ArticleBMC health services research2020
Determinants of subnational disparities in antenatal care utilisation: a spatial analysis of demographic and health survey data in Kenya.
Article in BMC health services research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
30 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Maternal and neonatal health service access and utilisation in sub-Saharan Africa (2015-2023): a systematic review and meta-analysis.BMC health services research · 2026Pooled it
- Compliance with WHO-recommended eight+ antenatal care contacts among adolescent and young mothers in Kenya: policy implications from the 2022 Kenya demographic health survey.Reproductive health · 2026Article
- Completion of the maternal continuum of care in Kenya and Tanzania: role of quality antenatal care and other factors in a cross-sectional study.Research square · 2026Article
- Utilization of antenatal care services among pregnant women in an urban informal settlement in Nairobi, Kenya.BMC pregnancy and childbirth · 2026Article
- Toward a Principled Workflow for Prevalence Mapping Using Household Survey Data.Journal of survey statistics and methodology · 2026Article
- Molecular diagnosis of arboviruses (dengue, Chikungunya, yellow fever, Rift Valley fever, Mayaro, West Nile, and Zika viruses) in non-malaria acute febrile illnesses in Kenya's Garissa County, July 2023, and Mombasa County, July 2024.BMC infectious diseases · 2026Article
- Global health data precarity: Safeguarding the Demographic and Health Survey program as a global public good.Scientific data · 2025Article
- Determinants of antenatal care service utilisation in sub-Saharan Africa: an analysis of demographic and health surveys data (2015-2022).Archives of public health = Archives belges de sante publique · 2025Article
- Satisfaction of Mothers in the Puerperium Period With the Quality of Inpatient Stay: A Cross-Sectional Study in Mogadishu Public Hospitals.Nursing open · 2025Article
- Assessing and adjusting for bias in ecological analysis using multiple sample datasets.BMC medical research methodology · 2025Article
- Individual and community level factors of malaria among under-five children in Kenya: Based on the Kenya Demographic and Health Survey.PloS one · 2025Article
- Only 9% of mothers have eight and more ANC visit in 14 sub-saharan African countries; evidence from the most recent DHS 2018-2023: a multilevel analysis.BMC public health · 2024Article
- Utilization of Antenatal Care and Skilled Birth Delivery Services in Sub-Saharan Africa: A Systematic Scoping Review.International journal of environmental research and public health · 2024Article
- Determinants of quality antenatal care use in Kenya: Insights from the 2022 Kenya Demographic and Health Survey.PLOS global public health · 2024Article
- Adapting the preterm birth phenotyping framework to a low-resource, rural setting and applying it to births from Migori County in western Kenya.BMC pregnancy and childbirth · 2023Observational
- Predicting the drop out from the maternal, newborn and child healthcare continuum in three East African Community countries: application of machine learning models.BMC medical informatics and decision making · 2023Article
- Early Sexual Debut and the Associated Factors among School Going Adolescents in Selected Schools in Kenya.The East African health research journal · 2023Article
- Spatial variation and inequities in antenatal care coverage in Kenya, Uganda and mainland Tanzania using model-based geostatistics: a socioeconomic and geographical accessibility lens.BMC pregnancy and childbirth · 2022Article
- Article
- Acceptability and feasibility of community-based provision of urine pregnancy tests to support linkages to reproductive health services in Western Kenya: a qualitative analysis.BMC pregnancy and childbirth · 2022Article
Corrections and comments
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Authors and funding
4 authors.
Funding
Abstract
backgroundThe spatial variation in antenatal care (ANC) utilisation is likely associated with disparities observed in maternal and neonatal deaths. Most maternal deaths are preventable through services offered during ANC; however, estimates of ANC coverage at lower decision-making units (sub-county) is mostly lacking. In this study, we aimed to estimate the coverage of at least four ANC (ANC4) visits at the sub-county level using the 2014 Kenya Demographic and Health Survey (KDHS 2014) and identify factors associated with ANC utilisation in Kenya.
methodsData from the KDHS 2014 was used to compute sub-county estimates of ANC4 using small area estimation (SAE) techniques which relied on spatial relatedness to yield precise and reliable estimates at each of the 295 sub-counties. Hierarchical mixed-effect logistic regression was used to identify factors influencing ANC4 utilisation. Sub-county estimates of factors significantly associated with ANC utilisation were produced using SAE techniques and mapped to visualise disparities.
resultsThe coverage of ANC4 across sub-counties was heterogeneous, ranging from a low of 17% in Mandera West sub-county to over 77% in Nakuru Town West and Ruiru sub-counties. Thirty-one per cent of the 295 sub-counties had coverage of less than 50%. Maternal education, household wealth, place of delivery, marital status, age at first marriage, and birth order were all associated with ANC utilisation. The areas with low ANC4 utilisation rates corresponded to areas of low socioeconomic status, fewer educated women and a small number of health facility deliveries.
conclusionSuboptimal coverage of ANC4 and its heterogeneity at sub-county level calls for urgent, focused and localised approaches to improve access to antenatal care services. Policy formulation and resources allocation should rely on data-driven strategies to guide national and county governments achieve equity in access and utilisation of health interventions.
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