Epidemiology and Health

Original Article

Association between early antenatal care and antenatal care contacts across low-and middle-income countries: effect modification by place of residence: Paschal Awingura Apanga, Maxwell Tii Kumbeni; Epidemiol Health. 2021;43:e2021092. Published online November 2, 2021; DOI: https://doi.org/10.4178/epih.e2021092

8,008 View
154 Download
4 Web of Science
4 Crossref

Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
The relationship between receiving early antenatal care (ANC) and 8 or more antenatal contacts (ANC8+) has not been well characterised across low-and middle-income countries (LMICs). It is also unclear whether the association between early ANC and ANC8+ is modified by a woman’s place of residence. Our primary aim was to assess the relationship between early ANC and ANC8+ and to investigate whether this relationship was modified by place of residence. We also estimated the coverage of ANC8+ across LMICs.

METHODS

We analysed data on 207,388 mothers with a recent live birth using multiple indicator cluster surveys conducted between 2017 and 2020 in 30 LMICS. Modified Poisson regression with robust variance was used to evaluate the relationship between early ANC and ANC8+, whilst adjusting for country, clustering, stratification, and sampling weights. Effect modification by place of residence was assessed on additive and multiplicative scales. A meta-analysis was conducted to pool prevalence estimates of ANC8+ across all countries.

RESULTS

The overall prevalence of ANC8+ was 35.6%, ranging from 1.7% in Madagascar to 99.4% in Belarus. Early ANC was positively associated with ANC8+ (adjusted prevalence ratio [aPR], 2.61; 95% confidence interval [CI], 1.82 to 3.74). There was evidence of positive effect modification on additive (relative excess risk due to interaction, 0.39; 95% CI, 0.35 to 0.44) and multiplicative (aPR, 1.78; 95% CI, 1.08 to 2.95) scales.

CONCLUSIONS

Many LMICs may not have adopted the 2016 World Health Organization guidelines on ANC8+. Receiving early ANC was associated with a higher likelihood of ANC8+, particularly for women in rural areas.

Summary

Key Message
Our findings suggest that early antenatal care (ANC) was associated with the likelihood of receiving eight or more ANC contacts (ANC8+) among all mothers across low-and middle-income countries. This association was modified by a woman’s place of residence such that mothers living in rural areas who received early ANC had a higher prevalence of ANC8+. Public health programs, which focus on increasing the coverage of ANC8+ should encourage all pregnant women to receive early ANC, particularly those living rural areas.

Citations

Citations to this article as recorded by

The practice of polygyny on the utilisation of reproductive health services among married women in Ghana
Maxwell Tii Kumbeni, John Ndebugri Alem, Florence Assibi Ziba, Agani Afaya, Paschal Awingura Apanga
Journal of Biosocial Science.2024; : 1. CrossRef
Determinants of Focused Antenatal Care Utilization Among Women in Simiyu Region Tanzania
Agatha F. Ngowi, Serafina Mkuwa, Laura Shirima, Frida Ngalesoni, Gasto Frumence
SAGE Open Nursing.2023; 9: 237796082311707. CrossRef
Contents of antenatal care services in Afghanistan: findings from the national health survey 2018
Muhammad Haroon Stanikzai, Essa Tawfiq, Massoma Jafari, Abdul Wahed Wasiq, Mohammad Khaled Seddiq, Sheena Currie, Hadia Sayam, Ahmad Haroon Baray, Sayed Ataullah Saeedzai
BMC Public Health.2023;[Epub] CrossRef
The moderating role of partners’ education on early antenatal care in northern Ghana
Paschal Awingura Apanga, Maxwell Tii Kumbeni, James Kotuah Sakeah, Ayokunle A. Olagoke, Olufemi Ajumobi
BMC Pregnancy and Childbirth.2022;[Epub] CrossRef

Cohort Profile

Cohort profile: the Kisalaya cohort of mother-infant dyads in rural south India (2008-2012): Smitha Chandrashekarappa, Krupa Modi, Karl Krupp, Kavitha Ravi, Anisa Khan, Vijaya Srinivas, Poornima Jaykrishna, Anjali Arun, Murali Krishna, Purnima Madhivanan; Epidemiol Health. 2020;42:e2020010. Published online March 11, 2020; DOI: https://doi.org/10.4178/epih.e2020010

11,055 View
166 Download
2 Web of Science
1 Crossref

Abstract PDF

Abstract

The Kisalaya cohort was established in 2008, providing integrated antenatal care (ANC) and human immunodeficiency virus (HIV) testing in order to reduce adverse birth outcomes and pediatric HIV infections. The program used a mobile clinic model to deliver health education, ANC, and HIV/sexually transmitted infection testing and management to pregnant women in rural communities in southern India. This cohort includes pregnant women residing in 144 villages of the Mysuru taluk (a rural region) who received ANC through the mobile clinic and delivered their infants between 2008 and 2011. Of the 1,940 women registered for ANC at primary healthcare centers during this time period, 1,675 (75.6%) were enrolled in the Kisalaya cohort. Once women enrolled in the Kisalaya cohort gave birth, the cohort expanded to include the mother-infant dyads with a retention rate of 100% at follow-up visits at 15 days and at 6 months post-delivery. The baseline data collected during the Kisalaya study included both questionnaire-based data and laboratory-based investigations. Presently, a study entitled “Early life influences on adolescent mental health: a life course study of the Kisalaya birth cohort in south India” is in the process of data collection (2019-2020).

Summary

Citations

Citations to this article as recorded by

Vulnerability to Sexually Transmitted Infections (STI) / Human Immunodeficiency Virus (HIV) among adolescent girls and young women in India: A rapid review
Sohini Paul, Anupam Sharma, Radhika Dayal, Mahika Mehta, Sudeshna Maitra, Kuhika Seth, Monal Nagrath, Sowmya Ramesh, Niranjan Saggurti, Ajoke Basirat Akinola
PLOS ONE.2024; 19(2): e0298038. CrossRef

First
Prev
Page of 1
Next
Last

Search