Noncompliance with the WHO's Recommended Eight Antenatal Care Visits among Pregnant Women in Sub-Saharan Africa: A Multilevel Analysis

Odusina, Emmanuel Kolawole, Ahinkorah, Bright Opoku, Ameyaw, Edward Kwabena, Seidu, Abdul-Aziz, Budu, Eugene, Zegeye, Betregiorgis, and Yaya, Sanni (2021) Noncompliance with the WHO's Recommended Eight Antenatal Care Visits among Pregnant Women in Sub-Saharan Africa: A Multilevel Analysis. BioMed Research International, 2021. 6696829.

PDF (Published Version) - Published Version
Available under License Creative Commons Attribution.

Download (561kB) | Preview
View at Publisher Website:


Background: In 2016, the World Health Organization (WHO) introduced a minimum of eight antenatal care (ANC) visits for positive pregnancy outcomes. This study examined the prevalence of noncompliance with 8+ ANCvisits and its associated factors in sub-Saharan Africa (SSA).

Methods: We used data from the Demographic and Health Surveys of eight countries in SSA. A pooled sample of 63,266 pregnant women aged 15-49 years who had given birth to children within 5 years prior to the surveys was included in this study. To examine the factors associated with noncompliance with ANC 8+ visits, multilevel binary logistic regression analysis was conducted, and the results were reported using odds radios at 95% confidence interval (CI).

Results: The pooled prevalence of noncompliance with ANC 8+ visits was 92.3% (95% CI: 91.1%-93.3%) with the highest and lowest prevalence in Zambia (98.7%, 95% CI: 98.3%-99.1%) and Libya (73.4%, 95% CI: 70.4%-76.2%), respectively. With the individual level factors, women's age (44-49 years-aOR=0.33, 9% CI: 0.14-0.78), health insurance registration, (yes-aOR=0.53, 95% CI: 0.29-0.98), and economic status (richest-aOR=0.16, 95% CI: 0.05-0.49) were negatively associated with noncompliance with 8+ ANC visits, while parity (five or more children-aOR=1.68, 95% CI: 1.12-2.52) was positively associated with noncompliance with 8+ ANC visit. With the community level factors, community level literacy was negatively associated with noncompliance with 8+ ANC visit (high-aOR=0.56, 95% CI: 0.32-0.99).

Conclusion: About eight out of ten pregnant women did not comply with the WHO's recommended minimum of eight ANC visits for positive pregnancy outcomes in SSA. Empowering the economic status of women, enhancing health insurance and education coverage, and giving more attention to young pregnant women and those with more children are crucial for improving the coverage of ANC 8+ visits in the region.

Item ID: 70569
Item Type: Article (Research - C1)
ISSN: 2314-6141
Copyright Information: Copyright © 2021 Emmanuel Kolawole Odusina et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Date Deposited: 25 May 2022 02:00
Downloads: Total: 285
Last 12 Months: 119
More Statistics

Actions (Repository Staff Only)

Item Control Page Item Control Page