SURVIVAL ANALYSIS OF TIME TO FIRST ANTENATAL CARE VISIT AMONG PREGNANT WOMEN IN ETHIOPIA

ATRSAW, AREFAYNE

dc.contributor.author	ATRSAW, AREFAYNE
dc.date.accessioned	2019-09-25T05:17:18Z
dc.date.available	2019-09-25T05:17:18Z
dc.date.issued	2019-09-25
dc.identifier.uri	http://hdl.handle.net/123456789/9752
dc.description.abstract	Abstract Antenatal care is the systemic supervision of women during pregnancy to monitor the progress of fetal growth and to ascertain the well-being of the mother and fetus. Starting as early as possible within 12 th weeks, all pregnant women should have minimum of four ANC visits. However, the existing evidence from Ethiopia indicate that majority of pregnant mothers did not start their first visit as recommended. The aim of this study was to assess the timing of first ANC visit and identify its determinants among pregnant women in Ethiopia. The 2016 EDHS data were used for this analysis. The study considered all women age 15-49, who had a live birth in the 5 years before the survey from nine regional states and two city administrations. The gestational age at time of first ANC visit for the last pregnancy was taken as the survival time. Descriptive statistics and parametric shared frailty models were employed to identify determinant factors for time to first ANC visit. The accelerated factor (ϕ) were reported to show association of factors with time to first ANC visit where accelerated factor (ϕ) >1 indicates prolonged time-to-first ANC visit, and accelerated factor (ϕ) <1 indicates shorter survival time to first ANC visit. From a total women (N= 7559) only 20.4% started first ANC on recommended time within 12 weeks. The median survival time of first ANC visit in Ethiopia was 18 weeks (4.5 months). The clustering effect was significant for all baseline parametric shared frailty models. A log logistic gamma shared frailty model was preferred over other models based on smallest AIC. Mother‟s rural residence (ϕ = 1.29, 95% CI: 1.19, 1.40), birth order of 2-3, 4-5 and 6+ (ϕ =1.06, 1.08, and 1.21, respectively), long distance to health facility (ϕ = 1.08, 95% CI: 1.04, 1.12), has ϕ >1 acceleration factors, while women‟s primary, secondary and above educational level (ϕ= 0.91 and 0.87 respectively), wealth index middle, rich (ϕ= 0.87 and 0.86 respectively), women‟s had media access (ϕ = 0.92) and women‟s involved on health care decision have ϕ <1 acceleration factor. The finding of this study suggest that spouse‟s high level of education, having media access, urban resident, lower birth order and increasing wealth index of the family shorten time-to-first ANC visit, while residing in rural areas, higher birth order and long distance to health facility prolong time to first ANC visit. The log logistic gamma shared frailty model fits the dataset. Therefore, provide information, education and communication to create community awareness about importance of early ANC visit through health extension workers and concerned bodies. th Keywords: Antenatal Care, timing to first ANC visit, acceleration factor, Determinants, shared frailty.	en_US
dc.language.iso	en_US	en_US
dc.subject	Statistics	en_US
dc.title	SURVIVAL ANALYSIS OF TIME TO FIRST ANTENATAL CARE VISIT AMONG PREGNANT WOMEN IN ETHIOPIA	en_US
dc.type	Thesis	en_US