Abstract:
Abstract
Background: Antenatal Care is a care before birth and includes education, counseling,
screening and treatment to monitor and to promote the wellbeing of the mother and the fetus.
Antenatal Care is an important determinant of safe motherhood and key strategy for reducing
maternal morbidity and mortality. The aim of this study was to investigate factors that influence
the number of antenatal care visits among pregnant women in Ethiopia using EDHS, 2016 data.
Methods: The study design was a cross sectional study design using EDHS, 2016 data. A total of
7174 women aged 15-49 who fulfill the inclusion criterion were considered in this study. Count
multilevel regression models were employed to explore factors associated with the number of
antenatal care visits for pregnant women in Ethiopia.
Results: From this study 34.6% of the pregnant mothers did not received ANC visits during
their period of pregnancy and the variance of the number of antenatal care visits was higher than
its mean so different count regression models were considered to select the best fit for the data.
Among different count regression models, ZIP regression model was found the best fits for the
data. The LRT test suggested that, the number of ANC visits varies among regions and multilevel
count regression model was preferable than the single level count regression model. The expected
number of ANC visits for rural pregnant women was 0.9139 times the expected number of ANC
visits for the urban pregnant women. The study also showed that there is a significant regional
variation for the number of antenatal care visits across regions (
= 0.2465, P - value =
0.0096 and
= 0.1340, P - value = 0.0024)
Conclusions: From the selected multilevel ZIP regression model the study depicted that there
was a significant regional variation for the number of ANC visits across regions. Moreover,
mother education level, exposure to mass media, place of delivery, wealth index and distance to
health facility effects on the number of ANC visits vary across regions of Ethiopia. The predictor
variables residence, husband education, husband occupation, women education, wealth index,
birth order, place of delivery, exposure to mass media, religion and distance to health facility
were identified as significant factors for the number of ANC visits among pregnant women in
Ethiopia. This research also suggested that to reduce inadequate number of ANC visits in
Ethiopia, attention should be given to uneducated women and rural women.
Key words: Antenatal Care, Ethiopia, Zero Inflated Poisson, Multilevel.