Dataset Information

Determinants of antenatal care use in nine sub-Saharan African countries: a statistical analysis of cross-sectional data from Demographic and Health Surveys.

ABSTRACT:

Objective

To explore the factors associated with antenatal care (ANC) visits.

Design

A secondary data analysis from cross-sectional studies was conducted.

Setting

Sub-Saharan Africa.

Participants

56 002 women aged 15-49 years in Ghana (3224), Kenya (10 981), Malawi (9541), Namibia (2286), Rwanda (4416), Senegal (6552), Tanzania (5536), Uganda (7979) and Zambia (5487) were analysed.

Outcomes

4⁺ANC visits.

Results

Overall, 55.52% (95% CI: 55.11% to 55.93%) of women made 4⁺ANC visits. The highest 4⁺ANC visits were in Ghana (85.6%) and Namibia (78.9%), and the lowest were in Senegal (45.3%) and Rwanda (44.5%). Young women 15-19 years had the lowest uptake of 4⁺ANC visits. Multivariable analysis indicated that the odds of 4⁺ANC visits were 14% lower among women from rural areas compared with those living in towns (adjusted OR (AOR) 0.86; 95% CI: 0.81 to 0.91). This difference was significant in Kenya, Malawi, Senegal and Zambia. However, in Zambia, the odds of 4⁺ANC visits were 48% higher (AOR 1.48; 95% CI: 1.2 to 1.82) among women from rural compared with urban areas. Women with higher educational level had more than twofold higher odds of 4⁺ANC visits in seven of the nine countries, and was significant in Kenya, Malawi, Rwanda and Zambia. Compared with the poorest household wealth category, odds of 4⁺ANC visits increased by 12%, 18%, 32% and 41% for every 20% variation on the wealth quantile. Women in their first-time pregnancy had higher odds of 4⁺ANC visits compared with others across all countries, and women who had access to media at least once a week had a 22% higher probability of 4⁺ANC visits than women who had no access to media (AOR 1.22, 95% CI: 1.15 to 1.29).

Conclusion

The number of ANC visits was considered to be inadequate with substantial variation among the studied countries. Comprehensive interventions on scaling uptake of ANC are needed among the low-performing countries. Particular attention should be given to women of low economic status and from rural areas.

SUBMITTER: Andegiorgish AK

PROVIDER: S-EPMC8845176 | biostudies-literature | 2022 Feb

REPOSITORIES: biostudies-literature

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Publications

Determinants of antenatal care use in nine sub-Saharan African countries: a statistical analysis of cross-sectional data from Demographic and Health Surveys.

Andegiorgish Amanuel Kidane AK Elhoumed Mohamed M Qi Qi Q Zhu Zhonghai Z Zeng Lingxia L

BMJ open 20220211 2

<h4>Objective</h4>To explore the factors associated with antenatal care (ANC) visits.<h4>Design</h4>A secondary data analysis from cross-sectional studies was conducted.<h4>Setting</h4>Sub-Saharan Africa.<h4>Participants</h4>56 002 women aged 15-49 years in Ghana (3224), Kenya (10 981), Malawi (9541), Namibia (2286), Rwanda (4416), Senegal (6552), Tanzania (5536), Uganda (7979) and Zambia (5487) were analysed.<h4>Outcomes</h4>4<sup>+</sup>ANC visits.<h4>Results</h4>Overall, 55.52% (95% CI: 55.11 ...[more]

PMID: 35149562

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Project description:IntroductionExtant studies universally document a positive gradient between socioeconomic status (SES) and health. A notable exception is the apparent concentration of HIV/AIDS among wealthier individuals. This paper uses data from the Demographic Health Surveys and AIDS Indicator Surveys to examine socioeconomic inequalities in HIV/AIDS prevalence in 24 sub-Saharan African (SSA) countries, the region that accounts for two-thirds of the global HIV/AIDS burden.MethodsThe relative and generalized concentration indices (RC and GC) were used to quantify wealth-based socioeconomic inequalities in HIV/AIDS prevalence for the total adult population (aged 15-49), for men and women, and in urban and rural areas in each country. Further, we decomposed the RC and GC indices to identify the determinants of socioeconomic inequalities in HIV/AIDS prevalence in each country.ResultsOur findings demonstrated that HIV/AIDS was concentrated among higher SES individuals in the majority of SSA countries. Swaziland and Senegal were the only countries in the region where HIV/AIDS was concentrated among individuals living in poorer households. Stratified analyses by gender showed HIV/AIDS was generally concentrated among wealthier men and women. In some countries, including Kenya, Lesotho Uganda, and Zambia, HIV/AIDS was concentrated among the poor in urban areas but among wealthier adults in rural areas. Decomposition analyses indicated that, besides wealth itself (median = 49%, interquartile range [IQR] = 90%), urban residence (median = 54%, IQR = 81%) was the most important factor contributing to the concentration of HIV/AIDS among wealthier participants in SSA countries.ConclusionsFurther work is needed to understand the mechanisms explaining the concentration of HIV/AIDS among wealthier individuals and urban residents in SSA. Higher prevalence of HIV/AIDS could be indicative of better care and survival among wealthier individuals and urban adults, or reflect greater risk behaviour and incidence. Moreover, differential findings across countries suggest that effective intervention efforts for reducing the burden of HIV/AIDS in the SSA should be country specific.

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Project description:ObjectivesTo carry out a meta-analysis to assess the prevalence of four key breastfeeding indicators in four subregions of 29 sub-Saharan African countries.Design, settings and participantsThe 29 countries were categorised into four subregions, and using cross-sectional data from the most recent Demographic and Health Surveys (2010-2015) of these countries prevalence of each of four key breastfeeding indicators was estimated for each of the subregions by carrying out a meta-analysis. Due to the presence of significant heterogeneity among the various surveys (I2>50%), a random-effect analytic model was used, and sensitivity analysis was performed to examine the effects of outliers.Main outcome variablesEarly initiation of breast feeding, exclusive breast feeding, predominant breast feeding and bottle feeding.ResultsThe overall prevalence of early initiation of breast feeding varied between a lowest of 37.84% (95% CI 24.62 to 51.05) in Central Africa to a highest of 69.31% (95% CI 67.65 to 70.97) in Southern Africa; the overall prevalence of exclusive breast feeding ranged between a lowest of 23.70% (95% CI 5.37 to 42.03) in Central Africa to a highest of 56.57% (95% CI 53.50 to 59.95) in Southern Africa; the overall prevalence of predominant breast feeding ranged between a lowest of 17.63% (95% CI 12.70 to 22.55) in East Africa and a highest of 46.37% (95% CI 37.22 to 55.52) in West Africa; while the prevalence of bottle feeding varied between a lowest of 8.17% (95% CI 5.51 to 10.84) in West Africa and a highest of 30.05% (95% CI 28.42 to 31.69) in Southern Africa.ConclusionsWest Africa and Central Africa recorded lower overall prevalence of early initiation of breast feeding and exclusive breast feeding than the WHO's recommended target of 50% by the year 2025. Intervention for improved breastfeeding practices in sub-Saharan Africa should target West and Central Africa, while intervention to minimise bottle feeding should target Southern Africa.

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Dataset Information

Determinants of antenatal care use in nine sub-Saharan African countries: a statistical analysis of cross-sectional data from Demographic and Health Surveys.

Objective

Design

Setting

Participants

Outcomes

Results

Conclusion

Publications

Determinants of antenatal care use in nine sub-Saharan African countries: a statistical analysis of cross-sectional data from Demographic and Health Surveys.

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