Sociodemographic Predictors of Initiating Antenatal Care Visits by Pregnant Women During First Trimester of Pregnancy: Findings from the Afghanistan Health Survey 2018

Essa Tawfiq; Mohammad Rafi Fazli; Abdul Wahed Wasiq; Muhammad Haroon Stanikzai; Amena Mansouri; Sayed Ataullah Saeedzai

doi:10.2147/IJWH.S399544

Sociodemographic Predictors of Initiating Antenatal Care Visits by Pregnant Women During First Trimester of Pregnancy: Findings from the Afghanistan Health Survey 2018

Int J Womens Health. 2023 Apr 1:15:475-485. doi: 10.2147/IJWH.S399544. eCollection 2023.

Authors

Essa Tawfiq¹, Mohammad Rafi Fazli², Abdul Wahed Wasiq³, Muhammad Haroon Stanikzai⁴, Amena Mansouri⁵, Sayed Ataullah Saeedzai⁶

Affiliations

¹ Department of Epidemiology and Biostatistics, School of Population Health, the University of Auckland, Auckland, New Zealand.
² Department of Surgery, Faculty of Medicine and Health Science, the University of Auckland, Auckland, New Zealand.
³ Internal Medicine Department, Faculty of Medicine, Kandahar University, Kandahar, Afghanistan.
⁴ Public Health Department, Faculty of Medicine, Kandahar University, Kandahar, Afghanistan.
⁵ Formerly Ghalib Teaching Hospital, Herat, Afghanistan.
⁶ Ministry of Public Health, Kabul, Afghanistan.

Abstract

Purpose: Initiating antenatal care (ANC) visits by pregnant women during first trimester, known as timely initiation of ANC visits, is crucial for wellbeing of mothers and their unborn babies. We examined whether sociodemographic characteristics of pregnant women predict timely initiation of ANC visits.

Patients and methods: Data collected for the Afghanistan Health Survey 2018 (AHS 2018) were analyzed. A binary outcome variable was created as women with ANC visits in 0-3 months (first trimester) vs women with ANC visits in ≥4 months of pregnancy. A multivariable generalized linear model was employed.

Results: A total of 6862 ever-married women, aged 14-49 years, with a history of pregnancy, including current pregnancy, were included. The prevalence of timely initiation of ANC visits was 55.8%. The likelihood (OR = odds ratio) of timely initiation of ANC visits was higher in women aged 30-39 years [OR 1.12 (95% CI: 1.00-1.25)], in women who could read and write [OR 1.12 (95% CI: 0.99-1.21)], in women who used public primary care facilities [OR 1.14 (95% CI: 1.01-1.28)], in women who received consultation on ANC from a doctor or midwife [OR 1.22 (95% CI: 0.72-2.08), OR 1.13 (95% CI: 0.67-1.92)] respectively, in women at fourth and highest quintiles of wealth status [OR 1.24 (95% CI: 1.04-1.48), OR 1.14 (95% CI: 0.92-1.40)] respectively, in women who intended to become pregnant [OR 1.56 (95% CI: 1.35-1.81)], in women who used the internet [OR 1.53 (95% CI: 1.13-2.06)], and in women who listened to radio [OR 1.16 (95% CI: 1.03-1.30)]. However, the likelihood was lower in women who had given birth at least twice [OR 0.67 (95% CI: 0.50-0.89)], and in women who lived in rural areas [OR 0.87 (95% CI: 0.75-1.00)].

Conclusion: To promote timely initiation of ANC visits, healthcare interventions to increase availability of midwives and doctors, and improve accessibility to primary care clinics, especially in rural areas, need to be implemented.

Keywords: ANC; early ANC; late ANC; timely ANC.