Factors influencing timing and frequency of antenatal care in Uganda

Australas Med J. 2011;4(8):431-8. doi: 10.4066/AMJ.2011.729. Epub 2011 Aug 31.

Abstract

Background: Over 99% of mothers who die of complications related to pregnancy and childbirth each year are found in developing countries.3 In Uganda, maternal mortality is estimated at 435 deaths per 100,000 live births. We sought to understand the factors influencing frequency and timing of antenatal care in Uganda in order to inform policy on the key aspects that need to be influenced.

Method: We used data from the Uganda Demographic and Health Survey (UDHS) 2006 and employed both descriptive and quantitative approaches (probit estimation). After a probit estimation, we generated marginal effects to interpret the results as probabilities of utilisation of antenatal care given particular background characteristics.

Results: On average, only 17% and 47% of mothers initiate the first antenatal visit in the first trimester and attain at least four antenatal visits, respectively. The timing and frequency of antenatal visits were significantly associated with education of the mother and her partner, wealth status, regional disparities, religious differences, access to media, maternal autonomy in taking a health decision, occupations of the mother and her partner, timing of pregnancy, birth histories, and birth order.

Conclusion: Efforts are needed to educate girls beyond secondary level, establishment village outreach clinics with qualified staff to attract the hard-to-reach women, and to ensure universal access to prenatal care services irrespective of the ability to pay. Media penetration should also be increased amongst the population and this channel can be used to disseminate a standard piece of information concerning what pregnant women should expect and do during the prenatal period.

Keywords: Timing; Uganda; antenatal care; frequency.