Background
Methods
Data sources
Sample size
Study population
Variables
Statistical analysis
Ethical approval
Results
Characteristics of the study sample
VARIABLES | n | % |
---|---|---|
1. EXTERNAL ENVIRONMENTAL FACTORS
| ||
Geographical Region (state)
| ||
Upper Nile | 464 | 13.3 |
Jounglei | 452 | 12.9 |
Unity | 205 | 5.8 |
Warap | 480 | 13.7 |
Northern Bahr el Ghazal | 280 | 8.0 |
Western Bahr el Ghazal | 138 | 3.9 |
Lakes | 280 | 8.0 |
Western Equatoria | 313 | 8.9 |
Central Equatoria | 500 | 14.3 |
Eastern Equatoria | 392 | 11.2 |
Type of residence (total)
| ||
Urban | 808 | 23.0 |
Rural | 2697 | 77.0 |
2. PREDISPOSING FACTORS
| ||
Socio-demographic characteristic
| ||
Maternal age at her last birthday (years)
| ||
15-19 | 272 | 7.8 |
20-34 | 2520 | 71.9 |
35-49 | 713 | 20.3 |
Birth order
| ||
1st birth | 2794 | 86.5 |
2nd birth | 368 | 11.4 |
3rd + birth | 68 | 2.1 |
Number of previous pregnancies
| ||
1 pregnancy | 3113 | 95.1 |
2+ pregnancy | 161 | 4.9 |
Pregnancy outcome
| ||
Live birth | 3062 | 96.7 |
Other (Still birth, Miscarriage, Currently pregnant) | 105 | 3.3 |
Number of children
| ||
1-2 children | 1211 | 34.6 |
3-4 children | 1157 | 33.0 |
5 children and more | 1136 | 32.4 |
Maternal marital status
| ||
Currently married | 2702 | 77.1 |
Formerly married | 582 | 16.6 |
Never married (Single) | 220 | 6.3 |
Polygamy status
| ||
Husband have one wife | 1889 | 59.0 |
Husband have more than one wife | 1313 | 41.0 |
Maternal education
| ||
No education | 2745 | 78.4 |
Primary education | 615 | 17.6 |
Secondary + education | 143 | 4.1 |
Maternal literacy
| ||
Able to read | 334 | 10.0 |
Unable to read | 3018 | 90.0 |
Health knowledge
| ||
Knowledge of obstetric danger signs during pregnancy, delivery and post delivery
| ||
Good for (correct answer 8 or more) | 147 | 4.2 |
Fair for (correct answer between 5–7) | 170 | 4.8 |
Bad for (correct answer less than 5) | 3188 | 91.0 |
Knowledge on newborn danger signs
| ||
Good for (correct answer 8 or more) | 140 | 4.0 |
Fair for (correct answer between 5–7) | 180 | 5.1 |
Bad for (correct answer less than 5) | 3184 | 90.9 |
3. ENABLING FACTORS
| ||
Household wealth index
| ||
Poorest | 671 | 19.2 |
Poorer | 704 | 20.1 |
Middle | 654 | 18.7 |
Richer | 747 | 21.3 |
Richest | 728 | 20.8 |
4. NEED FACTORS
| ||
Desire for last pregnancy
| ||
Wanted to get pregnant then | 2995 | 85.5 |
Wanted to get pregnant later | 314 | 9.0 |
Never wanted to get pregnant | 106 | 3.0 |
Pregnancy complications
| ||
Yes with 1–2 complications | 1240 | 35.4 |
Yes with 3 and more complications | 1140 | 32.5 |
No without complications | 1124 | 32.1 |
Factors associated with non-use of the recommended number of ANC visits
VARIABLE | Number of antenatal care visits | ||||||
---|---|---|---|---|---|---|---|
None | 1-3 visits | 4+ visits | P | ||||
% | [95% CI] | % | [95% CI] | % | [95% CI] | ||
1. EXTERNAL ENVIRONMENTAL FACTORS
| |||||||
Geographical Region (state)
| |||||||
Upper Nile | 57.7 | (52.1, 63.1) | 22.3 | (18.7, 26.3) | 20.1 | (15.9, 25.1) | |
Jounglei | 72.5 | (66.0, 78.2) | 18.7 | (14.2, 24.2) | 8.8 | (5.6, 13.6) | |
Unity | 68.3 | (61.0, 74.8) | 18.9 | (14.1, 24.8) | 12.8 | (8.9, 18.1) | |
Warap | 78.8 | (73.8, 83.1) | 15.7 | (11.9, 20.6) | 5.5 | (3.2, 9.1) | |
Northern Bahr el Ghazal | 58.2 | (51.0, 65.0) | 29.5 | (22.7, 37.3) | 12.3 | (9.0, 16.7) | |
Western Bahr el Ghazal | 51.3 | (46.2, 56.5) | 20.9 | (16.7, 25.9) | 27.7 | (23.8, 32.1) | |
Lakes | 53.7 | (47.8, 59.5) | 30.3 | (25.9, 35.1) | 16.0 | (11.5, 21.7) | |
Western Equatoria | 41.9 | (33.6, 50.7) | 31.2 | (23.1, 40.5) | 26.9 | (19.6, 35.8) | |
Central Equatoria | 33.5 | (28.6, 38.8) | 33.9 | (28.3, 40.0) | 32.6 | (27.7, 37.9) | |
Eastern Equatoria | 58.5 | (52.1, 64.6) | 23.2 | (18.6, 28.4) | 18.4 | (13.2, 25.1) | <0.001 |
Type of resident (total)
| |||||||
Urban | 40.8 | (36.5, 45.2) | 28.4 | (23.1, 34.3) | 30.9 | (26.3, 35.9) | |
Rural | 62.9 | (60.6, 65.2) | 23.3 | (21.7,25.0) | 13.8 | (12.6, 15.2) | <0.001 |
2. PREDIPOSING FACTORS
| |||||||
Scio-Demographic characteristic
| |||||||
Maternal age at her last birthday (years)
| |||||||
15-19 years | 52.3 | (44.2, 60.3) | 22.6 | (17.7, 28.3) | 25.1 | (19.3, 32.1) | |
20-34 years | 57.0 | (54.4, 59.6) | 25.3 | (23.2, 27.5) | 17.7 | (15.9, 19.7) | |
35-49 years | 62.7 | (58.8, 66.5) | 22.1 | (18.6, 26.2) | 15.1 | (12.3, 18.5) | 0.0156 |
Birth order
| |||||||
1st birth | 59.4 | (57.2, 61.6) | 24.0 | (22.1, 25.9) | 15.6 | (15.3, 18.0) | |
2nd birth | 47.8 | (41.6, 54.2) | 27.9 | (22.2, 34.5) | 24.2 | (18.8, 30.6) | |
3rd + birth | 26.0 | (15.4, 40.5) | 34.0 | (20.9, 50.0) | 40.0 | (25.7, 56.3) | <0.001 |
Number of previous pregnancies
| |||||||
1 pregnancy | 55.3 | (53.2, 57.3) | 26.0 | (24.1, 27.9) | 18.8 | (17.3, 20.3) | |
2+ pregnancy | 46.7 | (38.3, 55.3) | 29.8 | (23.7, 36.7) | 23.5 | (17.0, 31.6) | <0.001 |
Pregnancy outcome
| |||||||
Live birth | 54.9 | (52.9, 56.9) | 26.1 | (24.2, 28.1) | 19.0 | (17.6, 20.6) | |
Other (Still birth, Miscarriage, Currently pregnant) | 62.8 | (51.9, 72.4) | 17.8 | (11.0, 27.6] | 19.4 | (11.6, 30.6) | <0.001 |
Number of children
| |||||||
1-2 children | 55.3 | (51.6, 56.0) | 25.3 | (22.3, 28.6) | 19.4 | (16.7, 22.4) | |
3-4 children | 61.6 | (58.2, 64.9) | 22.8 | (19.9, 25.9) | 15.6 | (13.3, 18.4) | |
5 children and more | 56.6 | (53.5, 59.7) | 25.2 | (22.2, 28.5) | 18.2 | (15.8, 20.9) | 0.1245 |
Maternal marital status
| |||||||
Currently married | 55.6 | (53.2, 58.0) | 25.3 | (23.3, 27.4) | 19.1 | (17.4, 21.0) | |
Formerly married | 66.0 | (60.9, 70.8) | 21.2 | (17.2, 25.8) | 12.8 | (10.0, 16.3) | |
Never married (Single) | 63.4 | (55.6, 70.5) | 22.5 | (16.2, 30.5) | 14.1 | (9.4, 20.6) | 0.0022 |
Polygamy status
| |||||||
Husband have one wife | 54.5 | (52.0, 57.0) | 25.3 | (22.9, 27.9) | 20.2 | (17.9, 22,7) | |
Husband have more than one wife | 61.2 | (58.1, 64.0) | 23.8 | (21.4, 26.5) | 15.0 | (13.0, 17.3) | 0.0033 |
Maternal education
| |||||||
No education | 64.8 | (62.6, 67.0) | 22.4 | (20.7, 24.2) | 12.8 | (11.5, 14.3) | |
Primary education | 33.0 | (28.8, 37.5) | 33.2 | (28.6, 38.2) | 33.8 | (29.1, 38.8) | |
Secondary + education | 29.8 | (19.8, 42.1) | 26.1 | (18.6, 35.2) | 44.2 | (34.4, 54.5) | <0.001 |
Maternal literacy
| |||||||
Able to read | 36.5 | (30.8, 42.6) | 34.1 | (27.7, 41.2) | 29.4 | (23.9, 35.6) | |
Unable to read | 61.4 | (59.2, 63.6) | 23.3 | (21.5, 25.2) | 15.3 | (13.9, 16.7) | <0.001 |
Health knowledge
| |||||||
Knowledge of obstetric danger signs during pregnancy, delivery and post delivery
| |||||||
Good for (correct answer 8 or more) | 42.6 | (33.9, 51.7) | 30.7 | (23.1, 39.4) | 26.8 | (19.2, 36.0) | |
Fair for (correct answer between 5–7) | 52.1 | (42.9, 61.2) | 28.6 | (21.0, 37.7) | 19.3 | (11.6, 30.4) | |
Bad for (correct answer less than 5) | 58.8 | (56.6, 61.0) | 23.9 | (22.0, 25.9) | 17.3 | (15.9, 18.7) | 0.0247 |
Knowledge on newborn danger signs
| |||||||
Good for (correct answer 8 or more) | 45.3 | (33.8, 57.3) | 25.6 | (17.0, 36.7) | 29.1 | (19.6, 40.9) | |
Fair for (correct answer between 5–7) | 37.8 | (29.9, 46.3) | 42.1 | (32.7, 52.0) | 20.2 | (13.8, 28.6) | |
Bad for (correct answer less than 5) | 59.5 | (57.3, 61.6) | 23.4 | (21.6, 25.2) | 17.1 | (15.6, 18.7) | <0.001 |
3. ENABLING FACTORS
| |||||||
Household wealth index
| |||||||
Poorest | 74.5 | (70.3, 78.3) | 20.3 | (17.3, 23.7) | 5.2 | (3.3, 8.2) | |
Poorer | 66.8 | (62.8, 70.6) | 20.7 | (17.6, 24.2) | 12.5 | (10.3, 15.0) | |
Middle | 62.6 | (59.3, 65.9) | 23.9 | (20.7, 27.5) | 13.4 | (10.8, 16.7) | |
Richer | 52.5 | (48.0, 56.9) | 26.5 | (23.2, 30.2) | 21.0 | (17.9, 24.6) | |
Richest | 34.8 | (29.6, 40.4) | 30.2 | (25.0, 36.0) | 35.0 | (30.3, 40.0) | <0.001 |
4. NEED FACTORS
| |||||||
Desire for last pregnancy
| |||||||
Wanted to get pregnant then | 59.1 | (57.1, 61.2) | 23.7 | (21.9, 25.7) | 17.1 | (15.6, 18.7) | |
Wanted to get pregnant later | 47.9 | (40.0, 55.8) | 29.0 | (22.9, 35.8) | 23.2 | (17.8, 29.6) | |
Never wanted to get pregnant | 42.9 | (33.6, 52.8) | 34.5 | (25.7, 44.5) | 22.6 | (15.3, 32.0) | 0.007 |
Pregnancy complications
| |||||||
Yes with 1–2 complications | 49.5 | (46.6, 52.5) | 28.6 | (25.6, 31.8) | 21.9 | (19.5, 24.4) | |
Yes with 3 and more complications | 52.6 | (49.7, 55.4) | 27.1 | (24.3, 30.0) | 20.4 | (18.1, 22.9) | |
No without complications | 72.3 | (68.8, 75.5) | 17.2 | (14.9, 19.7) | 10.6 | (8.7, 12.7) | <0.001 |
VARIABLE | Unadjusted odds ratio | Adjusted odds ratio (AOR)*# | ||||
---|---|---|---|---|---|---|
OR | [95% CI] | P value | AOR | [95% CI] | P value | |
1. EXTERNAL ENVIRONMENTAL FACTORS
| ||||||
Geographical Region (state)
| ||||||
Upper Nile | 1.00 | 1.00 | ||||
Jounglei | 1.94 | (1.37, 2.74) | <0.001 | 1.76 | (1.19, 2.60) | 0.005 |
Unity | 1.58 | (1.01, 2.47) | 0.044 | 1.42 | (0.90, 2.23) | 0.127 |
Warap | 2.73 | (1.95, 3.82) | <0.001 | 1.66 | (1.16, 2.38) | 0.006 |
Northern Bahr el Ghazal | 1.02 | (0.69, 1.52) | 0.913 | 0.81 | (0.52, 1.27) | 0.354 |
Western Bahr el Ghazal | 0.77 | (0.60, 1.01) | 0.055 | 0.73 | (0.54, 0.98) | 0.037 |
Lakes | 0.85 | (0.60, 1.20) | 0.349 | 0.63 | (0.41, 0.97) | 0.036 |
Western Equatoria | 0.53 | (0.34, 0.83) | 0.006 | 0.43 | (0.26, 0.69) | 0.001 |
Central Equatoria | 0.37 | (0.27, 0.83) | <0.001 | 0.42 | (0.29, 0.62) | <0.001 |
Eastern Equatoria | 1.03 | (0.74, 1.45) | 0.849 | 0.93 | (0.66,1.32) | 0.698 |
Type of resident (total)
| ||||||
Urban | 1.00 | |||||
Rural | 2.46 | (2.01, 3.03) | <0.001 | |||
2. PREDISPOSING FACTORS
| ||||||
Socio-demographic characteristic
| ||||||
Maternal age at her last birthday (years)
| ||||||
15-19 years | 1.00 | |||||
20-34 years | 1.21 | (0.85, 1.71) | 0.278 | |||
35-49 years | 1.53 | (1.08, 2.17) | 0.017 | |||
Birth order
| ||||||
1st birth | 1.00 | |||||
2nd birth | 0.67 | (0.52, 0.86) | 0.003 | |||
3rd + birth | 0.52 | (0.26, 1.04) | 0.063 | |||
Number of previous pregnancies
| ||||||
1 pregnancy | 1.00 | |||||
2+ pregnancy | 0.71 | (0.49, 1.02) | 0.064 | |||
Pregnancy outcome
| ||||||
Live birth | 1.00 | |||||
Other (Still birth, Miscarriage, Currently pregnant) | 1.38 | (0.86, 2.22) | 0.172 | |||
Number of children
| ||||||
1-2 children | 1.00 | |||||
3-4 children | 1.29 | (1.04, 1.61) | 0.021 | |||
5 children and more | 1.05 | (0.84, 1.32) | 0.642 | |||
Maternal marital status
| ||||||
Currently married | 1.00 | |||||
Formerly married | 1.55 | (1.20, 2.01) | 0.001 | |||
Never married (Single) | 1.38 | (1.02, 1.88) | 0.040 | |||
Polygamy status
| ||||||
Husband have one wife | 1.00 | 1.00 | ||||
Husband have more than one wife | 1.31 | (1.12, 1.54) | 0.001 | 1.23 | (1.00, 1.51) | 0.047 |
Maternal education
| ||||||
No education | 1.00 | |||||
Primary education | 0.27 | (0.22, 0.33) | <0.001 | |||
Secondary + education | 0.23 | (0.13, 0.39) | <0.001 | |||
Maternal literacy
| ||||||
Able to read | 1.00 | 1.00 | ||||
Unable to read | 2.77 | (2.09, 3.67) | <0.001 | 1.79 | (1.31, 2.45) | 0.001 |
Health knowledge
| ||||||
Knowledge of obstetric danger signs during pregnancy, delivery and post delivery
| ||||||
Good for (correct answer 8 or more) | 1.00 | |||||
Fair for (correct answer between 5–7) | 1.47 | (0.89, 2.43) | 0.132 | |||
Bad for (correct answer less than 5) | 1.93 | (1.34, 2.78) | 0.001 | |||
Knowledge on newborn danger signs
| ||||||
Good for (correct answer 8 or more) | 1.00 | 1.00 | ||||
Fair for (correct answer between 5–7) | 0.73 | (0.41, 1.31) | 0.288 | 0.81 | (0.40, 1.63) | 0.545 |
Bad for (correct answer less than 5) | 1.77 | (1.11, 2.84) | 0.018 | 1.77 | (1.03, 3.05) | 0.040 |
3. ENABLING FACTORS
| ||||||
Household wealth index
| ||||||
Poorest | 1.00 | |||||
Poorer | 0.69 | (0.51, 0.93) | 0.015 | |||
Middle | 0.57 | (0.44, 0.74) | <0.001 | |||
Richer | 0.38 | (0.29, 0.50) | <0.001 | |||
Richest | 0.18 | (0.13, 0.25) | <0.001 | |||
4. NEED FACTORS
| ||||||
Desire for last pregnancy
| ||||||
Wanted to get pregnant then | 1.00 | |||||
Wanted to get pregnant later | 0.63 | (0.46, 0.88) | 0.008 | |||
Never wanted to get pregnant | 0.52 | (0.36, 0.75) | 0.001 | |||
Pregnancy complications
| ||||||
Yes with 1–2 complications | 1.00 | |||||
Yes with 3 and more complications | 1.13 | (0.95, 1.34) | 0.16 | |||
No without complications | 2.65 | (2.20, 3.19) | <0.001 |