Background
Methods
Study design, study population and sample size
Data collection procedures
Variables
Utilization of antenatal care services
Socio-demographic and psychosocial factors
Statistical analysis
Results
Socio-demographic and psychosocial characteristics
Characteristics | Total n (%) | ≤2visits n (%) | ≥3visits n (%) |
p-value | ≤2visitsa
n (%) | ≥4visitsb
n (%) |
p-value |
---|---|---|---|---|---|---|---|
Age groups (n = 919) | |||||||
15–30 | 632(68.8) | 72(59.0) | 560(70.3) | 0.01 | 194(61.2) | 438(72.8) | 0.0001 |
31–46 | 287(31.2) | 50(41.0) | 237(29.7) | 123(38.8) | 164(27.2) | ||
Number of people in the household (n = 917) | |||||||
0–6 | 748(81.6) | 86(70.5) | 662(83.3) | 0.001 | 244(77.2) | 504(83.9) | 0.01 |
7 or more | 169(18.4) | 36(29.5) | 133(16.7) | 72(22.8) | 97(16.1) | ||
Relationship with household head (n = 919) | |||||||
Not wife | 166(18.1) | 42(34.4) | 124(15.6) | 0.0001 | 74(33.3) | 92 (15.3) | 0.003 |
Wife | 753(81.9) | 80(65.6) | 673(84.4) | 243(76.7) | 510(84.7) | ||
Sex of the house hold head (n = 914) | |||||||
Female | 70(7.7) | 17(14.0) | 53(6.7) | 0.005 | 33(10.5) | 37(6.2) | 0.02 |
Male | 844(92.3) | 104(86.0) | 740(93.3) | 282(89.5) | 562(93.8) | ||
Marital status (n = 919) | |||||||
Single, divorced, widowed, separated | 145(15.8) | 37(30.3) | 108(13.6) | 0.0001 | 69(21.8) | 76(12.6) | 0.0001 |
Married or cohabitating | 774(84.2) | 85(69.7) | 689(86.4) | 248(78.2) | 526(87.4) | ||
Ever attended school (n = 913) | |||||||
Yes | 829(90.8) | 105(86.1) | 724(91.5) | 0.05 | 285(90.2) | 544(91.1) | 0.64 |
No | 84(9.2) | 17(13.9) | 67(8.5) | 31(9.8) | 53(8.9) | ||
Highest attained level of education (n = 830) | |||||||
Incomplete primary school | 416(50.1) | 59(55.7) | 357(49.3) | 167(58.2) | 249(45.9) | ||
Complete primary school or vocational training | 219(26.4) | 21(19.8) | 198(27.3) | 0.24 | 64(22.3) | 155(28.5) | 0.003 |
Secondary school or university | 195(23.5) | 26(24.5) | 169(23.3) | 56(19.5) | 139(25.6) | ||
Occupation (n = 907) | |||||||
Skilled work, civil servant, student | 119(13.1) | 16(13.2) | 103(13.1) | 40(12.8) | 79(13.3) | ||
Non skilled work | 528(58.2) | 66(54.5) | 462(58.8) | 0.62 | 186(59.6) | 342(57.5) | 0.82 |
Not employed, other occupation | 260(28.7) | 39(32.2) | 221(28.1) | 86(27.6) | 174(29.2) | ||
Social support (n = 919) | |||||||
Yes | 733(79.8) | 87(71.3) | 646(81.1) | 0.01 | 253(79.8) | 480(79.7) | 0.97 |
No | 186(20.2) | 35(28.7) | 151(18.9) | 64(20.2) | 122(20.3) | ||
Partner Characteristics | |||||||
Husband age (n = 775) | |||||||
≤ 40 | 667(86.1) | 61(72.6) | 606(87.7) | 0.0001 | 196(78.1) | 471(89.9) | 0.0001 |
41–70 | 108(13.9) | 23(27.4) | 85(12.3) | 55 (21.9) | 53(10.1) | ||
Husband ever attended school(n = 766) | |||||||
Yes | 667(87.0) | 69(84.1) | 598(87.3) | 0.42 | 212(85.1) | 455(87.8) | 0.29 |
No | 100(13.0) | 13(15.9) | 87(12.7) | 37(14.9) | 63(12.2) | ||
Highest level of education (n = 659) | |||||||
Incomplete primary school | 283(42.9) | 31(45.6) | 252(42.6) | 91(42.9) | 192(43.0) | ||
Complete primary school or vocational training | 248(37.6) | 28(41.2) | 220(37.2) | 0.32 | 92(43.4) | 156(34.9) | 0.02 |
Secondary school or university | 128(19.4) | 9(13.2) | 119(20.1) | 29(13.7) | 99(22.1) | ||
Husband’s occupation (n = 770) | |||||||
Skilled work, civil servant, student | 174(22.6) | 14(17.1) | 160(23.3) | 55(22.2) | 119(22.8) | ||
Non skilled work | 343(44.5) | 33(40.2) | 310(45.1) | 0.11 | 122(49.2) | 221(42.3) | 0.15 |
Not employed or other occupation | 253(32.9) 253 | 35(42.7) | 218(31.7) | 71(28.6) | 182(34.9) | ||
Total household monthly income (n = 861) | |||||||
< 17500FRW | 258(30.0) | 35(31.3) | 223(29.8) | 103(35.0) | 155(27.3) | ||
17501-35999FRW | 240(28.0) | 24(21.4) | 216(28.8) | 0.24 | 75(25.5) | 165(29.1) | 0.06 |
36000 or more FRW | 363(42.0) | 53(47.3) | 310(41.4) | 116(39.5) | 247(43.6) | ||
Household assets summary measure (n = 909) | |||||||
Improved (≥1 item) | 715(78.7) | 91(74.6) | 624(79.3) | 0.23 | 247(78.7) | 468(78.7) | 0.99 |
Poor (none of the items) | 194(21.3) | 31(25.4) | 163(20.7) | 67(21.3) | 127(21.3) |
Pregnancy related characteristics of the study population
Variables |
n
| % |
---|---|---|
Pregnancies before the latest one (n = 889) | ||
First time pregnancy | 288 | 32.4 |
≥ 2 pregnancies | 601 | 67.6 |
Type of ANC facility visited (n = 915) | ||
Health center or dispensary | 887 | 97.0 |
District hospital | 12 | 1.3 |
Referral hospital | 7 | 0.8 |
Private clinic | 8 | 0.9 |
Other | 1 | 0.1 |
Responsible health care professional during first visit (n = 896) | ||
Nurse/midwife | 822 | 91.3 |
Doctor | 74 | 8.7 |
Who accompanied pregnant woman during first visit to ANC clinic (n = 914) | ||
Husband | 746 | 81.6 |
Mother, family member or any other person | 19 | 2.1 |
Community Health Worker | 45 | 4.9 |
None | 104 | 11.4 |
Time walking to ANC clinic (n = 892) | ||
5–30 min | 349 | 39.1 |
31–60 min | 267 | 29.9 |
1–2 h | 195 | 21.8 |
2–3 h | 68 | 7.6 |
> 3 h | 13 | 1.5 |
Place of delivery (n = 919) | ||
At home or on the way to a health facility | 47 | 5.1 |
Health center or dispensary | 582 | 63.3 |
District hospital | 230 | 25.0 |
Referral hospital | 50 | 5.4 |
Private clinic | 10 | 1,1 |
Did you attend ANC clinic during pregnancy? | ||
Yes | 910 | 99.5 |
No | 5 | 0.5 |
Number of Antenatal care visits (n = 915) | ||
1 visit | 23 | 2.5 |
2 visits | 94 | 10.3 |
3 visits | 380 | 41.6 |
4 visits | 380 | 41.6 |
≥ 5 visits | 38 | 4.0 |
Antenatal care (ANC) visits (n = 920) | ||
≤ 2 visits | 122 | 13.3 |
≥ 3 visits | 798 | 86.7 |
Antenatal care (ANC) visits (n = 920) | ||
≤ 2 Visits + 3 visits but none during first trimester of pregnancy | 317 | 34.5 |
≥ 3 visits | 603 | 65.5 |
Risk factors of poor utilization of antenatal care
n (%) with poor ANC utilization | ORb
| 95% CI | |
---|---|---|---|
Age groups (years) | |||
15–30 | 72 (11.4) | 1 | |
31–46 | 50 (17.4) | 1.64 | 1.11–2.42 |
Number of people in the household | |||
1–6 | 86(11.5) | 1 | |
≥ 7 | 36 (21.3) | 2.08 | 1.35–3.21 |
Pregnancies before the latest one | |||
No pregnancy before | 29 (10.1) | 1 | |
One or more pregnancies before | 87 (14.5) | 1.51 | 0.96–2.35 |
Sex of the household head | |||
Male | 104 (12.3) | 1 | |
Female | 17 (24.3) | 2.28 | 1.27–4.09 |
Relation with household head | |||
Wife | 80 (10.6) | 1 | |
Relationship other than wife | 42 (25.3) | 2.85 | 1.87–4.33 |
Marital status | |||
Married or cohabitating | 85 (11.0) | 1 | |
Single, divorced, widowed, separated | 37(25.5) | 2.77 | 1.79–4.29 |
Ever attended school | |||
Yes | 105 (12.7) | 1 | |
No | 17 (20.2) | 1.75 | 0.98–3.09 |
Social support | |||
Yes | 87 (11.9) | 1 | |
No | 35 (18.8) | 1.72 | 1.12–2.65 |
Time walking to ANC clinic | |||
1–60 min | 76 (12.3) | 1 | |
> 1 h | 35 (12.7) | 1.03 | 0.67–1.58 |
Husband’s age (years) | |||
≤ 40 | 61(9.1) | 1 | |
41–70 | 23 (21.3) | 2.69 | 1.58–4.57 |
Household assets summary measure | |||
Improved (≥1 item) | 91 (12.7) | 1 | |
Poor (none of the items) | 31 (16.0) | 1.30 | 0.83–2.03 |
Variable | Poor utilization of antenatal care serviceb
| |||||
---|---|---|---|---|---|---|
Model 1 | Model 2 | Model 3 | Model 4 | Model 5 | Model 6c
| |
Age groups | ||||||
15–30 | 1 | |||||
31–46 | 1.64(1.11, 2.42) | 1.35(0.88, 2.06) | 1.82(1.17, 2.83) | 1.80(1.15, 2.80) | 1.76(1.13, 2.27) | 1.78(1.14, 2.78) |
Number of people in the household | ||||||
1–6 | 1 | |||||
7 or more | 1.84(1.16, 2.93) | 1.45(0.91,2.31) | 1.45(0.91, 2.31) | 1.49(1.01, 2.39) | 1.50(0.93, 2.40) | |
Marital status | ||||||
Married or cohabitating | 1 | |||||
Single, divorced, widowed, separated | 3.06(1.92, 4.89) | 3.06(1.92, 4.90) | 3.04(1.89, 4.86) | 2.99(1.83, 4.75) | ||
Ever attended school | ||||||
Yes | 1 | |||||
No | 1.69(0.94, 3.03) | 1.63(0.90, 2.92) | 1.55(0.85, 2.84) | |||
Social support | ||||||
Yes | 1 | |||||
No | 1.73(1.11, 2.69) | 1.71(1.09, 2.67) | ||||
Assets in household, summary measure | ||||||
Improved (≥1 higher standard item) | 1 | |||||
Poor (none of higher standard item) | 1.12 (0.69, 1.79) |