords

• antenatal care
• women
• rural ethiopia
• multilevel negative binomial count analysis