Department of Demography and Social Statistics, Faculty of Social Sciences, Federal University, Oye Ekiti, Nigeria.
The Australian Centre for Public and Population Health Research (ACPPHR), Faculty of Health, University of Technology, Sydney, Australia.
Biomed Res Int. 2021 Sep 17;2021:6696829. doi: 10.1155/2021/6696829. eCollection 2021.
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).
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).
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).
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.
2016 年，世界卫生组织（WHO）提出了至少 8 次产前护理（ANC）就诊以实现积极的妊娠结局。本研究旨在调查撒哈拉以南非洲（SSA）地区不符合 8+ ANC 就诊次数的比例及其相关因素。
我们使用了来自 SSA 八个国家的人口与健康调查数据。本研究纳入了在调查前 5 年内分娩过孩子的 63266 名 15-49 岁的孕妇的汇总样本。为了研究与不符合 ANC 8+就诊次数相关的因素，我们进行了多水平二项逻辑回归分析，并使用 95%置信区间（CI）的比值比（OR）报告了结果。
8+ ANC 就诊次数的不符合率为 92.3%（95%CI：91.1%-93.3%），其中赞比亚（98.7%，95%CI：98.3%-99.1%）和利比亚（73.4%，95%CI：70.4%-76.2%）的不符合率最高和最低。就个体因素而言，妇女年龄（44-49 岁-aOR=0.33，9%CI：0.14-0.78）、医疗保险登记（是-aOR=0.53，95%CI：0.29-0.98）和经济状况（最富裕-aOR=0.16，95%CI：0.05-0.49）与不符合 8+ANC 就诊次数呈负相关，而产次（5 次或以上-aOR=1.68，95%CI：1.12-2.52）与不符合 8+ANC 就诊次数呈正相关。就社区因素而言，社区文化程度与不符合 8+ANC 就诊次数呈负相关（高-aOR=0.56，95%CI：0.32-0.99）。
在 SSA，约十分之八的孕妇不符合 WHO 推荐的至少 8 次 ANC 就诊以实现积极的妊娠结局。增强妇女的经济地位、提高医疗保险和教育的覆盖率，并更加关注年轻孕妇和生育子女较多的孕妇，对于提高该地区 8+ ANC 就诊覆盖率至关重要。
