Mare Kusse Urmale, Andargie Gashaye Gobena, Moloro Abdulkerim Hassen, Mohammed Ahmed Adem, Mohammed Osman Ahmed, Wengoro Beriso Furo, Lahole Begetayinoral Kussia, Hadaro Tesfahun Simon, Leyto Simeon Meskele, Mamo Petros Orkaido, Hedato Abdulhakim Hora, Seifu Beminate Lemma, Wondmeneh Temesgen Gebeyehu, Ebrahim Oumer Abdulkadir, Sabo Kebede Gemeda
Department of Nursing, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia.
Department of Biomedical Sciences, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia.
PLoS One. 2025 Jan 31;20(1):e0316671. doi: 10.1371/journal.pone.0316671. eCollection 2025.
Although late initiation of antenatal care has been linked with adverse pregnancy outcomes, a significant number of pregnant women in resource-limited regions are seeking this care late. There has been a lack of information on the extent and factors influencing late initiation of antenatal care in the African context following the implementation of the new antenatal care model in 2016. Thus, we aimed to determine the pooled prevalence of late antenatal care visit and its determinants among women in Sub-Saharan Africa (SSA) using national surveys conducted after the implementation of new guidelines.
We analyzed data from the recent demographic and health survey (DHS) conducted in 16 SSA between 2018 and 2022 using a weighted sample of 101,983 women who had antenatal care follow-up during their index pregnancy. A multilevel logistic regression models were fitted and likelihood and deviance values were used for model selection. In the regression model, we used adjusted odds ratios along with their corresponding 95% confidence intervals to determine the factors associated with late antenatal care visit.
The pooled prevalence of late antenatal care visit among pregnant women in SSA was 53.8% [95% CI: 46.2% - 61.3%], ranging from 27.8% in Liberia to 75.8% in Nigeria. Women's age and education, working status, partner's education, health insurance coverage, birth order, household wealth, age at marriage, decision on health care, residence, and community-level women's illiteracy were the factors associated with late antenatal care visit.
More than half of pregnant women in SSA initiated attending antenatal care during late pregnancy, with significant differences seen among countries. These results underscore the necessity for focused interventions to tackle these issues and enhance prompt access to antenatal services for better maternal and child health outcomes in the area. Moreover, creating tailored interventions for younger women, those with multiple previous births, employed women, and those who experienced early marriage to address their specific challenges and obstacles in seeking care is crucial.
尽管产前护理开始时间较晚与不良妊娠结局有关，但资源有限地区仍有相当数量的孕妇较晚才寻求这种护理。2016年实施新的产前护理模式后，在非洲背景下，关于产前护理开始时间较晚的程度和影响因素的信息一直缺乏。因此，我们旨在利用新指南实施后进行的全国性调查，确定撒哈拉以南非洲（SSA）地区妇女产前护理就诊延迟的合并患病率及其决定因素。
我们分析了2018年至2022年期间在16个SSA国家进行的最近一次人口与健康调查（DHS）的数据，使用了101,983名在其本次妊娠期间接受产前护理随访的妇女的加权样本。拟合了多层次逻辑回归模型，并使用似然值和偏差值进行模型选择。在回归模型中，我们使用调整后的比值比及其相应的95%置信区间来确定与产前护理就诊延迟相关的因素。
SSA地区孕妇产前护理就诊延迟的合并患病率为53.8%[95%CI：46.2%-61.3%]，范围从利比里亚的27.8%到尼日利亚的75.8%。妇女的年龄和教育程度、工作状况、伴侣的教育程度、医疗保险覆盖范围、生育顺序、家庭财富、结婚年龄、医疗保健决策、居住地以及社区层面妇女的文盲率是与产前护理就诊延迟相关的因素。
SSA地区超过一半的孕妇在妊娠晚期才开始接受产前护理，各国之间存在显著差异。这些结果强调了采取针对性干预措施来解决这些问题并加强及时获得产前服务以改善该地区母婴健康结局的必要性。此外，为年轻女性、有多次生育史的女性、职业女性以及早婚女性制定量身定制的干预措施，以解决她们在寻求护理方面的特定挑战和障碍至关重要。
