Effects of socioeconomic factors and booking time on the WHO recommended eight antenatal care contacts in Liberia

Abstract

Antenatal care (ANC) is an important intervention that has been linked to reduce maternal and newborn adverse outcomes. However, the long years of war in Liberia may have contributed to the poor health indices including the uptake of maternal health care services. The objective of this study was to determine the marginal interaction effects between booking time and socioeconomic factors in eight or more ANC contacts. A total sample of 4,185 women who had given birth were included in this study. The 2020 Liberia Demographic and Health Survey (LDHS) dataset was analyzed. The outcome variable was eight or more ANC contacts. Percentage and Chi-square test were used in univariate and bivariate analyses respectively. The marginal interaction effects between booking time and socioeconomic factors of eight or more ANC contacts were estimated. The statistical significance was determined at 5%. The weighted prevalence of eight or more ANC contacts was 26.6% (95% CI: 23.8%, 29.6%). The uptake of eight or more ANC contacts increased steadily by increasing women’s level of education and household wealth index. Women with higher educational attainment had a prevalence of 49.0% (95%CI: 36.5%, 61.6%) and those in the richest households had an estimated prevalence of 31.4% (95%CI: 24.9%, 38.8%) respectively. Furthermore, the urban dwellers had a weighted eight or more ANC contacts prevalence of 29.0% (95%CI: 24.6%, 34.0%). The key finding is increased marginal interaction effects for higher education and early booking (48.4%), richest households and early booking (35.4%), and urban residential status and early booking (36.2%) respectively. Overall, the prevalence of eight or more ANC contacts was low. However, we found higher coverage of eight or more ANC contacts among women who initiated ANC within the first trimester and among those with higher socioeconomic status. We recommend the Liberian government to design and/or support programmes targeted at promoting early ANC initiation and supporting the disadvantaged women such as the uneducated, poor and those living in rural or remote settings.