Differential Associated Factors for Inadequate Receipt of Components and Non-Use of Antenatal Care Services among Adolescent, Young, and Older Women in Nigeria
Abstract
:1. Introduction
2. Materials and Methods
2.1. Data Sources
2.2. Outcome Variables
2.3. Potential Confounding Variables
2.4. Statistical Analysis
3. Results
3.1. Characteristics of the Sample among Adolescent, Young, and Older Women
3.2. Components of ANC Services Received by Participants
3.3. Prevalence and 95% Confidence Intervals (Cis) of Receipt of ANC Services
3.4. Factors Associated with Inadequate Receipt and Non-Use of ANC Services
3.4.1. Women Aged 15–19 Years
3.4.2. Women Aged 20–34 Years
3.4.3. Women Aged 35–49 Years
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Abbreviations
References
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Characteristics | Adolescent (N * = 1210) | Young (N * = 14,649) | Older (N * = 6013) |
---|---|---|---|
(n, %) * | (n, %) * | (n, %) * | |
External Factors | |||
Geographical region | |||
North Central | 143 (11.9) | 2119 (14.5) | 763 (12.7) |
North East | 288 (23.8) | 2595 (17.7) | 975 (16.2) |
North West | 581 (48.0) | 5058 (34.5) | 2000 (33.3) |
South East | 69 (5.7) | 1387 (9.5) | 675 (11.2) |
South West | 77 (6.3) | 1361 (9.3) | 574 (9.6) |
South-South | 51 (4.2) | 2129 (14.5) | 1025 (17.1) |
Type of place of residence | |||
Urban | 243 (20.1) | 5836 (39.8) | 2611 (43.4) |
Rural | 967 (79.9) | 8813 (60.2) | 3402 (56.6) |
Predisposing factors | |||
Maternal Factors | |||
Household Wealth Index | |||
Rich | 42 (3.4) | 2523 (17.2) | 1217 (20.2) |
Middle | 414 (34.3) | 5845 (39.9) | 2275 (37.8) |
Poor | 754 (62.3) | 6282 (42.9) | 2521 (41.9) |
Mother’s working status | |||
Non-working | 718 (59.4) | 5347 (36.5) | 1450 (24.1) |
Working | 492 (40.7) | 9302 (63.5) | 4563 (75.9) |
Husband’s Education | |||
Secondary | 359 (33.8) | 7149 (52.6) | 2606 (46.4) |
Primary | 139 (13.1) | 1747 (12.9) | 940 (16.7) |
No education | 564 (53.2) | 4697 (34.6) | 2072 (36.9) |
Husband’s occupation | |||
Non-agricultural work | 566 (46.8) | 8480 (57.9) | 3297 (54.8) |
Agricultural work | 466 (38.5) | 4820 (32.9) | 2167 (36.1) |
Unemployed | 178 (14.7) | 1349 (9.2) | 549 (9.1) |
Mother’s Education | |||
Secondary | 321 (26.6) | 6476 (44.2) | 2058 (34.2) |
Primary | 157 (13.0) | 2043 (13.9) | 1083 (18.0) |
No education | 731 (60.5) | 6131 (41.9) | 2872 (47.8) |
Mother’s marital status | |||
Currently married | 1085 (89.7) | 13,816 (94.3) | 5701 (94.8) |
Never in marriage | 125 (10.3) | 833 (5.7) | 312 (5.2) |
Place of delivery | |||
Home | 872 (72.1) | 6067 (41.4) | 2590 (43.1) |
Health Facility | 338 (27.9) | 8582 (58.6) | 3423 (56.9) |
Wanted pregnancy at the time | |||
Then | 1046 (86.5) | 13,000 (88.7) | 5172 (86.0) |
Later | 158 (13.1) | 1431 (9.8) | 341 (5.7) |
No more | 6 (0.5) | 218 (1.5) | 500 (8.3) |
Child Factors | |||
Preceding birth interval | |||
None | 968 (80.0) | 2696 (18.4) | 128 (2.1) |
Short/long interval | 242 (20.0) | 11,954 (81.6) | 5886 (97.9) |
Birth Order | |||
1 | 964 (79.7) | 2666 (18.2) | 123 (2.1) |
2 to 4 | 246 (20.3) | 8387 (57.3) | 1445 (24.0) |
5 | 3597 (24.6) | 4446 (73.9) | |
Health knowledge | |||
Frequency of reading newspapers or magazine | |||
At least once a week | 17 (1.4) | 468 (3.2) | 220 (3.7) |
Less than once a week | 48 (4.0) | 1272 (8.7) | 522 (8.7) |
Never | 1144 (94.6) | 12,909 (88.1) | 5272 (87.7) |
Frequency of listening to the radio | |||
At least once a week | 222 (18.4) | 4130 (28.2) | 1937 (32.2) |
Less than once a week | 233 (19.2) | 3697 (25.2) | 1406 (23.4) |
Never | 755 (62.4) | 6822 (46.6) | 2669 (44.4) |
Frequency of watching television | |||
At least once a week | 149 (12.3) | 4168 (28.5) | 1640 (27.3) |
Less than once a week | 184 (15.3) | 2486 (17.0) | 1125 (18.7) |
Never | 877 (72.5) | 7996 (54.6) | 3248 (54.0) |
Enabling Factors | |||
Seek permission to visit health services | |||
Big problem | 184 (15.2) | 1692 (11.6) | 726 (12.1) |
Not a big problem | 1026 (84.8) | 12,958 (88.5) | 5287 (87.9) |
Getting money to pay for health services | |||
Big problem | 632 (52.3) | 6990 (47.7) | 2925 (48.6) |
Not a big problem | 578 (47.8) | 7659 (52.3) | 3088 (51.4) |
Distance to a health facility | |||
Big problem | 425 (35.1) | 4022 (27.5) | 1667 (27.7) |
Not a big problem | 785 (64.9) | 10,628 (72.6) | 4346 (72.3) |
Accompany to a health facility | |||
Big problem | 263 (21.7) | 2292 (15.7) | 875 (14.6) |
Not a big problem | 947 (78.3) | 12,357 (84.4) | 5138 (85.5) |
Antenatal care services | |||
Antenatal Clinical visits | |||
8+ | 76 (6.5) | 2165 (15.6) | 969 (17.2) |
4 to 7 | 415 (35.4) | 5547 (39.9) | 2118 (37.5) |
1 to 3 | 279 (23.8) | 2564 (18.4) | 911 (16.1) |
None | 402 (34.3) | 3629 (26.1) | 1652 (29.2) |
Uptake of receipt of Antenatal care | |||
Receipt of adequate | 76 (6.3) | 2165 (14.8) | 969 (16.1) |
Receipt of inadequate | 692 (57.2) | 8069 (55.1) | 3017 (50.2) |
Non-ANC | 442 (36.5) | 4416 (30.1) | 2026 (33.7) |
Variable | Adolescent (N * = 1210) | Young (N * = 14,649) | Older (N * = 6013) | All Women (N * = 21,872) | ||||
---|---|---|---|---|---|---|---|---|
n * | % * (95% CI) | n * | % * (95% CI) | n * | % * (95% CI) | n * | % * (95% CI) | |
Given iron tablets/syrup | ||||||||
Yes | 758 | 62.6 (58.6, 66.5) | 10,336 | 70.6 (68.6, 72.4) | 4067 | 67.6 (65.4, 69.8) | 15,161 | 69.3 (67.5, 71.1) |
Taken drugs for intestinal parasites | ||||||||
Yes | 153 | 12.7 (10.6, 15.1) | 2575 | 17.6 (16.5, 18.7) | 932 | 15.5 (14.3, 16.8) | 3660 | 16.7 (15.8, 17.7) |
Had tetanus injections before birth | ||||||||
Yes | 734 | 60.7 (56.7, 64.5) | 10,423 | 71.2 (69.3, 72.9) | 4079 | 67.8 (65.7, 69.9) | 15,235 | 69.6 (67.9, 71.4) |
Blood pressure taken | ||||||||
Yes | 733 | 60.6 (56.6, 64.5) | 10,579 | 72.2 (70.2, 74.2) | 4222 | 70.2 (68.1, 72.3) | 15,535 | 71.0 (69.1, 72.9) |
Had blood sample taken | ||||||||
Yes | 650 | 53.7 (49.9, 57.4) | 9894 | 67.5 (65.5, 69.5) | 3949 | 65.7 (63.4, 67.9) | 14,493 | 66.3 (64.3, 68.2) |
Had urine sample taken | ||||||||
Yes | 652 | 53.9 (49.9, 57.9) | 9744 | 66.5 (64.4, 68.5) | 3890 | 64.7 (62.5, 66.9) | 14,286 | 65.3 (63.4, 67.2) |
Characteristics | Inadequate Receipt of ANC | Non-ANC | ||||||
---|---|---|---|---|---|---|---|---|
Unadjusted OR | p-Value | Adjusted OR | p-Value | Unadjusted OR | p-Value | Adjusted OR | p-Value | |
Place of delivery | ||||||||
Health Facility | 1.00 | 1.00 | 1.00 | 1.00 | ||||
Home | 7.78 (4.12, 14.68) | <0.001 | 3.40 (1.52, 7.61) | <0.001 | 31.86 (14.94, 67.97) | <0.001 | 4.70 (2.08, 11.35) | <0.001 |
Distance to a health facility | ||||||||
Not a big problem | 1.00 | 1.00 | 1.00 | 1.00 | ||||
Big problem | 2.26 (1.15, 4.45) | 0.018 | 2.06 (0.91, 4.69) | 0.083 | 5.51 (2.80, 10.88) | <0.001 | 16.53 (6.71, 40.73) | <0.001 |
Geographical region | ||||||||
North Central | 1.00 | 1.00 | 1.00 | 1.00 | ||||
North East | 7.22 (2.01, 25.93) | 0.002 | 5.02 (1.38, 18.26) | 0.014 | 4.65 (1.24, 17.39) | 0.022 | 2.10 (0.54, 8.10) | 0.281 |
North West | 3.43 (1.12, 10.50) | 0.031 | 2.23 (0.67, 7.45) | 0.189 | 2.72 (0.87, 8.47) | 0.085 | 1.23 (0.36, 4.24) | 0.733 |
South East | 0.21 (0.08, 0.56) | 0.002 | 0.24 (0.09, 0.66) | 0.005 | 0.10 (0.03, 0.32) | <0.001 | 0.18 (0.06, 0.59) | 0.005 |
South West | 0.29 (0.10, 0.84) | 0.023 | 0.21 (0.08, 0.61) | 0.004 | 0.24 (0.08, 0.67) | 0.007 | 0.13 (0.05, 0.40) | <0.001 |
South South | 0.07 (0.02, 0.20) | <0.001 | 0.08 (0.03, 0.26) | <0.001 | 0.05 (0.02, 0.16) | <0.001 | 0.09 (0.03, 0.36) | 0.001 |
Type of place of residence | ||||||||
Urban | 1.00 | 1.00 | 1.00 | 1.00 | ||||
Rural | 7.78 (4.12, 14.69) | <0.001 | 3.40 (1.52, 7.61) | 0.003 | 31.87 (14.94, 67.97) | <0.001 | 16.53 (6.71, 40.73) | <0.001 |
Characteristics | Inadequate Reciept of ANC | Non-ANC | ||||||
---|---|---|---|---|---|---|---|---|
Unadjusted OR | p-Value | Adjusted OR | p-Value | Unadjusted OR | p-Value | Adjusted OR | p-Value | |
Maternal Factors | ||||||||
Mother’s working status | ||||||||
Not working | 1.00 | 1.00 | 1.00 | 1.00 | ||||
working | 0.50 (0.42, 0.59) | <0.001 | 0.97 (0.81, 1.16) | 0.763 | 0.39 (0.33, 0.48) | <0.001 | 0.80 (0.66, 0.97) | 0.025 |
Mother’s Education | ||||||||
Secondary | 1.00 | 1.00 | 1.00 | 1.00 | ||||
Primary | 3.04 (2.48, 3.75) | <0.001 | 1.52 (1.24, 1.87) | <0.001 | 3.39 (2.68, 4.27) | <0.001 | 1.57 (1.25, 1.96) | <0.001 |
No education | 11.21 (8.89, 14.14) | <0.001 | 1.35 (1.02, 1.78) | 0.034 | 28.38 (21.95, 36.70) | <0.001 | 3.09 (2.34, 4.08) | <0.001 |
Contraceptive use | ||||||||
Yes | 1.00 | 1.00 | 1.00 | 1.00 | ||||
No | 2.95 (2.53, 3.44) | <0.001 | 1.44 (1.21, 1.71) | <0.001 | 4.98 (4.17, 5.95) | <0.001 | 1.73 (1.42, 2.11) | <0.001 |
Wanted pregnancy at the time | ||||||||
Then | 1.00 | 1.00 | 1.00 | 1.00 | ||||
Later | 0.58 (0.48, 0.70) | <0.001 | 1.05 (0.86, 1.27) | 0.657 | 0.51 (0.42, 0.62) | <0.001 | 1.07 (0.86, 1.33) | 0.559 |
No more | 0.63 (0.40, 0.97) | 0.038 | 1.36 (0.83, 2.22) | 0.224 | 1.12 (0.71, 1.78) | 0.626 | 2.37 (1.41, 3.99) | 0.001 |
Frequency of reading newspapers or magazine | ||||||||
At least once a week | 1.00 | 1.00 | 1.00 | 1.00 | ||||
Less than once a week | 0.76 (0.55, 1.04) | 0.087 | 0.67 (0.48, 0.94) | 0.020 | 1.12 (0.72, 1.74) | 0.606 | 0.87 (0.53, 1.41) | 0.566 |
Never | 1.91 (1.42, 2.56) | <0.001 | 0.70 (0.51, 0.96) | 0.026 | 4.73 (3.30, 6.79) | <0.001 | 0.76 (0.50, 1.15) | 0.194 |
Frequency of watching television | ||||||||
At least once a week | 1.00 | 1.00 | 1.00 | 1.00 | ||||
Less than once a week | 1.14 (0.97, 1.35) | 0.107 | 1.17 (0.98, 1.40) | 0.087 | 1.52 (1.26, 1.83) | <0.001 | 1.34 (1.09, 1.64) | 0.005 |
Never | 2.61 (2.16, 3.14) | <0.001 | 1.03 (0.84, 1.26) | 0.797 | 5.05 (4.09, 6.25) | <0.001 | 1.43 (1.14, 1.78) | 0.002 |
Seek permission to visit health services | ||||||||
Not a big problem | 1.00 | 1.00 | 1.00 | 1.00 | ||||
Big problem | 0.75 (0.56, 1.02) | 0.064 | 0.85 (0.63, 1.15) | 0.304 | 2.25 (1.66, 3.06) | <0.001 | 1.62 (1.17, 2.24) | 0.003 |
Getting money to pay for health services | ||||||||
Not a big problem | 1.00 | 1.00 | 1.00 | 1.00 | ||||
Big problem | 1.46 (1.24, 1.72) | <0.001 | 1.10 (0.89, 1.35) | 0.367 | 2.35 (1.94, 2.85) | <0.001 | 1.31 (1.03, 1.66) | 0.027 |
Child Factors | ||||||||
Preceding birth interval | ||||||||
None | 1.00 | 1.00 | 1.00 | 1.00 | ||||
Short/long interval | 2.05 (1.79, 2.35) | <0.001 | 1.22 (1.05, 1.41) | 0.008 | 2.58 (2.19, 3.04) | <0.001 | 1.23 (1.03, 1.48) | 0.023 |
Household Factors | ||||||||
Geographical region | ||||||||
North Central | 1.00 | 1.00 | 1.00 | 1.00 | ||||
North East | 5.59 (3.36, 9.31) | <0.001 | 4.28 (2.58, 7.08) | <0.001 | 4.11 (2.35, 7.19) | <0.001 | 1.73 (1.01, 2.96) | 0.046 |
North West | 3.97 (2.63, 6.01) | <0.001 | 2.96 (1.95, 4.48) | <0.001 | 4.45 (2.79, 7.10) | <0.001 | 1.77 (1.15, 2.73) | 0.010 |
South East | 0.29 (0.20, 0.42) | <0.001 | 0.39 (0.27, 0.57) | <0.001 | 0.13 (0.08, 0.20) | <0.001 | 0.41 (0.27, 0.62) | <0.001 |
South West | 0.18 (0.13, 0.26) | <0.001 | 0.20 (0.15, 0.28) | <0.001 | 0.25 (0.17, 0.36) | <0.001 | 0.42 (0.30, 0.59) | <0.001 |
South South | 0.08 (0.06, 0.12) | <0.001 | 0.12 (0.09, 0.18) | <0.001 | 0.13 (0.09, 0.19) | <0.001 | 0.41 (0.29, 0.59) | <0.001 |
Household Wealth Index | ||||||||
Rich | 1.00 | 1.00 | 1.00 | 1.00 | ||||
Middle | 2.82 (2.25, 3.53) | <0.001 | 1.30 (1.05, 1.61) | 0.014 | 2.76 (2.24, 3.40) | <0.001 | 1.02 (0.79, 1.31) | 0.870 |
Poor | 10.66 (8.11, 14.02) | <0.001 | 1.23 (0.93, 1.63) | 0.154 | 22.73 (17.2, 30.03) | <0.001 | 1.51 (1.10, 2.08) | 0.011 |
Type of place of residence | ||||||||
Urban | 1.00 | 1.00 | 1.00 | 1.00 | ||||
Rural | 4.78 (4.04, 5.65) | <0.001 | 1.57 (1.31, 1.88) | <0.001 | 14.24 (11.4, 17.78) | <0.001 | 4.06 (3.33, 4.95) | <0.001 |
Characteristics | Inadequate Receipt of ANC | Non-ANC | ||||||
---|---|---|---|---|---|---|---|---|
Unadjusted OR | p-Value | Adjusted OR | p-Value | Unadjusted OR | p-Value | Adjusted OR | p-Value | |
Mother’s working status | ||||||||
Not working | 1.00 | 1.00 | 1.00 | 1.00 | ||||
Working | 0.47 (0.36, 0.61) | <0.001 | 0.88 (0.62, 1.25) | 0.472 | 0.28 (0.21, 0.36) | <0.001 | 0.54 (0.38, 0.75) | <0.001 |
Mother’s Education | ||||||||
Secondary | 1.00 | 1.00 | 1.00 | 1.00 | ||||
Primary | 2.24 (1.68, 2.98) | <0.001 | 1.14 (0.85, 1.53) | 0.388 | 2.65 (2.04, 3.45) | <0.001 | 1.18 (0.87, 1.59) | 0.284 |
No education | 12.76 (9.26, 17.58) | <0.001 | 1.52 (1.00, 2.31) | 0.049 | 28.9 (20.75, 40.27) | <0.001 | 3.07 (2.00, 4.70) | <0.001 |
Contraceptive use | ||||||||
Yes | 1.00 | 1.00 | 1.00 | 1.00 | ||||
No | 2.74 (2.26, 3.31) | <0.001 | 1.22 (0.99, 1.50) | 0.058 | 4.31 (3.49, 5.34) | <0.001 | 1.35 (1.05, 1.75) | 0.019 |
Distance to the health facility | ||||||||
Not a big problem | 1.00 | 1.00 | 1.00 | 1.00 | ||||
Big problem | 1.31 (1.00, 1.73) | 0.052 | 1.07 (0.80, 1.44) | 0.649 | 2.68 (1.99, 3.61) | <0.001 | 1.81 (1.31, 2.51) | <0.001 |
Geographical region | ||||||||
North Central | 1.00 | 1.00 | 1.00 | 1.00 | ||||
North East | 6.21 (3.39, 11.35) | <0.001 | 3.77 (2.02, 7.03) | <0.001 | 5.31 (2.84, 9.93) | <0.001 | 1.94 (1.04, 3.63) | 0.038 |
North West | 5.56 (3.39, 9.11) | <0.001 | 3.30 (1.98, 5.53) | <0.001 | 6.27 (3.68, 10.68) | <0.001 | 2.22 (1.30, 3.80) | 0.003 |
South East | 0.36 (0.25, 0.53) | <0.001 | 0.51 (0.35, 0.74) | <0.001 | 0.14 (0.09, 0.22) | <0.001 | 0.38 (0.24, 0.61) | <0.001 |
South West | 0.25 (0.17, 0.38) | <0.001 | 0.31 (0.21, 0.46) | <0.001 | 0.37 (0.24, 0.57) | <0.001 | 0.72 (0.47, 1.10) | 0.131 |
South South | 0.12 (0.08, 0.17) | <0.001 | 0.17 (0.12, 0.25) | <0.001 | 0.17 (0.11, 0.26) | <0.001 | 0.48 (0.31, 0.74) | 0.001 |
Household Wealth Index | ||||||||
Rich | 1.00 | 1.00 | 1.00 | 1.00 | ||||
Middle | 2.97 (2.30, 3.84) | <0.001 | 1.41 (1.10, 1.80) | 0.007 | 2.5 (1.79, 3.49) | <0.001 | 0.92 (0.66, 1.27) | 0.597 |
Poor | 12.92 (9.09, 18.36) | <0.001 | 1.87 (1.29, 2.70) | 0.001 | 22.51 (15.34, 33.01) | <0.001 | 1.75 (1.16, 2.65) | 0.008 |
Type of place of residence | ||||||||
Urban | 1.00 | 1.00 | 1.00 | 1.00 | ||||
Rural | 7.78 (4.12, 14.69) | <0.001 | 2.15 (1.59, 2.90) | <0.001 | 31.87 (14.94, 67.97) | <0.001 | 5.61 (3.99, 7.89) | <0.001 |
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Envuladu, E.A.; Issaka, A.I.; Dhami, M.V.; Sahiledengle, B.; Agho, K.E. Differential Associated Factors for Inadequate Receipt of Components and Non-Use of Antenatal Care Services among Adolescent, Young, and Older Women in Nigeria. Int. J. Environ. Res. Public Health 2023, 20, 4092. https://doi.org/10.3390/ijerph20054092
Envuladu EA, Issaka AI, Dhami MV, Sahiledengle B, Agho KE. Differential Associated Factors for Inadequate Receipt of Components and Non-Use of Antenatal Care Services among Adolescent, Young, and Older Women in Nigeria. International Journal of Environmental Research and Public Health. 2023; 20(5):4092. https://doi.org/10.3390/ijerph20054092
Chicago/Turabian StyleEnvuladu, Esther Awazzi, Abukari Ibrahim Issaka, Mansi Vijaybhai Dhami, Biniyam Sahiledengle, and Kingsley Emwinyore Agho. 2023. "Differential Associated Factors for Inadequate Receipt of Components and Non-Use of Antenatal Care Services among Adolescent, Young, and Older Women in Nigeria" International Journal of Environmental Research and Public Health 20, no. 5: 4092. https://doi.org/10.3390/ijerph20054092