Utilization of Antenatal Care Services in Bangladesh: A Cross-sectional Study Exploring the Associated Factors

INTRODUCTION: The study aims to identify the associated factors with antenatal care (ANC) service utilization by pregnant women in Bangladesh.
METHODS: Using Bangladesh Demographic and Health Survey, 2014, Chi-square association test detected significant explanatory variables for the number of ANC visits. For adjusted effects estimation, the study considered multinomial logistic regression (MLR) with relative risk ratio (RRR) and proportional odds model (POM). Akaike Information Criterion (AIC) compared and selected a better-fitted model.
RESULTS: This study included 4488 responses who are women aged from 15-49 years. From MLR, primary educated women (RRR=1.344, 95% CI=1.253-1.747, p<0.001) with highly educated partners (RRR=1.478, 95% CI=1.255-1.908, p<0.001) were more likely to use ANC services. Besides, women belonging to the middle (RRR=1.209, 95% CI=1.114-1.644, p<0.001) and rich (RRR=1.506, 95% CI=1.307-1.970, p<0.001) wealth index had more chances of utilizing ANC services. However, ANC attendance decreased significantly with the increment in birth order (p<0.001). ANC visits was also lower for rural women (RRR=0.711, 95% CI=0.555-0.891, p<0.001), Dhaka (RRR=0.623, 95% CI=0.493-0.955, p<0.001), Khulna (RRR=0.457, 95% CI=0.388-0.687, p<0.001), and Rangpur (RRR=0.579, 95% CI=0.484-0.780, p<0.001) divisions.
DISCUSSION AND CONCLUSION: To increase the ANC attendance, improvement of maternal education in rural areas is highly recommended. Dhaka, Khulna, and Rangpur divisions also need special focus.