Individual and contextual factors associated with antenatal care utilization among women of reproductive age in South Africa

Abstract

Background: The main objective of this study was to determine the individual and contextual determinants of using eight or more antenatal visits among women of reproductive age in South Africa. Over eight in ten pregnant women worldwide receive antenatal care (ANC) from a qualified practitioner at least once, whereas 65% receive about four visits. For most countries, not much is known about the new recommendations of eight or more ANC visits. Methods: This study used secondary data from the 2016 South African Demographic and Health Survey (SADHS). Three types of analyses were chosen; these included univariate, bivariate, and multivariate analyses. Results: The findings showed that age at birth, birth order, population group, marital status, employment status, media exposure, place of residence, household wealth and province were statistically associated with 8+ ANC visits (p<0.05). The findings also showed that the use of 8+ ANC visits fluctuates with age at birth. There was a high prevalence (18.5%) of 8+ ANC visits among women whose first birth was at age 20-34 and those whose first birth was at age 35-49 (16.0%). Women with birth order 2-3 had the highest prevalence of 8+ ANC visits (18.4%), followed by those with birth order 1 (16.8%). Women from the ‘other’ population group had a higher prevalence of 8+ ANC visits (31.2%), followed by those from the coloured population group (25.9%), while women from the black population group had the lowest prevalence of 8+ ANC visits (16.0%). In reference to marital status, women who were currently in union had a higher prevalence of 8+ ANC visits (19.2%) and those who were formerly in union had a 17.9% prevalence of 8+ ANC visits. Conclusion: The findings show that the use of 8+ ANC visits is low among women of reproductive age in South Africa. The study findings revealed that factors such as age at birth, birth order, population group, marital status, employment status, media exposure, place of residence, household wealth and province were important factors in the use of 8+ ANC visits. The findings further revealed that community-level factors were important in explaining the use of 8+ ANC visits among women in the country. There should be a provision of more clinics in rural areas; this will improve women's accessibility to maternal health facilities and shorten the travelling time between their home and the nearby clinic, and therefore this will increase their ANC attendance.