ArticleFrontiers in public health2025
Spatial disparities of antenatal care utilization among pregnant women in sub-Saharan Africa-Bayesian geo-additive modelling approach.
Article in Frontiers in public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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7 citing papers in PubMed.
- Maternal health literacy among pregnant women attending antenatal care in Ghana: a cross-sectional study.Global epidemiology · 2026Article
- Article
- Spatial disparities and associated factors of composite index of anthropometric failure for under-five children across three African countries.Global epidemiology · 2026Article
- Supervised machine learning algorithms for classifications of gender-based violence in Somalia: a comparison of oversampling techniques.Scientific reports · 2026Article
- Decomposition analysis and spatial change of age disparities in antenatal care utilisation among women with high-risk pregnancies in Nigeria.BMC pregnancy and childbirth · 2026Article
- Determinants of chronic malnutrition among under-five children in Ethiopia using simultaneous quantile regression.Scientific reports · 2025Article
- Mapping the covariate-adjusted spatial effects of childhood anemia in Ethiopia using a semi-parametric additive model.Frontiers in pediatrics · 2025Article
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Abstract
Background: Antenatal care (ANC) is critical for ensuring healthy pregnancies and positive birth outcomes. Despite its importance, significant disparities in ANC access and utilization exist across sub-Saharan Africa (SSA), influenced by various socioeconomic, geographical, and systemic factors. This study aimed to analyze the spatial disparities in the proportion of recommended ANC utilization and its associated risk factors among pregnant women in 34 sub-Saharan African countries. Method: This study utilized the most recent Demographic and Health Survey (DHS) data from 34 countries across the SSA region. To assess the spatial disparities and their associated risk factors of ANC utilization, a geo-additive model via the Integrated Nested Laplace Approximation (INLA) was adopted. Result: The overall prevalence of recommended ANC utilization in SSA was 22.15%, with a significant difference between countries, ranging from 0.27% in Rwanda to 76.28% in Zimbabwe. Both Moran's I and Geary's C tests, with different neighborhood structures, evidenced the existence of spatial autocorrelation of ANC utilization among women in SSA countries. A Bayesian geo-additive model with Besag-York-Mollié (BYM) mixed effect was found to be the best model to assess the spatial dependencies and the non-linear effects of the factors on ANC utilization among women of reproductive age. The study showed that the existence of spatial disparities in ANC utilization and media exposure, as well as the mother's work status, partner's working status, age of mother, age at first cohabitation, and place of delivery, has a significant effect on ANC utilization. Conclusion: The overall coverage of recommended ANC in SSA countries falls short of the global minimum recommended ANC utilization. The lower coverage and inequality of ANC utilizations are influenced by underutilization of healthcare services, economic status, women's education coverage, poor/absence of transportation facilities, and media exposure related to healthy reproduction. Empowering women through different media outlets, strengthening their economic power, easy access to health facilities, and decision-making power increases maternal healthcare service utilization.
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