Status of the latest 2016 World Health Organization recommended frequency of antenatal care contacts in Sierra Leone: a nationally representative survey

Quraish Sserwanja; Milton W Musaba; Kassim Kamara; Linet M Mutisya; David Mukunya

doi:10.1186/s12913-022-08594-y

Status of the latest 2016 World Health Organization recommended frequency of antenatal care contacts in Sierra Leone: a nationally representative survey

BMC Health Serv Res. 2022 Sep 28;22(1):1208. doi: 10.1186/s12913-022-08594-y.

Authors

Quraish Sserwanja¹, Milton W Musaba², Kassim Kamara³, Linet M Mutisya⁴, David Mukunya^{5

6}

Affiliations

¹ Programs Department, GOAL, Khartoum, Sudan. qura661@gmail.com.
² Department of Obstetrics and Gynaecology, Busitema University, Mbale, Uganda.
³ National Disease Surveillance Programme, Ministry of Health and Sanitation, Free town, Sierra Leone.
⁴ Maternal and Child Health Project, Swedish Organization for Global Health, Mayuge, Uganda.
⁵ Department of Public Health, Busitema University, Mbale, Uganda.
⁶ Department of Research, Nikao Medical Center, Kampala, Uganda.

Abstract

Background: Timely and increased frequency of quality antenatal care (ANC) contacts is one of the key strategies aimed at decreasing maternal and neonatal deaths. In 2016, the World Health Organization (WHO) revised the ANC guidelines to recommend at least eight ANC contacts instead of four. This study aimed to determine the proportion of women who received eight or more ANC contacts and associated factors in Sierra Leone.

Methods: We used Sierra Leone Demographic and Health Survey (UDHS) 2019 data of 5,432 women aged 15 to 49 years who had a live birth, within three years preceding the survey. Multistage stratified sampling was used to select study participants. We conducted multivariable logistic regression to identify factors associated with utilisation of eight or more ANC contacts using SPSS version 25 complex samples package.

Results: Out of 5,432 women, 2,399 (44.8%) (95% CI: 43.1-45.7) had their first ANC contact in the first trimester and 1,197 (22.0%) (95% CI: 21.2-23.4) had eight or more ANC contacts. Women who had their first ANC contact after first trimester (adjusted odds ratio, aOR, 0.58, 95% CI 0.49-0.68) and women aged 15 to 19 years had less odds of having eight or more contacts (aOR 0.64, 95% CI 0.45 to 0.91). Working (aOR 1.33, 95%CI 1.10 to 1.62) and wealthier women had higher odds of having eight or more contacts compared to poorer ones and those not working respectively. Women residing in the southern region, those using internet and less parous (less than five) women were associated with higher odds of having eight or more ANC contacts. Women who had no big problem obtaining permission to go health facilities also had higher odds of having eight or more ANC contacts compared to those who had big problems.

Conclusion: Sierra Leone's adoption of eight or more ANC contacts is low and less than half of the women initiate ANC in the first trimester. To ensure increased access to recommended ANC visits, timely ANC should be encouraged. Attributes of women empowerment such as workings status, socio-economic status, and decision-making should also be emphasized.

Keywords: Antenatal care; DHS; Sierra Leone; Utilisation; Women.

MeSH terms

Female
Health Facilities*
Humans
Infant, Newborn
Patient Acceptance of Health Care
Pregnancy
Prenatal Care*
Sierra Leone / epidemiology
Surveys and Questionnaires
World Health Organization