Factors Associated with the Utilization of Antenatal Care Services among Pregnant Women: Data Analysis of the Cambodia Demographic and Health Survey 2014

Keywords

Maternal and child health
Antenatal care
ANC visit
CDHS
Cambodia

Abstract

Introduction

Maternal and child health (MCH) is one of the most significant health and development concerns worldwide, especially in low- and middle-income countries, because these countries have higher rates of mortality and morbidity than do developed countries. Antenatal care (ANC) lowers maternal and perinatal morbidity and mortality through the early detection and treatment of pregnancy-related complications as well as the identification of women and girls who are more likely than others to experience complications during labor and delivery. This study aimed to identify the proportion of pregnant women with at least four ANC visits (ANC 4) and assess the associations between socioeconomic and maternal health characteristics and ANC 4 or more visits to the last childbirth in the past five years preceding the survey.

Methods

This study used existing women’s data aged 15-49 years from the Cambodia Demographic Health Survey (CDHS) 2014. We restricted our sample to women who had given birth and had at least ANC 4 visits for the last childbirth, with a total eligible sample of 5972. As CDHS is a complex survey design, we used weighted analysis taking into account the cluster design and sampling weight. We used Stata 14 for the data analysis. Chi-square tests and multiple logistic regression analyses were conducted to assess the independent associations between factors and at least 4 ANC visits reported as adjusted odds ratios (AORs) and 95% CIs. P values <0.05 were considered statistically significant.

Results

Overall, 75.9% of the women had at least 4 ANC visits during their last childbirth. Having at least four ANC visits was significantly associated with mothers aged 21--34 years (AOR=1.62, 95% CI 1.15, 2.27), mothers aged 35--49 years (AOR=1.65, 95% CI 1.08, 2.53), mothers completing primary school (AOR=1.44, 95% CI 1.16, 1.79), mothers who had completed secondary school or higher (AOR=1.70, 95% CI 1.27, 2.27), and women from a higher wealth index household with AOR=2.04 (95% CI 1.52, 2.73). Furthermore, women who had their first pregnancy at the age of 25--49 years (AOR=1.28, 95% CI 1.02, 1.61), mothers who had five or more living children (AOR= 0.40, 95% CI 0.25, 0.63), mothers who had delivered their last baby at health institution (AOR=3.12, 95% CI, 2.52, 3.87), and women who listened to radio at least once a week (AOR=1.38, 95% CI, 1.09, 1.75).

Conclusion

Close to 76% of mothers received at least four ANC visits, which was higher than that reported by CDHS 2010 (59%) but lower than that reported by CDHS 2021-2022. Having at least four ANC visits were significantly associated with mothers’ sociodemographic characteristics and maternal health factors. Efforts to further improve ANC utilization should pay particular attention to women who are poor, with many living children, and encourage them to use health institutions and work with different media so that women can easily access information about maternal health, particularly ANC services.