Prevalence and Factors Associated with the Fourth Standard Antenatal Care Utilization among Pregnant Women Attending Ruli District Hospital, Rwanda
DOI:
https://doi.org/10.47604/gjhs.3072Keywords:
Prevalence, Factors, Fourth Standard Antenatal Care, Pregnant WomenAbstract
Purpose: The purpose of this research is to identify the prevalence of adherence to the recommended four antenatal care (ANC) visits and to analyze factors associated with achieving the fourth ANC visit among pregnant women attending Ruli District Hospital in Gakenke District, Rwanda. The study aims to address gaps in ANC attendance, focusing on improving maternal and fetal health.
Methodology: A cross-sectional study design was used, with a sample size of 421 women, determined through Fisher et al.'s (1998) formula. Systematic sampling was employed to select participants between November 20, 2023, and January 20, 2023. Data collection included informing participants about the study and obtaining consent. Confidentiality was maintained by anonymizing participant data. Analysis was conducted using SPSS version 25, applying descriptive statistics such as percentages, means, and frequencies. Bivariate and multivariate regression analyses were used to identify relationships between independent and dependent variables, with significance assessed at p < 0.05.
Findings: The study found that 57.5% of respondents adhered to the four recommended ANC visits, while 42.5% attended fewer than four. Factors significantly associated with increased ANC attendance included higher educational attainment, abstinence from alcohol by both the mother (AOR=1.953, CI: 1.202-3.174, P<0.007) and husband (AOR=2.041, CI: 1.112-3.747, P<0.002), planned pregnancies (AOR=4.159, CI: 1.975-10.326, P<0.001), and absence of mistreatment toward women (AOR=3.040, CI: 1.367-6.762, P=0.006).
Unique Contribution to Theory, Practice and Policy: The study recommends enhanced supportive supervision and mentorship of Community Health Workers for home visits to pregnant women. Additionally, improving customer care and the quality of ANC services is advised. These insights are expected to guide policymakers in Rwanda, including the Ministry of Health, Ruli District Hospital, and other stakeholders, in enhancing ANC adherence and improving maternal health outcomes.
Downloads
References
Adewuyi, E. O., Auta, A., Khanal, V., Bamidele, O. D., Akuoko, C. P., Adefemi, K., & Zhao, Y. (2018). Prevalence and factors correlated with underutilization of antenatal care services in Nigeria: A comparative study of rural and urban residences based on the 2013 Nigeria demographic and health survey. PloS one, 13(5), e0197324.
Ayalew, T. W., & Nigatu, A. M. (2018). Focused antenatal care utilization and associated factors in Debre Tabor Town, northwest Ethiopia, 2017. BMC research notes, 11(1), 1-6.
Babalola, S. O. (2014). Factors correlated with use of maternal health services in Haiti: a multilevel analysis. Revista Panamericana de Salud Pública, 36, 1-09.
Chilot D, Belay DG, Ferede TA, Shitu K, Asratie MH, Ambachew S, Shibabaw YY, Geberu DM, Deresse M and Alem AZ (2023) Pooled prevalence and determinants of antenatal care visits in countries with high maternal mortality: A multi-country analysis. Front. Public Health 11:1035759. doi: 10.3389/fpubh.2023.1035759
Chorongo, D., Okinda, F. M., Kariuki, E. J., Mulewa, E., Ibinda, F., Muhula, S., & Muga, R. (2016). Factors influencing the utilization of focused antenatal care services in Malindi and Magarini sub-counties of Kilifi county, Kenya. The Pan African Medical Journal, 25(Suppl 2).
Duodu, P. A., Bayuo, J., Mensah, J. A., Aduse-Poku, L., Arthur-Holmes, F., Dzomeku, V. M., & Nutor, J. J. (2022). Trends in antenatal care visits and associated factors in Ghana from 2006 to 2018. BMC pregnancy and childbirth, 22(1), 59.
Ftwi M, Gebretsadik GG, Berhe H, Haftu M, Gebremariam G, Tesfau YB. (2020). Coverage of completion of four ANC visits based on recommended time schedule in Northern Ethiopia: A community-based cross-sectional study design. PLoS One. 2020 Aug 18;15(8):e0236965. doi: 10.1371/journal.pone.0236965. PMID: 32810140; PMCID: PMC7437465.
Jiee, S. F. A. (2018). Late Antenatal Booking and its Predictors in Lundu District of Sarawak, Malaysia. International Journal of Public Health Research, 8(2), 956-964.
Joshi, C., Torvaldsen, S., Hodgson, R., & Hayen, A. (2014). Factors correlated with the use and quality of antenatal care in Nepal: a population-based study using the demographic and health survey data. BMC pregnancy and childbirth, 14(1), 1-11.
Kenya Demographic Health Survey (2022): Maternal care. Available: https://dhsprogram.com/pubs/pdf/PR143/PR143.pdf
Konate, F. O., Konate, M. F., & Coulibaly, Y. (2021). Analysis of Factors Associated with Four or More ANC among Pregnant Women in the City of Kita, Mali. Open Journal of Social Sciences, 9(7), 335-351.
Mulondo, S. A. (2020). Factors correlated with underutilisation of antenatal care services in Limpopo, South Africa. British Journal of Midwifery, 28(11), 788-795.
Nizeyimana Fidele, Jean Marie Vianney Nkurikiyintwali, Singirankabo Vital, MutabaziPlacide, Muhammad Akram,
WalaaFikryElbossaty, Nderelimana Olivier (2022)Factors Associated with discontinuing Four Antenatal Care Standard Visits in Musanze. J Cli Ped Chi Res, 3(1):91-98.
Okedo-Alex, I. N., Akamike, I. C., Ezeanosike, O. B., &Uneke, C. J. (2019). Determinants of antenatal care utilisation in sub-Saharan Africa: a systematic review. BMJ open, 9(10), e031890.
Osterman, M. J. K., & Martin, J. A. (2018).SystemTiming and adequacy of prenatal care in the United States, 2016.
Rurangirwa, A.A., Mogren, I., Nyirazinyoye, L. et al. Determinants of poor utilization of antenatal care services among recently delivered women in Rwanda; a population based study. BMC Pregnancy Childbirth 17, 142 (2017). https://doi.org/10.1186/s12884-017-1328-2
Rwabilimbo, A. G., Ahmed, K. Y., Page, A., & Ogbo, F. A. (2020). Trends and factors associated with the utilisation of antenatal care services during the millennium development goals era in Tanzania. Tropical Medicine and Health, 48(1), 1-16.
Rwanda Demographic health survey.(2019-2020).Maternal health care, 131-140.
Sarker, B. K., Rahman, T., Rahman, T., &Rahman, M. (2021). Factors associated with the timely initiation of antenatal care: findings from a cross-sectional study in Northern Bangladesh. BMJ open, 11(12), e052886.
Sinyange, N., Sitali, L., Jacobs, C., Musonda, P., &Michelo, C. (2016). Factors associated with late antenatal care booking: population based observations from the 2007 Zambia demographic and health survey. The Pan African Medical Journal, 25.
Somé, A., Baguiya, A., Coulibaly, A., Bagnoa, V., &Kouanda, S. (2020). Prevalence and factors associated with late first antenatal care visit in Kaya Health District, Burkina Faso. African Journal of Reproductive Health, 24(2), 19–26.
Sserwanja, Q., Mukunya, D., Nabachenje, P., Kemigisa, A., Kiondo, P., Wandabwa, J. N., & Musaba, M. W. (2022). Continuum of care for maternal health in Uganda: a national cross-sectional study. PloS one, 17(2), e0264190.
Ted, L. B., Aliocha, N. N., Philippe, L. N., Joel, M. B., & Roger, M. M. (2020). Determinants of Delay in First Prenatal Consultation at Hospital Environment in Kimpese Health Zone in Democratic Republic of Congo: Cross-sectional Study. Journal of Health and Environmental Research, 6(3), 98-103.
Teshale, A. B., &Tesema, G. A. (2020).Prevalence and associated factors of delayed first antenatal care booking among reproductive age women in Ethiopia; a multilevel analysis of EDHS 2016 data. PloS one, 15(7), e0235538
Tola, W., Negash, E., Sileshi, T., &Wakgari, N. (2021). Late initiation of antenatal care and associated factors among pregnant women attending antenatal clinic of Ilu Ababor Zone, southwest Ethiopia: A cross-sectional study. Plos one, 16(1), e0246230.
Tolefac, P. N., Halle-Ekane, G. E., Agbor, V. N., Sama, C. B., Ngwasiri, C., &Tebeu, P. M. (2017). Why do pregnant women present late for their first antenatal care consultation in Cameroon?. Maternal health, neonatology and perinatology, 3(1), 1-6.
UNICEF global databases.(2021):Antenatal care available:https://data.unicef.org/topic/maternal-health/antenatal-care/
VandenBroeck, J., Feijen-de Jong, E., Klomp, T., Putman, K., &Beeckman, K. (2016). Antenatal care use in urban areas in two European countries: Predisposing, enabling and pregnancy-related determinants in Belgium and the Netherlands. BMC health services research, 16(1), 1-11.
Warri, D., & George, A. (2020). Perceptions of pregnant women of reasons for late initiation of antenatal care: a qualitative interview study. BMC Pregnancy and Childbirth, 20(1), 1-12.
Wolde, F., Mulaw, Z., Zena, T., Biadgo, B., &Limenih, M. A. (2018). Determinants of late initiation for antenatal care follow up: the case of northern Ethiopian pregnant women. BMC Research Notes, 11(1), 1–7.
World Health Organization (2023): Maternal mortality: Fact sheets: https://www.who.int/news-room/fact-sheets/detail/maternal-mortality.
World Health Organization. (2018). WHO recommendations on antenatal care for a positive pregnancy experience: summary: highlights and key messages from the World Health Organization's 2016 global recommendations for routine antenatal care (No. WHO/RHR/18.02). World Health Organization.
World Health Organization. (2019). Trends in maternal mortality 2000 to 2017: estimates by WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division.
World Health Organization.(2016). WHO recommendations on antenatal care for a positive pregnancy experience.World Health Organization.
World Health Organization.(2019) Maternal mortality Factsheets. Available: https://www. who. int/ news- room/ facts- sheets/ detail/ maternal- mortality
Wynne, S. J., Duarte, R., de Wildt, G., Meza, G., &Merriel, A. (2020).The timing and quality of antenatal care received by women attending a primary care centre in Iquitos,Peru: A facility exit survey. PloS One, 15(3), e0229852
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Mbarushimana Victorien, Dr. Charles Nsanzabera MPH, PhD
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution (CC-BY) 4.0 License that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal.
