Analyzing Predictors and Geospatial Trends of the Number of Visits and Timing of Antenatal Care in Zambia: A Generalized Linear Mixed Model (GLMM) Investigation from 1992 to 2018

Author:

Shumba SamsonORCID,Fwemba Isaac,kaymba Violet

Abstract

AbstractAntenatal care (ANC) plays a crucial role in preventing and detecting pregnancy risks, facilitating prompt treatment, and disseminating essential information to expectant mothers. This role is particularly vital in developing countries, where a 4.65% rise in maternal mortality rate was observed in 2022, with 800 maternal and 7,700 perinatal deaths reported. The study aims to analyse the predictors and geospatial trends of the number of visits and timing of antenatal care in Zambia from 1992 to 2018, utilizing a generalised linear mixed model approach. The analysis utilized the Zambia Demographic Health Survey (ZDHS) database. The relationship between dependent and independent variables was examined using the Rao-Scott Chi-square test. Predictors of inadequate utilisation of ANC were identified through the multilevel generalised linear model. Spatial effects were modeled using Quantum Geographic Information System (QGIS) version 3.34.1 to develop univariate choropleth maps. A total of 45, 140 (31, 482 women had less than 8 ANC visits and 2, 004 had 8 or more ANC visits) women with a prior childbirth were included in the study. The findings in the study revealed that among women aged 15 to 19 years in 1992, 1996 and 2013/14, the rates of inadequate antenatal care utilization (less than eight ANC visits) was 90.87%, 90.99%, and 99.63%, respectively. Lack of formal education was associated with inadequate ANC from 1992 to 2018, with percentages ranging from 91.12% to 99.64%. They were notable geospatial variations in the distribution of ANC underutilization across provinces with Luapula, Muchinga, Northwestern, Northern and Eastern recording higher proportions. Furthermore, the study showed that age (25 to 29 and 30 to 34) was associated with increased risk of inadequacy ANC utilization (AOR, 2.94; 95% CI, 1.20 – 7.19 and AOR, 2.65; 95% CI, 1.05 – 6.65 respectively). Higher education and wealth index correlated with reduced odds of inadequate ANC utilization. In conclusion, this study highlights worrisome trends in ANC utilization in Zambia, with a significant rise in inadequacy, especially in adhering to the WHO’s recommended eight ANC visits. Over the period from 1996 to 2018, there was a discernible decline in the prevalence of delayed initiation of ANC. The findings underscore a notable disparity between current ANC practices and established guidelines. Additionally, various factors predicting suboptimal ANC attendance have been identified. These insights call for targeted interventions to address the identified challenges and improve the overall quality and accessibility of ANC services in Zambia.

Publisher

Cold Spring Harbor Laboratory

Reference47 articles.

1. WHO, 2020. Maternal mortality (who.int). https://www.who.int/news-room/fact-sheets/detail/maternal-mortality#:∼:text=Key%20facts,dropped%20by%20about%2034%25%20worldwide.

2. World Health Organization, UNICEF, United Nations Population Fund and The World Bank, Trends in Maternal Mortality: 2000 to 2017 WHO, Geneva, 2019. (2)

3. UN Inter-agency Group for Child Mortality Estimation (UNICEF, WHO UNPD, WB), 2021

4. UNICEF, 2023. Improving Emergency Obstetric Care, A Top Priority to Save Lives of Mothers and Newborns | UNICEF Zambia. https://www.unicef.org/zambia/stories/improved-emergency-obstetric-care-saves-mothers-and-newborns-lives

5. World Health Organization & United Nations Children’s Fund. Accountability for maternal, newborn and child survival: The 2013 Update. Countdown to 2015 maternal, newborn and child survival. Geneva: WHO Press; 2013. From http://www.who.int/woman_child_accountability/ierg/reports/Countdown_Accountability_2013Report.pdf. (Accessed 24 October 2013).

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3