The Relationship Between Attendance of at Least Four Antenatal Care Visits and Facility Delivery

Abstract

Abstract Background The current global situation is such that 340,000 women still die annually of avoidable maternal health-related complications. Recent statistics in Uganda indicate that maternal deaths among women of age 15 – 49 years are 18% translating to a maternal mortality ratio of 336 deaths per 100,000 live births. Moreover, at least 26% of live deliveries are not attended to by professional practitioners, and 27% are not delivered at a health facility. Additionally, 40% of the last Uganda Demographic and health survey did not attend at least four antenatal care visits, a minimum formerly advocated for before the introduction of the eight contact visits. Methods The study used a cross-sectional research design with the dataset of the most recent UDHS of 2016. A sample of 9869 most recent births for which full information of delivery and ANC was attained, was used. The multilevel logistic regression model was fitted at both bivariate and multivariate levels, as well as a random intercept model to establish latent influence within the communities/clusters. Stata 16 was used for data analysis. Results The results showed that 28.2% Inter class correlation relates to the latent community influence on the health-seeking behavior of mothers on whether to deliver in health facilities or otherwise. Determinants positively associated with facility delivery included at least four ANC (OR=1.59, CI=1.28 – 1.85), professionally employed partner (OR = 1.38; CI =1.09 - 1.74) use of mobile phones (OR =1.23; CI). Those negatively associated include; no education (OR = 0.41; CI = 0.19 - 0.84), unwanted pregnancy (OR=0.98; CI = 0.87 - 1.13), and partner with primary education level (OR = 0.71; CI = 0.51 - 0.99). Conclusion There is a need to ensure sensitization about the 8 ANC visits which the bivariate stage of this study found positively associated with facility delivery, even with limited awareness. More so, advocacy through social marketing to positively influence the latent effect and encourage contraception use or abstinence to avoid unwanted pregnancies.