NDLI: Spatiotemporal distribution and determinants of delayed first antenatal care visit among reproductive age women in Ethiopia: a spatial and multilevel analysis

Content Provider	Springer Nature : BioMed Central
Author	Belay, Daniel Gashaneh Aragaw, Fantu Mamo Anley, Denekew Tenaw Tegegne, Yibeltal Shitu Gelaye, Kassahun Alemu Tessema, Zemenu Tadesse
Abstract	Background Antenatal care (ANC) is one of the four pillars of the initiative for safe motherhood. ANC helps to improve the health of pregnant women and reduce the risk of adverse pregnancy outcome. First ANC is used to know the health status of the mothers and the fetus, to estimate the gestational age and expected date of delivery. Our research aims to investigate the Spatio-temporal distribution of delayed first ANC visit and its predictors using multilevel binary logistic regression analysis. Method A total of 10,184 women (2061 in 2005, 3366 in 2011, and 4757 in 2016) were included for this study. The data were cleaned and weighted using STATA version 14. A multilevel binary logistic regression model was fitted to identify significant predictors of delayed first ANC visit. ArcGIS software was used to explore the spatial distribution of delayed first ANC visits and a Bernoulli model was fitted using SaTScan software to identify significant clusters of delayed first ANC visits. Results Overall, 77.69, 73.95, and 67.61% of women had delayed their first ANC visit in 2005, 2011, and 2016 EDHSs respectively. Women education [AOR = 0.71; 95%CI; 0.60, 0.84], unwanted pregnancy [AOR = 1.41;95%CI; 1.04, 1.89], and rural residence [AOR = 1.68;95%CI; 1.19, 2.38] have significantly associated with delayed first ANC visit. The spatial analysis revealed that delayed first ANC visit varies in each EDHS period. The SaTScan analysis result of EDHS 2005 data identified 122 primary clusters located between the border of Oromia and Eastern SNNPR regions (RR = 1.30, LLR = 32.31, P-value< 0.001), whereas in 2011 EDHS, 145 primary clusters were identified in entire Tigray, B/Gumuz, Amhara western part of Afar and northwest Oromia regions (RR = 1.30, LLR = 40.79, P-value< 0.001). Besides in 2016 EDHS,198 primary clusters were located in the entire SNNPR, Gambella, Northen B/Gumuz, and western Oromia regions. (RR = 1.35, LLR = 83.21, P-value< 0.001). Conclusion In Ethiopia delayed first ANC visit was significantly varied across the country over time Women’s education, wanted the last child, and residence were significantly associated with delayed first ANC booking. The effect of each predictor was found to be different across regions of Ethiopia. Therefore, a targeted intervention program is required in highly affected areas of Ethiopia.
Related Links	https://bmcpublichealth.biomedcentral.com/counter/pdf/10.1186/s12889-021-11614-x.pdf
Ending Page	18
Page Count	18
Starting Page	1
File Format	HTM / HTML
ISSN	14712458
DOI	10.1186/s12889-021-11614-x
Journal	BMC Public Health
Issue Number	1
Volume Number	21
Language	English
Publisher	BioMed Central
Publisher Date	2021-08-19
Access Restriction	Open
Subject Keyword	Public Health Medicine Epidemiology Biostatistics Vaccine Environmental Health Delayed first ANC visit Multilevel analysis Spatiotemporal distribution Ethiopia Medicine/Public Health
Content Type	Text
Resource Type	Article
Subject	Public Health, Environmental and Occupational Health
Journal Impact Factor	3.5/2023
5-Year Journal Impact Factor	3.9/2023

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