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Determinants of Antenatal Care Utilization in Pakistan: Pakistan Demographic Health Survey 2012-2013
Authors: Ambreen Sahito, Unaib Rabbani, Aysha Zahidie, and Zafar Fatmi
Source: Journal of Pioneering Medical Sciences, 6(2): 27
Topic(s): Antenatal care
Health care utilization
Country: Asia
Published: APR 2016
Abstract: BACKGROUND: Antenatal Care (ANC) utilization is associated with better maternal, newborn and child health. There is strong evidence that ANC utilization influences maternal behavior and increases skill birth attendance, postnatal care and improves newborn care. Around 74% of maternal deaths can be averted if all women have access to maternal health care services. OBJECTIVES: To determine the factors affecting ANC utilization in Pakistan. METHODS: Pakistan Demographic and Health Survey (PDHS 2012-13) is a representative population based random cluster survey. Using PDHS a total of 7443 ever married women of reproductive age (15-49 years) with a live birth in five years preceding the survey were included in the analysis. Andersen's conceptual framework was adapted to examine predisposing and enabling factors affecting ANC utilization at individual and systems level by using multivariate logistic regression analysis. RESULTS: Only 37% women had 4 ANC visits during pregnancy. Most important predisposing factors for ANC utilization were women's education (aOR: 3.62, 95% CI: 2.86-4.59), husband's education (aOR: 1.25, 95% CI: 1.03-1.52), having first child (aOR: 5.87, 95% CI: 4.47-7.69). Living in urban areas (aOR: 3.20, 95% CI: 2.90-3.52), and wealthiest health quintile (aOR: 1.25, 95% CI: 1.03-1.52) enabled females for ANC utilization. Women in Balochistan province were less likely to utilize ANC (aOR: 0.14, 95% CI: 0.10-0.19). CONCLUSION: This is the first study focusing on factors affecting ANC utilization on a nationally representative data. ANC utilization is low in Pakistan. Significant improvement can be achieved through addressing education and providing access to services across all provinces.