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Multilevel negative binomial analysis of factors associated with numbers of antenatal care contacts in low and middle income countries: Findings from 59 nationally representative datasets

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  • Adugnaw Zeleke Alem
  • Biresaw Ayen Tegegne
  • Fantu Mamo Aragaw
  • Rediet Eristu Teklu
  • Tsegaw Amare Baykeda

Abstract

Background: Antenatal care (ANC) is one of the recommended interventions to reduce stillbirth, maternal, neonatal, and child mortality through early identification and management of pregnancy complications or pre-existing conditions. Although increasing number of ANC is a key priority of the 2016 WHO recommendations, ANC uptake in Low and Middle Income Countries (LMICs) is insufficient. Therefore, this study aimed to investigate factors associated with the number of ANC contacts in LMICs. Methods: Data for the study were drawn from 59 recent Demographic and Health Surveys (DHS) conducted in LMICS. We included a total sample of 520,377 mothers who gave birth in the five years preceding the survey. A multilevel negative binomial regression model was applied to identify factors that may affect number of ANC. Adjusted incidence rate ratios (AIRR) with 95% Confidence Interval (CI) were reported to show association. Results: This study found that mothers and their partner with higher educational attainment, mothers aged >35 years, mothers who had decision making autonomy, mothers from female headed household, mothers from richer and richest household, mothers exposed to media, and residing in urban areas had significantly more ANC contacts. However, number of ANC contacts were significantly lower among mothers who initiated ANC after 12 weeks of gestation and perceived healthcare access to be a big problem. Conclusion: Our results suggest that individual, household, and community-level factors were associated with number of ANC contacts among pregnant mothers in LMICs. Hence, local and international policymakers, and programmers should focus on improving community awareness about maternal health care services through mass media and outreach programs with especial emphasis on women’s and their partners educational attainment, rural mothers, women’s empowerment, and household socioeconomic status.

Suggested Citation

  • Adugnaw Zeleke Alem & Biresaw Ayen Tegegne & Fantu Mamo Aragaw & Rediet Eristu Teklu & Tsegaw Amare Baykeda, 2024. "Multilevel negative binomial analysis of factors associated with numbers of antenatal care contacts in low and middle income countries: Findings from 59 nationally representative datasets," PLOS ONE, Public Library of Science, vol. 19(4), pages 1-17, April.
    • Handle: RePEc:plo:pone00:0301542
    DOI: 10.1371/journal.pone.0301542
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    References listed on IDEAS

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    1. Fatema, Kaniz, 2020. "Mass Media Exposure and Maternal Healthcare Utilization in South Asia," SocArXiv 5dhyr, Center for Open Science.
    2. United Nations UN, 2015. "Transforming our World: the 2030 Agenda for Sustainable Development," Working Papers id:7559, eSocialSciences.
    3. repec:osf:socarx:5dhyr_v1 is not listed on IDEAS
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    1. Abel Endawkie & Natnael Kebede & Desale Bihonegn Asmamaw & Yawkal Tsega, 2024. "Predictors and number of antenatal care visits among reproductive age women in Sub-Saharan Africa further analysis of recent demographic and health survey from 2017–2023: Zero-inflated negative binomi," PLOS ONE, Public Library of Science, vol. 19(10), pages 1-16, October.

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