Gebrekidan Amanuel Yosef, Woldegeorgis Beshada Zerfu, Kassie Gizachew Ambaw, Haile Kirubel Eshetu, Abrha Ashenafi Teklay, Asnake Angwach Abrham, Asgedom Yordanos Sisay
School of Public Health, College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia.
Department of Internal Medicine, College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia.
Front Glob Womens Health. 2025 Aug 15;6:1477666. doi: 10.3389/fgwh.2025.1477666. eCollection 2025.
Antenatal care (ANC) is a crucial part of reproductive health care, providing opportunities for health promotion, screening, diagnosis, and illness prevention. However, evidence has shown that poor-quality ANC is prevalent. Therefore, this study aimed to investigate the effective coverage (quality-adjusted coverage) of ANC and its associated factors among pregnant women in Tanzania.
This research was based on data from the 2022 Tanzania Demographic and Health Survey. The study utilized a weighted sample of 3,890 pregnant women. Given the influence of clustering and the binary nature of the outcome variable, we used a multilevel binary logistic regression model. Statistical significance was determined using the adjusted odds ratio (AOR) with a 95% confidence interval (CI), taking into account the model with the lowest deviation that best matched the data.
In this study, the effective coverage of ANC was 39.3% [95% confidence interval (CI): 37.8, 40.8]. After considering both individual- and community-level variables, women's age, educational status, husbands'/partners' employment status, wealth index, number of ANC visits, administrative zones, and urban residence were all found to have statistically significant associations with effective ANC coverage among pregnant women in Tanzania.
Only four out of ten pregnant women received effective ANC (quality-adjusted ANC), underscoring that crude coverage and access to healthcare do not ensure quality ANC. Emphasis should be placed on integrating component-based indicators. Furthermore, all attempts to provide all components should be considered during women's first visit, in addition to the need to increase the number of visits by pregnant women. Additionally, more attention should be paid to disadvantaged groups in terms of wealth and residence, and the fee exemption strategy should be supported by boosting the availability of healthcare supplies, particularly in remote areas.
产前保健是生殖健康保健的关键部分，为促进健康、筛查、诊断和疾病预防提供了机会。然而，有证据表明，低质量的产前保健普遍存在。因此，本研究旨在调查坦桑尼亚孕妇产前保健的有效覆盖率（质量调整覆盖率）及其相关因素。
本研究基于2022年坦桑尼亚人口与健康调查的数据。该研究使用了3890名孕妇的加权样本。考虑到聚类的影响和结果变量的二元性质，我们使用了多水平二元逻辑回归模型。通过调整后的优势比（AOR）和95%置信区间（CI）确定统计学显著性，同时考虑与数据最匹配且偏差最小的模型。
在本研究中，产前保健的有效覆盖率为39.3%[95%置信区间（CI）：37.8，40.8]。在考虑了个体和社区层面的变量后，发现女性年龄、教育状况、丈夫/伴侣的就业状况、财富指数、产前检查次数、行政区和城市居住情况与坦桑尼亚孕妇产前保健的有效覆盖率均存在统计学显著关联。
每十名孕妇中只有四名接受了有效的产前保健（质量调整后的产前保健），这突出表明粗略的覆盖率和获得医疗保健的机会并不能确保高质量的产前保健。应强调整合基于组成部分的指标。此外，除了需要增加孕妇的就诊次数外，还应在女性首次就诊时考虑提供所有组成部分的所有尝试。此外，应更加关注财富和居住方面的弱势群体，并通过增加医疗用品的供应来支持费用豁免策略，特别是在偏远地区。
