Factors Affecting the Utilization of Antenatal Care Services During Pregnancy in Bangladesh and 28 Other Low- and Middle-income Countries: A Meta-analysis of Demographic and Health Survey Data

Abstract

The study aimed to identify the factors influencing the utilization of antenatal care (ANC) services among pregnant women to fulfill the Sustainable Development Goals (SDG) for maternal mortality ratio (MMR) by 2030; we also investigated the consistency of these factors. We have used the Demographic and Health Survey (DHS) data from 29 developing countries for analysis. A binary logistic regression model was run using Demographic and Health Survey data from Bangladesh to determine the factors influencing ANC utilization in Bangladesh. In addition, a random-effects model estimation for meta-analysis was performed using DHS data from 29 developing to investigate the overall effects and consistency between covariates and the utilization of ANC services. Logistic regression revealed that residence (odds ratio [OR] 1.436; 95% confidence interval [CI] 1.238, 1.666), respondent’s education (OR 3.153; 95% CI 2.204, 4.509), husband’s education (OR 2.507; 95% CI 1.922, 3.271) wealth index (OR 1.485; 95% CI 1.256, 1.756), birth order (OR 0.786; 95% CI 0.684, 0.904), working status (OR 1.292; 95% CI 1.136, 1.470), and media access (OR 1.649; 95% CI 1.434, 1.896) were the main significant factors for Bangladesh. Meta-analysis showed that residence (OR 2.041; 95% CI 1.621, 2.570), respondent’s age (OR 1.260; 95% CI 1.106, 1.435), respondent’s education level (OR 2.808; 95% CI 2.353, 3.351), husband’s education (OR 2.267; 95% CI 1.911, 2.690), wealth index (OR 2.715; 95% CI 2.199, 3.352), birth order (OR 1.722; 95% CI 1.388, 2.137), and media access (OR 2.474; 95% CI 2.102, 2.913) were the most conclusive factors in a subjects decision to attend ANC. Our results support the augmentation of maternal education and media access in rural areas with ANC services. Particular focus is needed for women from Afghanistan since they have a lower level of ANC services.