Evidence map›Paper›PMID 40468242›Full record

ArticleBMC pregnancy and childbirth2025

Multilevel analysis of late antenatal care booking and its predictors among pregnant women in extremely high and very high maternal mortality sub-Saharan African countries: evidence from recent demographic and health surveys data.

Tesfahun Zemene Tafere, Kaleb Assegid Demissie, Getachew Teshale, Misganaw Guadie Tiruneh, Endalkachew Dellie, Demiss Mulatu Geberu, Asebe Hagos, Nigusu Worku, Melak Jejaw

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Article in BMC pregnancy and childbirth, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2citing papers in PubMed
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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Tesfahun Zemene TafereDepartment of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia. tesfahunzemene4@gmail.com.
Kaleb Assegid DemissieDepartment of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Getachew TeshaleDepartment of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Misganaw Guadie TirunehDepartment of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Endalkachew DellieDepartment of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Demiss Mulatu GeberuDepartment of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Asebe HagosDepartment of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Nigusu WorkuDepartment of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Melak JejawDepartment of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLate booking of antenatal care is a major contributing factor to the high rate of maternal deaths. Despite the World Health Organization's recommendation for pregnant women to begin their first antenatal care visit within 12 weeks of gestation, delays in initiating antenatal care are common in sub-Saharan Africa. Therefore, this study intended to examine the prevalence of late antenatal care booking and its predictors in extremely high (over 1,000 maternal deaths per 100,000 live births) and very high (between 500 and 1,000 maternal deaths per 100,000 live births) maternal mortality sub-Saharan African countries.

methodsOur analysis utilized secondary data from the most recent Demographic and Health Surveys conducted between 2014 and 2022. A weighted sample of 74,552 women who had given birth within five years preceding the survey and had antenatal care visits for their last child were included. A multilevel mixed-effect logistic regression model was fitted. Statistical significance was declared at a p-value less than 0.05.

resultsThe pooled prevalence of late antenatal care booking in extremely high and very high maternal mortality sub-Saharan African countries was 70.16% (95% CI: 69.83,70.49). Poor wealth quantile (AOR = 1.71, 95%CI: 1.60,1.82), low community media exposure (AOR = 1.70, 95%CI: 1.63,1.78), grand multiparous (AOR = 1.66, 95%CI:1.52,1.81), no media exposure (AOR = 1.59, 95%CI, 1.52,1.67), married (AOR = 1.53, 95%CI: 1.44,1.63), middle wealth quantile (AOR = 1.41, 95%CI: 1.33,1.51), not autonomous of house-hold decision-making (AOR = 1.28, 95%CI: 1.22,1.34), multiparous (AOR = 1.27, 95%CI, 1.18,1.35), secondary education (AOR = 1.24, 95%CI: 1.16,1.34), family size of 5+ (AOR = 1.24, 95%CI:1.15,1.33), rural residence (AOR = 1.22, 95%CI: 1.15,1.30), big problem of distance (AOR = 1.20, 95%CI: 1.14,1.26), Not working (AOR = 1.17, 95%CI: 1.11,1.23), partner's no formal education (AOR = 1.17, 95%CI:1.08,1.27), age 15-24 years (AOR = 1.16, 95%CI:1.07,1.25), female household head (AOR = 0.85, 95%CI: 0.80,0.91) were significant predictors of late antenatal care booking.

conclusionsThis study revealed that on average, seven in ten pregnant women in extremely high and very high maternal mortality sub-Saharan African countries booked antenatal care late. Both individual and community-level factors influenced late antenatal care booking. The study recommends empowering women, improving rural healthcare access, and promoting comprehensive ANC education and community-based interventions to address late ANC booking in extremely high and very high maternal mortality SSA countries.

Indexed as

Maternal MortalityPatient Acceptance of Health CarePrenatal CareAdolescentAdultAfrica South of the SaharaFemaleHealth SurveysHumansMultilevel AnalysisPregnancySocioeconomic FactorsTime FactorsYoung AdultAntenatal careDHSLate bookingMultilevel analysisPredictor factorsSSA

Identifiers

PMID40468242
PMCPMC12139056

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