Kessy Sanun Ally, Kagoye Sophia A, Tibenderana Jovin R, Nyaki Ahmed Yusuph, Manongi Rachel N, Mboya Innocent B
Directorate of Training and Research, Benjamin Mkapa Hospital Dodoma Tanzania.
Ifakara Health Institute Dar es Salaam Tanzania.
Health Sci Rep. 2025 Jul 16;8(7):e71081. doi: 10.1002/hsr2.71081. eCollection 2025 Jul.
Maternal and neonatal mortality remain high in sub-Saharan Africa (SSA), which can be reduced by the expanded antenatal care (ANC) services intervention. Challenges exist in the quality coverage of ANC in Tanzania. We aimed to assess inequalities and determinants of quality ANC coverage among women of reproductive age (WRA, 15-49 years) in Tanzania.
We performed a secondary analysis of cross-sectional data from 6620 women of reproductive age using the 2022 Tanzania Demographic and Health Survey. Quality ANC coverage (ANCq) was measured using seven indicators, with scores ≥ 7 classified as adequate. Log-linear regression models were used to determine factors associated with ANCq using Stata version 18.0. Inequalities in ANCq by age categories, education level, socioeconomic status (SES), area of residence, and geographical zones were analyzed using WHO HEAT 3.1 through Difference and Population Attributable Risk measures.
Among 6620 WRA (43%), had adequate ANCq coverage. Higher inequalities were observed among women with low education, low SES, rural residence, and living in western zones. ANCq coverage was positively associated with high SES (RR 1.35, 95% CI: 1.20-1.52), secondary/higher education (RR 1.21, 95% CI: 1.06-1.38), high media exposure (RR 1.11, 95% CI: 1.00-1.21), easy access to health facility (RR 1.11, 95% CI: 1.01-1.27), and partner's higher education (RR 1.28, 95% CI: 1.08-1.52). Inverse associations were observed among older women (35-49 years) (RR 0.89, 95% CI: 0.80-0.97) and those with higher birth order (RR 0.78, 95% CI: 0.72-0.84).
The study demonstrates suboptimal ANCq coverage in Tanzania, especially among disadvantaged groups, which quality ANCq having a positive association with rich wealth status, higher education level, high media exposure, health facility access, and older maternal age. Addressing these socioeconomic disparities is crucial for improving ANCq coverage and maternal and child health outcomes.
撒哈拉以南非洲地区（SSA）的孕产妇和新生儿死亡率仍然很高，扩大产前保健（ANC）服务干预可降低这一死亡率。坦桑尼亚的ANC质量覆盖率存在挑战。我们旨在评估坦桑尼亚育龄妇女（15 - 49岁）中ANC质量覆盖率的不平等情况及其决定因素。
我们使用2022年坦桑尼亚人口与健康调查对6620名育龄妇女的横断面数据进行了二次分析。使用七个指标衡量ANC质量覆盖率（ANCq），得分≥7分为充足。使用Stata 18.0版的对数线性回归模型确定与ANCq相关的因素。通过世界卫生组织HEAT 3.1，利用差异和人群归因风险测量方法分析了按年龄类别、教育水平、社会经济地位（SES）、居住地区和地理区域划分的ANCq不平等情况。
在6620名育龄妇女中，43%的人有充足的ANCq覆盖率。在低教育水平、低SES、农村居住以及生活在西部地区的妇女中观察到更高的不平等。ANCq覆盖率与高SES（相对风险1.35，95%置信区间：1.20 - 1.52）、中等/高等教育（相对风险1.21，95%置信区间：1.06 - 1.38）、高媒体曝光率（相对风险1.11，95%置信区间：1.00 - 1.21）、方便获得卫生设施（相对风险1.11，95%置信区间：1.01 - 1.27）以及伴侣的高等教育（相对风险1.28，95%置信区间：1.08 - 1.52）呈正相关。在年龄较大的妇女（35 - 49岁）（相对风险0.89，95%置信区间：0.80 - 0.97）和生育顺序较高的妇女（相对风险0.78，95%置信区间：0.72 - 0.84）中观察到负相关。
该研究表明坦桑尼亚的ANCq覆盖率不理想，尤其是在弱势群体中，高质量的ANCq与富裕的财富状况、较高的教育水平、高媒体曝光率、获得卫生设施以及较高的产妇年龄呈正相关。解决这些社会经济差距对于提高ANCq覆盖率以及改善母婴健康结局至关重要。
