Department of Midwifery, College of Health Science, Woldia University, Woldia, Ethiopia.
Department of Public Health, College of Health Science, Woldia University, Woldia, Ethiopia.
PLoS One. 2021 May 6;16(5):e0251322. doi: 10.1371/journal.pone.0251322. eCollection 2021.
First-trimester pregnancy stage is the fastest developmental period of the fetus, in which all organs become well developed and need special care. Yet, many women make their first antenatal visit with the pregnancy already compromised due to fetomaternal complications. This study aimed to fill this dearth using the 2016 national representative data set to augment early antenatal care visits in Ethiopia.
A cross-sectional study design using the 2016 Ethiopia Demographic and Health Survey (EDHS) data set. Kaplan-Meir estimate was used to explain the median survival time of the timing of the first ANC visit. Multivariate Cox-proportional hazard regression analysis was performed to identify the factors related to the timing of the first ANC visit. Adjusted hazard ratios (AHR) with a 95% Confidence interval (CI) plus a p-value of < 0.05 were considered to declare a statistically significant association.
Data for 4666 study participants who had ANC follow-up history during pregnancy were included in the study and analyzed. The overall median survival time in this study was seven months. The timing of the first ANC visit was shorter by 2.5 times (AHR: 2.5; 95% CI: 2.34-3.68), 4.3 times (AHR: 4.3; 95% CI: 2.2-7.66), 4.8 times (AHR: 4.8, 95% CI: 4.56-10.8) among women who attended primary, secondary, and higher education as compared with non-educated one. Similarly, women who were residing in urban areas had 3.6 times (AHR: 3.6; 95% CI: 2.7-4.32) shorter timing of first ANC visit than rural residents. Furthermore, the timing of the first visit among the richest women was 3.2 times (AHR: 3.2; 95% CI: 2.5-9.65) shorter than the poorest women.
The median survival time of the first ANC visit was seven months. The timing of the first ANC was longer among younger, poorer women, those who had no access to media, who considered distances as a big challenge to reach a health facility and, those with no education. Therefore, health care providers and community health workers should provide health education to create community awareness regarding the timing of the first ANC visit.
妊娠早期是胎儿发育最快的阶段，所有器官都发育良好，需要特别护理。然而，许多女性在出现母婴并发症后才首次进行产前检查。本研究旨在利用 2016 年全国代表性数据集填补这一空白，增加埃塞俄比亚的早期产前保健服务。
本研究采用 2016 年埃塞俄比亚人口与健康调查（EDHS）数据集的横断面研究设计。Kaplan-Meier 估计用于解释首次 ANC 就诊时间的中位生存时间。多变量 Cox 比例风险回归分析用于确定与首次 ANC 就诊时间相关的因素。调整后的危险比（AHR）和 95%置信区间（CI）加 p 值<0.05 被认为具有统计学显著关联。
本研究纳入并分析了 4666 名在妊娠期间有 ANC 随访史的研究参与者的数据。在这项研究中，总的中位生存时间是七个月。与未受过教育的女性相比，接受过小学、中学和高等教育的女性首次 ANC 就诊时间分别缩短了 2.5 倍（AHR：2.5；95%CI：2.34-3.68）、4.3 倍（AHR：4.3；95%CI：2.2-7.66）和 4.8 倍（AHR：4.8，95%CI：4.56-10.8）。同样，与农村居民相比，居住在城市地区的女性首次 ANC 就诊时间也缩短了 3.6 倍（AHR：3.6；95%CI：2.7-4.32）。此外，最富有的女性首次就诊时间比最贫穷的女性短 3.2 倍（AHR：3.2；95%CI：2.5-9.65）。
首次 ANC 就诊的中位生存时间为七个月。首次 ANC 就诊时间较长的是年轻、贫穷、没有媒体接触、认为距离是获得医疗服务的一大挑战、以及没有受过教育的女性。因此，医疗保健提供者和社区卫生工作者应该提供健康教育，提高社区对首次 ANC 就诊时间的认识。
