Trends and determinants of late antenatal care initiation in three East African countries, 2007–2016: A population based cross-sectional analysis

Early antenatal care is critical for the mother and newborn’s health. Antenatal care is often delayed in Sub-Saharan Africa. The study aims to examine the trends and determinants of late antenatal care initiation in the Democratic Republic of Congo, Kenya, and Tanzania from 2007–2016. The study empl...

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Main Authors: Chenai Mlandu, Zvifadzo Matsena-Zingoni, Eustasius Musenge
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2022-01-01
Series:PLOS Global Public Health
Online Access:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10021240/?tool=EBI
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author Chenai Mlandu
Zvifadzo Matsena-Zingoni
Eustasius Musenge
author_facet Chenai Mlandu
Zvifadzo Matsena-Zingoni
Eustasius Musenge
author_sort Chenai Mlandu
collection DOAJ
description Early antenatal care is critical for the mother and newborn’s health. Antenatal care is often delayed in Sub-Saharan Africa. The study aims to examine the trends and determinants of late antenatal care initiation in the Democratic Republic of Congo, Kenya, and Tanzania from 2007–2016. The study employed Demographic Health Surveys data of reproductive-age women seeking antenatal care in the Democratic Republic of Congo (2007-2013/14), Kenya (2008–2014), and Tanzania (2010-2015/16). Bivariate and multivariate analysis was conducted per survey, taking sampling weights into account. The determinants of late antenatal care initiation were measured using multivariate logistic regression models and the trends were assessed using prediction scores. Late antenatal care initiation declined in Tanzania (60.9%-49.8%) and Kenya (67.8%-60.5%) but increased in the Democratic Republic of Congo (56.8%-61.0%) between surveys. In the Democratic Republic of Congo, higher birth order was associated with antenatal care initiation delays from 2007–2014, whilst rural residency (AOR:1.28;95%CI:1.09–1.52), lower maternal education (AOR:1.29;95%CI:1.13–1.47) and lower-income households (AOR:1.30;95%CI:1.08–1.55) were linked to antenatal care initiation delays in 2014. In Kenya, lower maternal education and lower-income households were associated with antenatal care initiation delays from 2008–2014, whilst rural residency (AOR:1.24;95%CI:1.11–1.38) and increased birth order (AOR:1.12; 95%CI:1.01–1.28) were linked to antenatal care initiation delays in 2014. In Tanzania, higher birth order and larger households were linked to antenatal care initiation delays from 2010–2016, whilst antenatal care initiation delays were associated with lower maternal education (OR:1.51;95%CI:1.16–1.97) in 2010 and lower-income households (OR:1.45;95%CI:1.20–1.72) in 2016. Except for the Democratic Republic of Congo, the sub-region is making progress in reducing antenatal care delays. Women from various geographic, educational, parity, and economic groups exhibited varying levels of delayed antenatal care uptake. Increasing women’s access to information platforms and strengthening initiatives that enhance female education, household incomes, and localise services may enhance early antenatal care utilisation.
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spelling doaj.art-265074c52a744bf1bb6490fd7ebfb2be2023-09-03T10:08:53ZengPublic Library of Science (PLoS)PLOS Global Public Health2767-33752022-01-0128Trends and determinants of late antenatal care initiation in three East African countries, 2007–2016: A population based cross-sectional analysisChenai MlanduZvifadzo Matsena-ZingoniEustasius MusengeEarly antenatal care is critical for the mother and newborn’s health. Antenatal care is often delayed in Sub-Saharan Africa. The study aims to examine the trends and determinants of late antenatal care initiation in the Democratic Republic of Congo, Kenya, and Tanzania from 2007–2016. The study employed Demographic Health Surveys data of reproductive-age women seeking antenatal care in the Democratic Republic of Congo (2007-2013/14), Kenya (2008–2014), and Tanzania (2010-2015/16). Bivariate and multivariate analysis was conducted per survey, taking sampling weights into account. The determinants of late antenatal care initiation were measured using multivariate logistic regression models and the trends were assessed using prediction scores. Late antenatal care initiation declined in Tanzania (60.9%-49.8%) and Kenya (67.8%-60.5%) but increased in the Democratic Republic of Congo (56.8%-61.0%) between surveys. In the Democratic Republic of Congo, higher birth order was associated with antenatal care initiation delays from 2007–2014, whilst rural residency (AOR:1.28;95%CI:1.09–1.52), lower maternal education (AOR:1.29;95%CI:1.13–1.47) and lower-income households (AOR:1.30;95%CI:1.08–1.55) were linked to antenatal care initiation delays in 2014. In Kenya, lower maternal education and lower-income households were associated with antenatal care initiation delays from 2008–2014, whilst rural residency (AOR:1.24;95%CI:1.11–1.38) and increased birth order (AOR:1.12; 95%CI:1.01–1.28) were linked to antenatal care initiation delays in 2014. In Tanzania, higher birth order and larger households were linked to antenatal care initiation delays from 2010–2016, whilst antenatal care initiation delays were associated with lower maternal education (OR:1.51;95%CI:1.16–1.97) in 2010 and lower-income households (OR:1.45;95%CI:1.20–1.72) in 2016. Except for the Democratic Republic of Congo, the sub-region is making progress in reducing antenatal care delays. Women from various geographic, educational, parity, and economic groups exhibited varying levels of delayed antenatal care uptake. Increasing women’s access to information platforms and strengthening initiatives that enhance female education, household incomes, and localise services may enhance early antenatal care utilisation.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10021240/?tool=EBI
spellingShingle Chenai Mlandu
Zvifadzo Matsena-Zingoni
Eustasius Musenge
Trends and determinants of late antenatal care initiation in three East African countries, 2007–2016: A population based cross-sectional analysis
PLOS Global Public Health
title Trends and determinants of late antenatal care initiation in three East African countries, 2007–2016: A population based cross-sectional analysis
title_full Trends and determinants of late antenatal care initiation in three East African countries, 2007–2016: A population based cross-sectional analysis
title_fullStr Trends and determinants of late antenatal care initiation in three East African countries, 2007–2016: A population based cross-sectional analysis
title_full_unstemmed Trends and determinants of late antenatal care initiation in three East African countries, 2007–2016: A population based cross-sectional analysis
title_short Trends and determinants of late antenatal care initiation in three East African countries, 2007–2016: A population based cross-sectional analysis
title_sort trends and determinants of late antenatal care initiation in three east african countries 2007 2016 a population based cross sectional analysis
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10021240/?tool=EBI
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AT eustasiusmusenge trendsanddeterminantsoflateantenatalcareinitiationinthreeeastafricancountries20072016apopulationbasedcrosssectionalanalysis