Economic factors influencing utilization of world health organization recommended ANC visits among women in Jordan: an analysis of Jordan population and family health survey 2023.

backgroundAntenatal care (ANC) is crucial for reducing maternal and neonatal mortality by identifying and managing complications early during pregnancy. In 2016, the World Health Organization (WHO) updated its guidelines, recommending a minimum of eight ANC visits to improve maternal health outcomes. Despite Jordan's efforts to enhance maternal healthcare, disparities in ANC utilization persist, particularly among vulnerable populations such as refugees. This study aimed to assess the economic factors influencing utilization of the WHO-recommended eight ANC visits among women in Jordan.

methodsThe study used data from the 2023 Jordan Population and Family Health Survey (JPFHS). A two-stage sampling technique was employed, selecting 12,595 women aged 15-49 years. The primary outcome was the number of ANC visits, categorized as less than eight and eight or more visits. Economic variables such as wealth index, bank account ownership, land and house ownership, and decision-making power on household purchases were analyzed. Bivariate and multivariate logistic regressions were conducted to assess the relationship between economic factors and ANC utilization.

resultsOf the women surveyed, 89.2% attended at least eight ANC visits. Wealth index emerged as the only significant economic factor influencing ANC utilization. Women from richer (aOR = 0.59, 95% CI: 0.38-0.94), middle (aOR = 0.44, 95% CI: 0.28-0.70), poorer (aOR = 0.43, 95% CI: 0.27-0.70), and poorest (aOR = 0.23, 95% CI: 0.15-0.37) wealth indices were less likely to utilize the WHO-recommended eight ANC visits compared to those in the richest wealth index. Additionally, socio-demographic factors such as women from female-headed households, those who initiated ANC after the first trimester, those not visited by a field worker, women who involved their partners in healthcare decision-making, and Syrian refugees living in camps were associated with more likelihood of utilizing eight or more ANC visits. Furthermore, lower odds of utilizing the WHO-recommended ANC visits were found among women from the Southern region, households with five or more members, and those not using the internet.

conclusionEconomic disparities play a critical role in influencing ANC utilization in Jordan. Targeted interventions, such as financial support for low-income women and addressing regional healthcare access inequalities, could enhance ANC coverage. These findings underscore the need for policies that address both direct and indirect costs associated with maternal healthcare.