Late initiation of antenatal care and its determinants: a hospital based cross-sectional study
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20160926Keywords:
Antenatal care, Late antenatal care, Late initiation, Mandalay, MyanmarAbstract
Background: Antenatal care (ANC) is important for both maternal and fetal health. Pregnant women with late initiation of ANC are more likely to attain poor outcomes of pregnancy. Little is known about the magnitude of receiving late ANC among pregnant women in Myanmar. Therefore, the present study was conducted to determine the prevalence of late initiation of ANC and its determinants among pregnant women attending antenatal clinic at Pyin-Oo-Lwin General Hospital, Mandalay region during 2014.
Methods: A hospital-based cross-sectional study was conducted. Altogether 333 pregnant women were included in the study. Data were collected through face-to-face interview after getting informed consent from the respondents.
Results: The prevalence of late initiation of ANC was 56.2% (95% CI: 50.6%, 61.6%). Univariate analysis revealed that residence; education and occupation of pregnant woman, husband’s occupation, gravidity, parity and being planned pregnancy were significantly related to late initiation of ANC. Based on the results of multivariate logistic regression analysis, residence, education of pregnant woman, occupation of husband, parity and being planned pregnancy were identified as significant determinants of receiving late ANC.
Conclusions: Late ANC attendance is high in the study area. Hence, it is important to provide health education on the timing of ANC among women with reproductive age. Community’s awareness on importance of receiving early ANC also needs to be promoted. Family planning program (i.e., birth-spacing in Myanmar) should be enhanced to prevent unplanned pregnancies.
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References
Sullivan TR, Hirst JE. Reducing maternal mortality: a review of progress and evidence-based strategies to achieve millennium development goal 5. Health Care for Women International. 2011;32(10): 901-16.
Carroli G, Rooney C, and Villar J. How effective is antenatal care in preventing maternal mortality and serious morbidity. An overview of the evidence. Paediatric and Perinatal Epidemiology. 2001;15(suppl 1):1-42.
World Health Organization (WHO).Antenatal Care in Developing Countries: Promises, Achievements and Missed Opportunities. An Analysis of Trends, Levels and Differentials.1990-2001;WHO,Geneva, Switzerland,2003.
Rowe RE, Garcia J. Social class, ethnicity and attendance for antenatal care in the United Kingdom: a systematic review. J Public Health Med. 2003;25(2):113-9.
Child Trends Databank. Late or no prenatal care. Available at: http://www.childtrends.org/?late-or-no-prenatal-care. 2015. Accessed 8 January 2016.
Sah RB, Gaurav K, Baral DD, JhaNand Pokharel PK. Antenatal care practices in hilly area of eastern region of Nepal. Journal of Chitwan Medical College. 2013;3(4):12-5.
Lewis G (Ed): The Confidential Enquiry into Maternal and Child Health (CEMACH). Saving Mothers’ Lives: reviewing maternal deaths to make motherhood safer. 2003-2005. The Seventh Report on Confidential Enquiries into Maternal Deaths in the United Kingdom. London: CEMACH.2007.
Centre for Maternal and Child Enquiries (CMACE): Saving Mothers’ Lives: reviewing maternal deaths to make motherhood safer: 2006-08. The Eighth Report on Confidential Enquiries into Maternal Deaths in the United Kingdom. BJOG. 2011;118(Suppl. 1):1-203.
Amnesty International. Struggle for Maternal Health, Barriers to Antenatal Care in South Africa. 2014. Index: AFR 53/007/2014. PP:8 Available at: http://www.amnesty.ca/sites/amnesty/files/mh_es_eng_final_low_resolution.pdf. Accessed 28 December 2015.
Shahjahan Md, Chowdhury HA, Akter J, Afroz A, Rahman MM, Hafez MA. Factors associated with use of antenatal care services in a rural area of Bangladesh. South East Asia Journal of Public Health. 2012;2(2):61-6.
Phafoli SH, Aswegen EJV, Alberts UU. Variables influencing delay in antenatal clinic attendance among teenagers in Lesotho. South African Family Practice. 2007;49(9):17a-h.
WHO. Maternal Mortality. Available at www.who.int/entity/mediacentre/factsheets/fs348/en. Accessed 8 January 2016.
Ministry of Health (MOH). Health in Myanmar 2014. MOH. Nay-Pyi-Taw. Myanmar, 2015.
Kyaw Oo, Le Le Win, Saw Saw, Myo Myo Mon, Yin Thet Nu Oo, Thae Maung Maung, Su Latt Tun Myint, Theingi Myint. Challenges faced by skilled birth attendants in providing antenatal and intrapartum care in selected rural areas of Myanmar. WHO South-East Asia Journal of Public Health. 2012;1(4):467-76.
United Nations Population Fund. Improving Myanmar’s maternal health care and boosting midwifery skills are UNFPA’s priorities. Available athttp://countryoffice.unfpa.org/myanmar/2015/05/26/12163/improving_myanmar_rsquo_s_maternal_health_care_and_boosting_midwifery_skills_are_unfpa_priorities/. Accessed 10 January 2016.
Chandler D. Late entry into prenatal care in a rural setting. Journal of Midwifery & Women’s Health. 2002;47(1):28-34.
Banda I, Michelo C, Hazemba A. Factors Associated with late antenatal care attendance in selected rural and urban communities of the Copperbelt Province of Zambia. Medical Journal of Zambia. Vol. 39. No. 2012;39(3):29-36.
Gebremeskel F, Dibaba Y, Admassu B. Timing of first antenatal care attendance and associated factors among pregnant women in Arba Minch Town and Arba Minch District, GamoGofa Zone, South Ethiopia. Journal of Environmental and Public Health.2015;DOI: 10.1155/2015/971506.
Ye Y, Yoshida Y, Harun-Or-Rashid, Sakamoto J. Factors affecting the utilization of antenatal care services among women in Kham District, Xiengkhouang Province, Lao PDR. Nagoya J Med Sci. 2010;72:23-33.
CresswellJA, Yu G, Hatherall B, Morris J, Jamal F, Harden A, Renton A. Predictors of the timing of initiationof antenatal care in an ethnically diverse urban cohort in the UK. BMC Pregnancy and Childbirth. 2013;13:103.
Trinh TTL, Rubin G. Late entry to antenatal care in New South Wales, Australia. BMC Journal of Reproductive Health. 2006;3:8.
Manzi A, Munyaneza F, Mujawase F, Banamwana L, Sayinzoga F,Thomson DR, NtaganiraJ, Hedt-Gauthier BL. Assessing predictors of delayed antenatal carevisits in Rwanda: a secondary analysis of Rwanda demographic and health survey 2010. BMC Pregnancy and Childbirth. 2014;14:290.
Adekanle DA, Isawumi AI. Late antenatal care booking and its predictors among pregnant women in south western Nigeria. Online Journal of Health and Allied Sciences. 2008;7(1):1-6.
Gross K, Alba S, Glass TR, Schellenberg JA, Obrist B. Timing of antenatal care for adolescent and adult pregnant women in South-Eastern Tanzania. BMC Pregnancy and Childbirth. 2012;12:16.
Mkandawire P. Gestational age at first antenatal care visit in Malawi. Matern Child Health J. 2015;19:2366-74.
Wang W, Alva S, Wang S, Fort A. Levels and Trends in the Use of Maternal Health Services in Developing Countries. DHS Comparative Reports No. 26. 2011. Calverton, Maryland, USA: ICF Macro.
Gudayu TW, Woldeyohannes SM, Abdo AA. Timing and factors associated with first antenatal care booking among pregnant mothers in Gondar Town; North West Ethiopia. BMC Pregnancy and Childbirth. 2014;14:287.
Zegeye AM, Bitew BD, Koye DN. Prevalence and determinants of early antenatal care visit among pregnant women attending antenatal care in debreberhan health institutions, Central Ethiopia. African Journal of Reproductive Health December. 2013;17(4):130-6.