Factors Affecting Antenatal Care Utilization Among the Disadvantaged Dalit Population of Nepal: A Cross- sectional Study

Abstract

Background: Antenatal Care (ANC) visits are intended to prevent, identify and treat conditions that may threaten the health of the mother and newborn, and to increase the chance she has a smooth pregnancy and and safe childbirth. The most disadvantaged and underprivileged caste (Dalit) of Nepal has benefitted the least from maternal health service improvements in the recent years. Objective: This study was conducted to determine the rate and factors associated with the antenatal care service utilization among the most disadvantaged ethnic group (Dalit women) and recommend interventions to improve ANC utilisaiton, in the Mahottari district of Nepal. Methods: A cross-sectional study was conducted during July-December 2014 using a structured questionnaire. A total of 328 recently delivered mothers were interviewed covering the entire district. Descriptive statistics, binary and multivariable logistic regression analyses were computed. Statistical significance was considered at p < 0.05 and the strength of statistical association was assessed by odds ratios with 95% confidence intervals. Results: ANC utilization rate (≥ 4 ANC visit) was found to be 42%. Mother’s education, husband’s education, mother’s occupation, perceived “good quality” ANC, hearing about incentive program, maternal health message, non-perception of health workers behaviours as discriminatory, and exposure to Female Community Health Volunteer were found to be significantly associated with ANC utilization. Conclusion: ANC service utilization is low. So, there is an urgent need to address the issue of ANC quality and discriminatory behaviour of health workers toward Dalit. A targeted and comprehensive maternal health program should be developed to raise awareness and motivate pregnant women for maximum utilisation of ANC services. © 2019 Open Public Health Journal. All rights reserved.