The determinants of access to antenatal care services in Uganda

Abstract

Access to Antenatal care (ANC) reduces maternal mortality and improves health outcomes. Developing countries like Uganda follow the World Health Organization’s (WHO) recommendation of four ANC visits within the first four months of pregnancy and at least four or more ANC visits during the course of an uncomplicated pregnancy. The study aimed at; a) Examining factors that determine access of ANC services in Uganda, b) Investigating the significant predictors of accessing ANC services four or more times during pregnancy. The 2016 UDHS data was analyzed using STATA 13.0 for 10,156 women, with significant predictors of women accessing ANC services four or more times defined by socio-economic factors such as; age, highest education level, type of place of residence, marital status, wealth index, and parity. Cross tabulations were used to investigate variations in ANC access across socio-economic groups, while the in-depth multivariate logistic regression analysis was used to examine socio-economic factors which influence access to ANC services. The socio-economic factors significantly associated to accessing ANC services four or more times, were; younger women, the highly educated, living in urban areas, being married, from a household belonging to the highest wealth quintile and women who had had four or fewer children in the past. The results of this study suggest that; interventions to increase accessibility and availability of maternal health services are important, particularly for women from rural communities and hard to reach areas, improving the quality and capacity of the health care providers, as well as extending financial support to enable women in the lowest wealth quintile access and use health care services. Maternal health promotion programs targeting mothers with low education are important in increasing awareness about the importance of accessing ANC services.