What Is a Doula and How to Choose the Right One? The risk of maternal mortality is the highest for adolescent women younger than years old. However, if this is not your first pregnancy and you are not facing any medical issues, then you may have approximately 7 to 9 antenatal visits. Your doctor may ask you to undergo some urine and. This is because women with medium and rich household wealth index were more likely to pay for care-seeking costs such as transportation, medications, and any associated costs and can easily get information about the benefit of completing the ANC visits. This may be because education positively impacts healthcare service utilization and increment of knowledge about specific issues. Conclusions. The recent DHS of the country-specific data set was extracted during the specified period. Based on known facts and literature works [25–28], the independent variables included in this study were a country, residence, age group, marital status, educational status, literacy level, husband education, occupational status, accessing health care, pregnant wontedness, birth order, contraceptive utilization, and wealth index. The aim is to keep your haemoglobin level above 10.5. The odds of completing at least four ANC visits among mothers who had primary, secondary, and higher education levels increased by 20% (AOR = 1.20; 95% CI: 1.13, 1.27), 35% (AOR = 1.35; 95% CI: 1.24, 1.47), and 91% (AOR = 1.91; 95% CI: 1.62, 2.14) as compared with mothers who had no education, respectively. Fourth ANC Check up In 9th month of pregnancy. Women may die as a result of complications during the pregnancy and perinatal period. In addition, creating a conducive environment in entrepreneurial activities for poor women is needed. Our findings suggest that women’s occupation influences the completeness of antenatal care visits. There are four types of bloo… Ethiopia recorded the lowest, completing four or more ANC visits, as compared with other countries. Zimbabwe was taken as a reference because it recorded better performance on completing four or more ANC visits than other countries (Table 3). This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Detailed survey methodology and sampling methods used in gathering the data have been reported elsewhere [23]. This might be due to the difference in their healthcare system and policy implementation that may differ in their healthcare access and community awareness towards antenatal care services. Antenatal care (ANC) coverage is a success story in Africa,since over two-thirds of pregnant women (69 percent) have at least one ANC contact.However,to achieve the full life-saving potential that ANC promises for women and babies, four visits providing essential … You may be asked to discuss any pregnancy-related concerns or queries that you may have. Your doctor may also discuss normal and caesarean delivery. If it’s your first pregnancy and you have a healthy pregnancy, with no medical issues or complications, then you may be required to visit your doctor 8 to 10 times on an average. You may be given more information in case your pregnancy may be expected to go beyond 41 weeks. This suggests that women with unplanned pregnancies could have been unwilling to seek or attend ANC. Birth order had a significant effect on ANC visits. In the case of membrane sweep not being successful, your doctor may suggest you go for an induction. In the same year, sub-Saharan Africa alone accounted for roughly two-thirds (196,000) of maternal deaths, while Southern Asia accounted for almost one-fifth (58,000) [3]. Your uterus may be measured to check the progress of your baby along with testing your urine for protein and checking your blood pressure too. As soon as you come to know that you’re pregnant, you should see an OB-GYN and schedule the appointments. Your blood and urine tests results will be discussed by your doctor. Zemenu Tadesse Tessema, Amare Minyihun, "Utilization and Determinants of Antenatal Care Visits in East African Countries: A Multicountry Analysis of Demographic and Health Surveys", Advances in Public Health, vol. Utilization and Determinants of Antenatal Care Visits in East African Countries: A Multicountry Analysis of Demographic and Health Surveys, Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia, Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia, Getting permission to go for treatment (v467b = 1), Distance to the health facility (v467d = 1), At least one problem accessing health care (one or more of the above), http://int/mediacentre/factsheets/fs348/en/, https://apps.who.int/iris/bitstream/10665/259947/1/WHO-RHR-18.02-eng.pdf?ua=1, https://extranet.who.int/rhl/topics/improving-health-system-performance/who-recommendation-antenatal-care-contact-schedules#:%7E:text=With%20the%20FANC%20model%2C%20the,if%20they%20experience%20danger%20signs, https://www.researchgate.net/journal/2047-2986_Journal_of_Global_Health, Ӧ. Tunçalp, J. Pena-Rosas, T. Lawrie et al., “WHO recommendations on antenatal care for a positive pregnancy experience-going beyond survival,”, E. Abalos, M. Chamillard, V. Diaz, Ӧ. Tuncalp, and A. Gülmezoglu, “Antenatal care for healthy pregnant women: a mapping of interventions from existing guidelines to inform the development of new WHO guidance on antenatal care,”, S. Downe, K. Finlayson, Ӧ. Tunçalp, and A. Metin Gülmezoglu, “What matters to women: a systematic scoping review to identify the processes and outcomes of antenatal care provision that are important to healthy pregnant women,”, T. Ganchimeg, E. Ota, N. Morisaki et al., “Pregnancy and childbirth outcomes among adolescent mothers: a World Health Organization multicountry study,”, F. Althabe, L. Gibbons, M. Berrueta et al., “Adverse maternal and perinatal outcomes in adolescent pregnancies: the Global Network’s Maternal Newborn Health Registry study,”, L. Say, D. Chou, A. Gemmill et al., “Global causes of maternal death: a WHO systematic analysis,”, B. C. Bwalya, K. S. Baboo, D. C. Sitali et al., “Experiences of antenatal care among pregnant adolescents at Kanyama and Matero clinics in Lusaka district,”, P. H. Fulpagare, “Antenatal care service utilization among adolescent pregnant women–evidence from,”, J. © 2003-2012 Princeton University, Farlex Inc. Translations. In such cases, your doctor may offer you a membrane swipe. A recent multination randomized control trial governed by the WHO, and a scientific review showed that essential interventions would be provided over four visits at specified intervals, a minimum for healthy mothers with no underlying medical problems. However, the decision always lies with you. Marital status is associated with the recommended antenatal care visits. The aims of good antenatal care are to ensure that pregnancy causes no harm to the mother and to keep the fetus healthy during the antenatal period. Women will either start antenatal care at that point or be referred to a maternity care provider or service; for example, the local hospital, … The adjusted odds ratio (AOR) and associated 95% confidence interval (Cis) obtained from the adjusted multilevel logistic regression model were used to declare that determinates associated with completing four or more antenatal care visit services in the East African countries. Your doctor or midwife will calculate how many weeks you have been pregnant and the due date of your baby. The largest study participants, 13,515 (13.49%), were from Malawi, and the smallest study participants, 1,891 (1.89%), were from Comoros. Theresa Lawrie reviewed the evidence … The pooled utilization of attending at least four antenatal care visit in the East African region was 52.44% (95% CI: 52.13, 52.74), with the highest attending at least four or more antenatal care visit visits in Zimbabwe (75.72%) and the lowest attending at least four or more antenatal care visit visits in Ethiopia (31.82%). The authors thank the MEASURE DHS program for providing the data set. You are close to your delivery, and thus your doctor or midwife may like to share the following information with you: Apart from discussing the above issues, your doctor or midwife will check the position of your baby. Also, your urine may be tested for the presence of protein. A high proportion of mothers attended 5 or more antenatal visits across all PHN … The majority of these deaths (94%) happened in low-resource settings, and most may want to have been prevented. The odds of completing at least four ANC visits among mothers whose husbands had primary, secondary, and higher education levels increased by 9% (AOR = 1.09; 95% CI: 1.0, 1.15), 22% (AOR = 1.22; 95% CI: 1.14, 1.31), and 51% (AOR = 1.51; 95% CI:1.35, 1.70) as compared with mothers whose husband had no education, respectively. care pathways in the antenatal period. Data are available online and can be accessed at http://www.measuredhs.com. The study aim was to describe the factors related to low visits for antenatal care (ANC) services among pregnant women in Indonesia. monitor pregnancy risk and to log the delivery of routine preventive services; including deworming, intermittent preventive treatment for malaria (IPT), tetanus toxoid vaccination, RPR screening for syphilis and insecticide treated net (ITN) distribution. Empowering women through education, household wealth, and decision-making increases the utilization of maternal healthcare service too. At this stage, if you face any sort of discomfort or concerns, ensure that you communicate with your doctor so she can advise you on the steps to take. Tooth Pain During Pregnancy – Causes and Remedies, Ways and Activities to Teach Children Patience, Pregnancy Discrimination and Laws to Prevent It in the US, 9 Essentials to Make Those Nine Months of Pregnancy Easier. According to the Fragile States Index of 2017, 15 countries have been viewed to be at an excessive risk of maternal death (South Sudan, Somalia, Central African Republic, Yemen, Syria, Sudan, the Democratic Republic of the Congo, Chad, Afghanistan, Iraq, Haiti, Guinea, Zimbabwe, Nigeria, and Ethiopia). A stepwise backward elimination process was performed at each stage, and determinants associated with completing four or more antenatal care service users were retained. mandated antenatal, new birth and 6-8 weeks reviews and the health visitor High Impact Areas of transition to parenthood and the early weeks, maternal (perinatal) mental health and breastfeeding. Copyright © 2021 Zemenu Tadesse Tessema and Amare Minyihun. period of 7 or 14 days. Socioeconomic and cultural influences are among important barriers. The odds of completing at least four ANC visits among mothers of age group 24–34 and 35–49 were increased by 24% (AOR = 1.24; 95% CI: 1.18, 1.31) and 42% (AOR = 1.42; 95% CI: 1.32, 1.53) compared with teenage mothers. In case of first-time pregnancy, you may have had a membrane swipe once before at around 40 weeks antenatal visit. The DHS program adopts standardized methods involving uniform questionnaires, manuals, and field procedures to gather information comparable across countries globally. The data were gathered following a common, internationally acceptable methodological procedure. The odds of completing at least four ANC visits among women who face serious healthcare problems decreased by 7% (AOR = 0.93; 95% CI: 0.89, 0.97) compared with its counterpart. Goals of good antenatal care 1-1 What are the aims and principles of good antenatal care? Learning outcomes By the end of this chapter you will be able to: 1. understand the midwife’s role in the antenatal period 2. develop a deeper knowledge of the monitoring and assessment required during the antenatal period… In addition, creating a conducive environment in entrepreneurial activities for poor women is needed. Background. Aim To understand the woman’s antenatal care needs, including monitoring and assessment of the woman throughout her pregnancy. Chinese Simplified / 中文简体. You may be asked about any physical or emotional symptoms that you are concerned about. In this visit you may be asked the following details: Here’s some information that your doctor or midwife may share with you: During this visit, your doctor could conduct your first ultrasound scan. The coverage of completing the recommended antenatal care visit was low in the region. This then allows the HV to offer/facilitate the appropriate level of support after the birth. Receiving antenatal care visits at least four times increases the likelihood of receiving effective maternal health interventions through the antenatal period. But if your pregnancy is uncomplicated and you're in good health, you may not be seen as often as someone who needs to be more closely monitored. Schematic diagram of selection of study countries among East African countries. In the data set, the index has five quintiles, such as the lowest quintile (poorest), 2nd quintile (poorer), 3rd quintile (middle), 4th quintile (wealthier), and the 5th quintile (wealthiest). … 6, no. ZTT and AM were responsible for the conception of the work, design of the work, data acquisition, analysis, and data interpretation. Besides, accessibility is related to transport issues, financial burden, and long distance to the health facility [43]. The study participants’ median age group was 28 years with an interquartile range of 24 to 34 years, with almost half of them 46,197 (46.47%) under the age group of 25 to 34 (Table 2). The study showed that both women’s and their husbands’ education influence antenatal care visits’ completeness. Arabic / العربية. When you will be going for the ultrasound scans, What tests and scans you may have to undergo, and your doctor will share the information of their pros and cons, You will be handed over a copy of your report after your visit, Any screening tests that may be required for your newborn baby, How you may take care of your health after delivery. So this includes info re … This result is similar to the findings of other previous studies [25, 27, 31, 35]. For the evidence on test accuracy, Khalid Khan and Ewelina Rogozinska reviewed and graded the scientific evidence. 3. Your weight and blood pressure will be measured too. The wealth variable was generated from the wealth index for the households. Your doctor may like to discuss your birth plan with you. Teenage girls who are pregnant will be less likely to use ANC compared with older pregnant women [10, 11]. Chien, “Family structure types and adequate utilization of antenatal care in Kenya,”, H. V. Doctor, “Intergenerational differences in antenatal care and supervised deliveries in Nigeria,”, S. M. Tarekegn, “Determinants of maternal health service utilization in Ethiopia: analysis of the 2011 Ethiopian Demographic and Health,”, J. O. Akinyemi, “Patterns and determinants of dropout from maternity care continuum in Nigeria,”, A. Verney, A. R. Barbara, K. K. Jacqueline et al., “Factors associated with socio‐demographic characteristics and antenatal care and iron supplement use in Ethiopia,”, S. Gupta, G. Yamada, R. Mpembeni et al., “Factors associated with four or more antenatal care visits and its decline among pregnant women in Tanzania between 1999,”, R. Haddrill, C. A. Mitchell, and D. O. C. Anumba et al., ““Understanding delayed access to antenatal care: a qualitative interview study,”, N. Habibov, H. Zainiddinov, and R. Healthcare, “Do family planning messages improve antenatal care utilization? The age group had a significant effect on the recommended antenatal care visit. These are specialist midwives or nurses who support young pregnant women from the antenatal period till their child is 2 years old. In such cases, your doctor may offer you a membrane swipe. Routine blood and urine work may follow. The following questions are included:(a)Getting permission to go for treatment (v467b = 1)(b)Getting money for treatment (v467c = 1)(c)Distance to the health facility (v467d = 1)(d)Not wanting to go alone (v467f = 1)(e)At least one problem accessing health care (one or more of the above). Completing four or more ANC visits among women who face a serious problem of accessing health care was less likely than women who did not face accessing health care. Zimbabwe was taken as a reference because it recorded better performance on completing four or more ANC visits than other countries. During counseling, women’s knowledge about available family planning services and the medical facilities that provide such services could be increased [40]. The result also revealed that women who had planned to become pregnant were more likely to have attended ANC at least four times relative to those who did not plan to become pregnant at all. 4. This is because mothers who were using family planning might have more awareness and knowledge about the health providers’ maternal health services. The odds of completing at least four ANC visits among married mothers increased by 11% compared with a single (AOR = 1.11; 95% CI: 1.05, 1.16). Your mental health may be checked to see if you are not suffering from any form of. In two of the 14 countries, their DHS was conducted outside of the study period (Figure 1). The antenatal register chronicles each visit made during the antenatal period. Your obstetrician may conduct a blood test to check your iron levels and also to check your antibodies. The age group had a significant effect on the recommended antenatal care visit. You may be suggested some dietary and lifestyle changes. increase with only four ANC visits and that an increase in the number of ANC contacts, regardless of the country, is associated with an increase in maternal satisfaction, WHO recommends a minimum of eight contacts: five contacts in the third trimester, one contact in the first trimester, and two contacts in the second trimester (see Table 1). This is because assessing healthcare services is important for promoting and maintaining their health and reducing unnecessary disability and premature death. The result of the current study revealed that women with medium and rich household wealth index were more likely to complete the minimum of 4 ANC services compared with women with poor household wealth index. The antenatal period grants opportunities for pregnant women with interventions that may also be necessary for their infants’ well-being and infants. Multilevel models were fitted using “svy” survey commands to adjust for the variables of clustering survey design (Country), sampling weights, and standard errors (SE). DHSs are nationally representative household surveys that provide data from a wide range of monitoring and impact evaluation indicators in population, health, and nutrition with face-to-face interviews of women aged 15 to 49. For a woman who is parous with an uncomplicated pregnancy, a schedule of 7 appointments should be adequate. Previously, the antenatal visits were: monthly until 32 weeks gestation, then fortnightly until 36 weeks, and weekly thereafter until delivery, resulting in up to 14 hospital visits during pregnancy. Antenatal care (ANC) coverage is an indicator of access to and use of health care during pregnancy. The purpose of the visit is to make an assessment of family health needs - in practice yes, this means asking what can be considered 'nosy' questions. Although ANC services’ coverage increases in many African countries, coverage alone does not provide sufficient information on the service [12]. N. N. Asundep, A. P. Carson, C. A. Turpin et al., “Determinants of access to antenatal care and birth outcomes in Kumasi, Ghana,”, B. Simkhada, E. R. v. Teijlingen, M. Porter, and P. Simkhada, “Factors affecting the utilization of antenatal care in developing countries: systematic review of the literature,”, I. N. Okedo-Alex, “Determinants of antenatal care utilisation in sub-Saharan Africa: a systematic review,”, Z. T. Tessema and G. Tesema, “Pooled prevalence and determinants of skilled birth attendant delivery in East Africa countries: a multilevel analysis of Demographic and Health Surveys,”.