Predictors for achieving adequate antenatal care visits during pregnancy: a cross-sectional study in rural Northwest Rwanda.
Antenatal care
Pregnancy
Rwanda
Journal
BMC pregnancy and childbirth
ISSN: 1471-2393
Titre abrégé: BMC Pregnancy Childbirth
Pays: England
ID NLM: 100967799
Informations de publication
Date de publication:
26 Jan 2023
26 Jan 2023
Historique:
received:
21
08
2022
accepted:
16
01
2023
entrez:
26
1
2023
pubmed:
27
1
2023
medline:
31
1
2023
Statut:
epublish
Résumé
Inadequate antenatal care (ANC) in low-income countries has been identified as a risk factor for poor pregnancy outcome. While many countries, including Rwanda, have near universal ANC coverage, a significant proportion of pregnant women do not achieve the recommended regimen of four ANC visits. The present study aimed to explore the factors associated with achieving the recommendation, with an emphasis on the distance from household to health facilities. A geo-referenced cross-sectional study was conducted in Rutsiro district, Western province of Rwanda with 360 randomly selected women. Multiple logistic regression analysis including adjusted odd ratio (aOR) were performed to identify factors associated with achieving the recommended four ANC visits. The majority (65.3%) of women had less than four ANC visits during pregnancy. We found a significant and negative association between distance from household to health facility and achieving the recommended four ANC visits. As the distance increased by 1 km, the odds of achieving the four ANC visits decreased by 19% (aOR = 0.81, P = 0.024). The odds of achieving the recommended four ANC visits were nearly two times higher among mothers with secondary education compared with mothers with primary education or less (aOR = 1.90, P = 0.038). In addition, mothers who responded that their household members always seek health care when necessary had 1.7 times higher odds of achieving four ANC visits compared with those who responded as unable to seek health care (aOR = 1.7, P = 0.041). Furthermore, mothers from poor households had 2.1 times lower odds of achieving four ANC visits than mothers from slightly better-off households (aOR = 2.1, P = 0.028). Findings from the present study suggest that, in Rutsiro district, travel distance to health facility, coupled with socio-economic constraints, including low education and poverty can make it difficult for pregnant women to achieve the recommended ANC regimen. Innovative strategies are needed to decrease distance by bringing ANC services closer to pregnant women and to enhance ANC seeking behaviour. Interventions should also focus on supporting women to attain at least secondary education level as well as to improve the household socioeconomic status of pregnant women, with a particular focus on women from poor households.
Sections du résumé
BACKGROUND
BACKGROUND
Inadequate antenatal care (ANC) in low-income countries has been identified as a risk factor for poor pregnancy outcome. While many countries, including Rwanda, have near universal ANC coverage, a significant proportion of pregnant women do not achieve the recommended regimen of four ANC visits. The present study aimed to explore the factors associated with achieving the recommendation, with an emphasis on the distance from household to health facilities.
METHODS
METHODS
A geo-referenced cross-sectional study was conducted in Rutsiro district, Western province of Rwanda with 360 randomly selected women. Multiple logistic regression analysis including adjusted odd ratio (aOR) were performed to identify factors associated with achieving the recommended four ANC visits.
RESULTS
RESULTS
The majority (65.3%) of women had less than four ANC visits during pregnancy. We found a significant and negative association between distance from household to health facility and achieving the recommended four ANC visits. As the distance increased by 1 km, the odds of achieving the four ANC visits decreased by 19% (aOR = 0.81, P = 0.024). The odds of achieving the recommended four ANC visits were nearly two times higher among mothers with secondary education compared with mothers with primary education or less (aOR = 1.90, P = 0.038). In addition, mothers who responded that their household members always seek health care when necessary had 1.7 times higher odds of achieving four ANC visits compared with those who responded as unable to seek health care (aOR = 1.7, P = 0.041). Furthermore, mothers from poor households had 2.1 times lower odds of achieving four ANC visits than mothers from slightly better-off households (aOR = 2.1, P = 0.028).
CONCLUSIONS
CONCLUSIONS
Findings from the present study suggest that, in Rutsiro district, travel distance to health facility, coupled with socio-economic constraints, including low education and poverty can make it difficult for pregnant women to achieve the recommended ANC regimen. Innovative strategies are needed to decrease distance by bringing ANC services closer to pregnant women and to enhance ANC seeking behaviour. Interventions should also focus on supporting women to attain at least secondary education level as well as to improve the household socioeconomic status of pregnant women, with a particular focus on women from poor households.
Identifiants
pubmed: 36703102
doi: 10.1186/s12884-023-05384-0
pii: 10.1186/s12884-023-05384-0
pmc: PMC9878946
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
69Informations de copyright
© 2023. The Author(s).
Références
Reprod Health. 2015;12 Suppl 2:S5
pubmed: 26062992
Br J Nutr. 2021 Oct 28;126(8):1203-1214
pubmed: 33298231
J Adv Nurs. 2008 Feb;61(3):244-60
pubmed: 18197860
Soc Sci Med. 2013 Sep;93:147-54
pubmed: 23906132
Int J Health Geogr. 2012 Sep 17;11:40
pubmed: 22984920
BMC Pregnancy Childbirth. 2022 Jul 5;22(1):544
pubmed: 35790931
S Afr Med J. 1984 Feb 4;65(5):161-5
pubmed: 6607541
J Hum Cap. 2009 Summer;3(2):144-176
pubmed: 22368727
Health Policy Plan. 2004 Mar;19(2):69-79
pubmed: 14982885
Prof Geogr. 2012 Apr 1;64(2):
pubmed: 24273346
Trop Med Int Health. 2009 Jan;14(1):54-61
pubmed: 19021892
Int Health. 2019 Nov 13;11(6):596-604
pubmed: 31145791
Health Place. 2002 Mar;8(1):3-13
pubmed: 11852259
Health Policy. 1996 Feb;35(2):123-43
pubmed: 10156650
Soc Sci Med. 2006 Aug;63(3):691-705
pubmed: 16574290
BMC Pregnancy Childbirth. 2019 Dec 21;19(1):514
pubmed: 31864320
Int J Environ Res Public Health. 2020 Jun 16;17(12):
pubmed: 32560132
BMC Pregnancy Childbirth. 2017 Oct 16;17(1):361
pubmed: 29037190
BMC Pregnancy Childbirth. 2014 Aug 28;14:290
pubmed: 25163525
PLoS One. 2021 Aug 25;16(8):e0256415
pubmed: 34432829
Midwifery. 2014 Jan;30(1):96-102
pubmed: 23538104
Int J Health Geogr. 2010 Jul 21;9:38
pubmed: 20663146
BJOG. 2017 May;124(6):860-862
pubmed: 28190290
Trop Med Int Health. 2010 Feb;15(2):182-90
pubmed: 19930141
Health Policy Plan. 2021 Nov 11;36(10):1659-1670
pubmed: 34331066
PLoS One. 2018 Jan 10;13(1):e0190739
pubmed: 29320556
Midwifery. 2015 Dec;31(12):1149-56
pubmed: 26471934
PLoS One. 2019 Sep 13;14(9):e0222566
pubmed: 31518365
Int J Health Geogr. 2013 Dec 07;12:55
pubmed: 24314170
PLoS One. 2012;7(10):e46475
pubmed: 23056319
Am J Trop Med Hyg. 2020 Jul;103(1):494-500
pubmed: 32314691
Int J Health Geogr. 2008 Feb 18;7:7
pubmed: 18282284
BMC Health Serv Res. 2018 Apr 10;18(1):262
pubmed: 29631583
PLoS One. 2021 Jan 14;16(1):e0245003
pubmed: 33444374
BMC Infect Dis. 2017 Mar 6;17(1):189
pubmed: 28264668
Int J Health Geogr. 2004 Sep 29;3(1):21
pubmed: 15456514
Soc Sci Med. 2010 Dec;71(11):1958-63
pubmed: 20980089
Int J Qual Health Care. 2016 Dec 01;28(6):657-664
pubmed: 28104794
Int J Health Plann Manage. 2003 Oct-Dec;18(4):293-311
pubmed: 14727709
BMC Pregnancy Childbirth. 2018 Oct 5;18(1):394
pubmed: 30290769
Afr J Prim Health Care Fam Med. 2017 Jun 29;9(1):e1-e5
pubmed: 28697619