Factors affecting the utilization of antenatal care services among pregnant women—Ashgabat, Turkmenistan, 2010

Author (s): 

Maral Aksakova, Head of HIV Surveillance and Parasitology Department, Ministry of health, Turkmenistan

Introduction: Antenatal care (ANC) plays an important role in improving pregnancy outcomes and in preventing maternal and fetal mortality and morbidity. According to the Public Health Law in Turkmenistan, ANC services are totally free and are offered to all pregnant women; the scope of services is in accordance with the national recommendations. The purpose of this study is to estimate the rate of and factors affecting utilization of ANC in Ashgabat, the capital city of Turkmenistan. Methods: We used systematic sampling to enroll in a cross-sectional study1000 women who delivered babies in 2010 in any of the city’s six maternity hospitals. We defined no utilization as not visiting ANC centers while pregnant. Through interviews, we collected information on the women’s demographics, socio-economic, behavioral, and other relevant ANC factors. Information on utilization of ANC was obtained from medical records. In multivariate analysis, a logistic regression model was fitted to estimate adjusted odds ratios for ANC determinants Results: of the 1000 women enrolled in the study, 78 (8%) never received antenatal care (95% CI 6.1%-9.4%), 404 (40%) were primipara and 663 (67%) were from low income families (<400 USD/month). In multivariate analysis, less likely to attend for ANC were: primipara women (OR=21.9, 95% CI 6.7 -71.5) and women from low income families (OR=2.5, 95% CI 1.1 -5.4). Conclusion: Primipara women and women from low income families are at higher risk for not attending ANC. We recommend the provision of educational interventions to women from poor neighborhoods and those wanting to have babies for the first time. Those messages can be distributed through mass media, community workers, and schools. Financial support for poor women should also be considered.

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