Methun, Md Injamul Haq, Ahinkorah, Bright Opoku, Hassan, Md Mehedi, Okyere, Joshua, Habib, Md Jakaria, Seidu, Abdul-Aziz, and Hasan, Md Kamrul (2024) Individual and community-level determinants of quality antenatal care in six South Asian countries. Scientific Reports, 14. 18646.

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Abstract

Maternal health is a global public health concern. The paucity of antenatal care (ANC) during pregnancy is directly associated with maternal mortality. This study assessed the individual and community-level determinants of quality ANC in six South-Asian countries. Data were obtained from a Demographic health survey of six South-Asian countries. This study included a sample of 180,567 (weighted) women aged 15–49 who had given birth in the preceding three years prior to the survey. The quality of ANC was determined by assessing whether a woman had received blood pressure monitoring, urine and blood sample screening, and iron supplements at any ANC visits. Frequency, percentage distribution, and inferential analysis (multilevel mixed-effects model) were conducted. The proportion of quality antenatal care utilization in South Asia was 66.9%. The multilevel analysis showed that women aged 35–49 years (AOR = 1.16; 95% CI = 1.09–1.24), higher education (AOR = 2.84; 95% CI = 2.69–2.99), middle wealth status (AOR = 1.55; 95% CI = 1.49–1.62), richest wealth status (AOR = 3.21; 95% CI = 3.04–3.39), unwanted pregnancy (AOR = 0.92; 95% CI = 0.89–0.95) and 2–4 birth order (AOR = 0.86; 95% CI = 0.83–0.89) were among the individual-level factors that were significantly associated with quality ANC utilization. In addition, rural residence (AOR = 0.77; 95% CI = 0.74–0.8), and big problem – distance to health facility (AOR = 0.63; 95% CI: 0.53–0.76) were the among community level factors there were also significantly associated with use of quality ANC. Meanwhile, women who lived in India (AOR: 22.57; 95% CI: 20.32–25.08) and Maldives (AOR: 33.33; 95% CI: 31.06–35.76) had higher odds of quality ANC than those lived in Afghanistan. Educational status, wealth status, pregnancy wantedness, sex of household head, birth order, place of residence, and distance to health facility were associated with quality ANC. Improving educational status, improving wealth status, reducing the distance to health facilities, and providing rural area-friendly interventions are important to increase the quality of ANC in South Asia.

Item ID:	85259
Item Type:	Article (Research - C1)
ISSN:	2045-2322
Copyright Information:	Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/ licenses/by-nc-nd/4.0/.
Date Deposited:	29 Apr 2025 01:13
FoR Codes:	42 HEALTH SCIENCES > 4206 Public health > 420606 Social determinants of health @ 100%
SEO Codes:	20 HEALTH > 2005 Specific population health (excl. Indigenous health) > 200509 Women's and maternal health @ 50% 20 HEALTH > 2002 Evaluation of health and support services > 200204 Health inequalities @ 50%
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