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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
How mistimed and unwanted pregnancies affect timing of antenatal care initiation in three districts in Tanzania
BMC Pregnancy and Childbirth, Volume 13, Article 35, Year 2013
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Description
Background: Early antenatal care (ANC) initiation is a doorway to early detection and management of potential complications associated with pregnancy. Although the literature reports various factors associated with ANC initiation such as parity and age, pregnancy intentions is yet to be recognized as a possible predictor of timing of ANC initiation.Methods: Data originate from a cross-sectional household survey on health behaviour and service utilization patterns. The survey was conducted in 2011 in Rufiji, Kilombero and Ulanga districts in Tanzania on 3,127 women from whom 910 of reproductive age who had given birth in the past two years and sought ANC at least once during pregnancy were selected for the current analysis. ANC initiation was considered to be early only if it occurred in the first trimester of pregnancy gestation. A recently completed pregnancy was defined as mistimed if a woman wanted it later, and if she did not want it at all the pregnancy was termed as unwanted. Chi-square was used to test for associations and multinomial logistic regression was conducted to examine how mistimed and unwanted pregnancies relate with timing of ANC initiation.Results: Although 49.3% of the women intended to become pregnant, 50.7% (34.9% mistimed and 15.8% unwanted) became pregnant unintentionally. While ANC initiation in the 1st trimester was 18.5%, so was 71.7% and 9.9% in the 2nd and 3rd trimesters respectively. Multivariate analysis revealed that ANC initiation in the 2nd trimester was 1.68 (95% CI 1.10-2.58) and 2.00 (95% CI 1.05-3.82) times more likely for mistimed and unwanted pregnancies respectively compared to intended pregnancies. These estimates rose to 2.81 (95% CI 1.41-5.59) and 4.10 (95% CI 1.68-10.00) respectively in the 3rd trimester. We controlled for gravidity, age, education, household wealth, marital status, religion, district of residence and travel time to a health facility.Conclusion: Late ANC initiation is a significant maternal and child health consequence of mistimed and unwanted pregnancies in Tanzania. Women should be empowered to delay or avoid pregnancies whenever they need to do so. Appropriate counseling to women, especially those who happen to conceive unintentionally is needed to minimize the possibility of delaying ANC initiation. © 2013 Exavery et al.; licensee BioMed Central Ltd.
Authors & Co-Authors
Exavery, Amon
Tanzania, Ifakara
Ifakara Health Institute
Kanté, Almamy Malick
Tanzania, Ifakara
Ifakara Health Institute
United States, New York
Mailman School of Public Health
Hingora, Ahmed
Tanzania, Ifakara
Ifakara Health Institute
Mbaruku, Godfrey M.
Tanzania, Ifakara
Ifakara Health Institute
Pemba, Senga K.
Tanzania
Tanzanian Training Centre for International Health Ttcih
Phillips, James Franklin
United States, New York
Mailman School of Public Health
Statistics
Citations: 100
Authors: 6
Affiliations: 3
Identifiers
Doi:
10.1186/1471-2393-13-35
e-ISSN:
14712393
Research Areas
Health System And Policy
Maternal And Child Health
Sexual And Reproductive Health
Study Design
Cross Sectional Study
Study Approach
Quantitative
Study Locations
Tanzania
Participants Gender
Female