Determinants of the Number of Antenatal Care Visits During Pregnancy Period: The Case of Tigray Reginal State Region, Ethiopia

Sebwedin Surur Jemal; Nejat Mehammed Aseffa; Hagos Mekonen

doi:doi:10.11648/j.sjcm.20221102.12

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Determinants of the Number of Antenatal Care Visits During Pregnancy Period: The Case of Tigray Reginal State Region, Ethiopia

Sebwedin Surur Jemal, Nejat Mehammed Aseffa, Hagos Mekonen

Published in Science Journal of Clinical Medicine (Volume 11, Issue 2)

Received: 8 April 2022 Accepted: 9 May 2022 Published: 19 May 2022

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Abstract

Antenatal care could be a preventive obstetric health care program geared toward optimizing maternal fetal outcome through regular monitoring of pregnancy. Whether or not world health organization (WHO) recommends a minimum of 4 antenatal care service (ANC) visits for normal pregnancy, existing evidence from developing countries including Ethiopia indicates there are few women who utilize it thanks to different reasons. 3711 pregnant women from Ethiopia demographic health survey (EDHS) of 2013 were used to analyze the determinants of the barriers in number of antenatal care service visits among pregnant women in Tigray regional state. The data were found to have no excess zeros since the number of zero visits less than non-zero visit of ANC and the variance (7.64) is much higher than its mean (2.46). This study provides numerical and graphical methods for checking the adequacy of the proportional odds regression model. Thus several count models such as Poisson, negative binomial (NB), zero inflated Poisson (ZIP), and zero inflated negative binomial (ZINB) regression models were fitted to select the model which best fits the data. Each of these models was compared using Statistical Package for the Social Sciences (SPSS ver. 16) by their likelihood ratio test (LR), Akaki and Bayesian information criteria and the model that have small Akaki and Bayesian information criteria’s was good fit the data. Negative binomial regression model was found to be better fitted with data which is characterized by non-excess zeros and high variability in the non-zero outcome. Through the analysis, access to modern ANC visits during pregnancy was low in Tigray regional state. Rural residence, absence of ANC, NGO medical institution, absence of education, lack of governmental hospital or medical institution, poverty, and never union with partner was significantly related to not attending ANC visits. The finding of this study indicates that the minimum ANC service within the region is mostly because the results of direct effect with absence of health post available. Policies and plans must improve visit of ANC service of pregnant women by arising health post available in rural residence and creating awareness on ANC for the society.

Published in	Science Journal of Clinical Medicine (Volume 11, Issue 2)
DOI	10.11648/j.sjcm.20221102.12
Page(s)	45-56
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2022. Published by Science Publishing Group

Keywords

Antenatal Care, Pregnancy, Maternal Health, Family Planning, Motherhood

References

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[2]	World Health Organization 1994: xi.
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[4]	World Health Organization 1994: 7.
[5]	Al Yaqoubi, H. N., Fatema, N., & Al Fahdi, B. S. (2019). A case of craniopagus parasiticus: an antenatal diagnosis by ultrasound screening at 16 weeks of gestation and a literature review of recently reported cases. The Turkish Journal of Pediatrics, 61 (6), 941-945.
[6]	CSA, ORC Macro, author. Ethiopia Demographic and Health Survey, Addis Ababa, Ethiopia and Calverton, Maryland, USA. Sep, 2006.
[7]	Edward N. Bernardin S. and Eric A. (2012). Determinants of utilization of antenatal care services in developing countries Recent evidence from Ghana. Department of Economics, University of Ghana, Accra, Ghana.
[8]	Central Statistical Authority (CSA) and Ethiopia Demographic and Health Survey 2005, Addis Ababa, Ethiopia.
[9]	McCullagh, P., & Nelder, J. A. (1989). Generalized linear models. London: Chapman & Hall.
[10]	Cameron, A. C. and P. K. Trivedi (1998). Regression Analysis of Count Data, Cambridge University Press, Cambridg.
[11]	Kothari, 2004, McCullagh, P., & Nelder, J. A. (1989). Generalized linear models. London: Chapman & Hall.
[12]	Md Abdullah al Mamun. (May 2014). Zero-inflated regression models for count data: an application to under-5 deaths. Ball State University, Muncie, Indiana.
[13]	Ministry of Health (2006). AIDS in Ethiopia, Sixth Report, Addis- Ababa, Ethiopia.
[14]	Yalem Tsegay Assfaw. (2010). Determinants of Antenatal Care, Institutional Delivery and Skilled Birth Attendant Utilization in Samre Saharti District, Tigray, Ethiopia. Umeå University, Sweden.
[15]	Floyd, Chai & Mercer 2001, author demographic and health survey.
[16]	Feleke. W and Samuel. G, 2008, assessement of reproductive health service.
[17]	Trends in Maternal Health in Ethiopia (December 2012), Challenges in achieving the MDG for maternal mortality. Addis Ababa; Journal.

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APA Style

Sebwedin Surur Jemal, Nejat Mehammed Aseffa, Hagos Mekonen. (2022). Determinants of the Number of Antenatal Care Visits During Pregnancy Period: The Case of Tigray Reginal State Region, Ethiopia. Science Journal of Clinical Medicine, 11(2), 45-56. https://doi.org/10.11648/j.sjcm.20221102.12

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ACS Style

Sebwedin Surur Jemal; Nejat Mehammed Aseffa; Hagos Mekonen. Determinants of the Number of Antenatal Care Visits During Pregnancy Period: The Case of Tigray Reginal State Region, Ethiopia. Sci. J. Clin. Med. 2022, 11(2), 45-56. doi: 10.11648/j.sjcm.20221102.12

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AMA Style

Sebwedin Surur Jemal, Nejat Mehammed Aseffa, Hagos Mekonen. Determinants of the Number of Antenatal Care Visits During Pregnancy Period: The Case of Tigray Reginal State Region, Ethiopia. Sci J Clin Med. 2022;11(2):45-56. doi: 10.11648/j.sjcm.20221102.12

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@article{10.11648/j.sjcm.20221102.12,
  author = {Sebwedin Surur Jemal and Nejat Mehammed Aseffa and Hagos Mekonen},
  title = {Determinants of the Number of Antenatal Care Visits During Pregnancy Period: The Case of Tigray Reginal State Region, Ethiopia},
  journal = {Science Journal of Clinical Medicine},
  volume = {11},
  number = {2},
  pages = {45-56},
  doi = {10.11648/j.sjcm.20221102.12},
  url = {https://doi.org/10.11648/j.sjcm.20221102.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.sjcm.20221102.12},
  abstract = {Antenatal care could be a preventive obstetric health care program geared toward optimizing maternal fetal outcome through regular monitoring of pregnancy. Whether or not world health organization (WHO) recommends a minimum of 4 antenatal care service (ANC) visits for normal pregnancy, existing evidence from developing countries including Ethiopia indicates there are few women who utilize it thanks to different reasons. 3711 pregnant women from Ethiopia demographic health survey (EDHS) of 2013 were used to analyze the determinants of the barriers in number of antenatal care service visits among pregnant women in Tigray regional state. The data were found to have no excess zeros since the number of zero visits less than non-zero visit of ANC and the variance (7.64) is much higher than its mean (2.46). This study provides numerical and graphical methods for checking the adequacy of the proportional odds regression model. Thus several count models such as Poisson, negative binomial (NB), zero inflated Poisson (ZIP), and zero inflated negative binomial (ZINB) regression models were fitted to select the model which best fits the data. Each of these models was compared using Statistical Package for the Social Sciences (SPSS ver. 16) by their likelihood ratio test (LR), Akaki and Bayesian information criteria and the model that have small Akaki and Bayesian information criteria’s was good fit the data. Negative binomial regression model was found to be better fitted with data which is characterized by non-excess zeros and high variability in the non-zero outcome. Through the analysis, access to modern ANC visits during pregnancy was low in Tigray regional state. Rural residence, absence of ANC, NGO medical institution, absence of education, lack of governmental hospital or medical institution, poverty, and never union with partner was significantly related to not attending ANC visits. The finding of this study indicates that the minimum ANC service within the region is mostly because the results of direct effect with absence of health post available. Policies and plans must improve visit of ANC service of pregnant women by arising health post available in rural residence and creating awareness on ANC for the society.},
 year = {2022}
}

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TY  - JOUR
T1  - Determinants of the Number of Antenatal Care Visits During Pregnancy Period: The Case of Tigray Reginal State Region, Ethiopia
AU  - Sebwedin Surur Jemal
AU  - Nejat Mehammed Aseffa
AU  - Hagos Mekonen
Y1  - 2022/05/19
PY  - 2022
N1  - https://doi.org/10.11648/j.sjcm.20221102.12
DO  - 10.11648/j.sjcm.20221102.12
T2  - Science Journal of Clinical Medicine
JF  - Science Journal of Clinical Medicine
JO  - Science Journal of Clinical Medicine
SP  - 45
EP  - 56
PB  - Science Publishing Group
SN  - 2327-2732
UR  - https://doi.org/10.11648/j.sjcm.20221102.12
AB  - Antenatal care could be a preventive obstetric health care program geared toward optimizing maternal fetal outcome through regular monitoring of pregnancy. Whether or not world health organization (WHO) recommends a minimum of 4 antenatal care service (ANC) visits for normal pregnancy, existing evidence from developing countries including Ethiopia indicates there are few women who utilize it thanks to different reasons. 3711 pregnant women from Ethiopia demographic health survey (EDHS) of 2013 were used to analyze the determinants of the barriers in number of antenatal care service visits among pregnant women in Tigray regional state. The data were found to have no excess zeros since the number of zero visits less than non-zero visit of ANC and the variance (7.64) is much higher than its mean (2.46). This study provides numerical and graphical methods for checking the adequacy of the proportional odds regression model. Thus several count models such as Poisson, negative binomial (NB), zero inflated Poisson (ZIP), and zero inflated negative binomial (ZINB) regression models were fitted to select the model which best fits the data. Each of these models was compared using Statistical Package for the Social Sciences (SPSS ver. 16) by their likelihood ratio test (LR), Akaki and Bayesian information criteria and the model that have small Akaki and Bayesian information criteria’s was good fit the data. Negative binomial regression model was found to be better fitted with data which is characterized by non-excess zeros and high variability in the non-zero outcome. Through the analysis, access to modern ANC visits during pregnancy was low in Tigray regional state. Rural residence, absence of ANC, NGO medical institution, absence of education, lack of governmental hospital or medical institution, poverty, and never union with partner was significantly related to not attending ANC visits. The finding of this study indicates that the minimum ANC service within the region is mostly because the results of direct effect with absence of health post available. Policies and plans must improve visit of ANC service of pregnant women by arising health post available in rural residence and creating awareness on ANC for the society.
VL  - 11
IS  - 2
ER  -

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Author Information

Sebwedin Surur Jemal

Department of Statistics, Collage of Natural and Computational Science, Mizan Tepi University, Jimma, Ethiopia
Nejat Mehammed Aseffa

Department of Law, Collage of Law and Governance, Jimma University, Tepi, Ethiopia
Hagos Mekonen

Department of Statistics, Collage of Natural and Computational Science, Mekelle University, Mekelle, Ethiopia

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APA Style

Sebwedin Surur Jemal, Nejat Mehammed Aseffa, Hagos Mekonen. (2022). Determinants of the Number of Antenatal Care Visits During Pregnancy Period: The Case of Tigray Reginal State Region, Ethiopia. Science Journal of Clinical Medicine, 11(2), 45-56. https://doi.org/10.11648/j.sjcm.20221102.12

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ACS Style

Sebwedin Surur Jemal; Nejat Mehammed Aseffa; Hagos Mekonen. Determinants of the Number of Antenatal Care Visits During Pregnancy Period: The Case of Tigray Reginal State Region, Ethiopia. Sci. J. Clin. Med. 2022, 11(2), 45-56. doi: 10.11648/j.sjcm.20221102.12

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AMA Style

Sebwedin Surur Jemal, Nejat Mehammed Aseffa, Hagos Mekonen. Determinants of the Number of Antenatal Care Visits During Pregnancy Period: The Case of Tigray Reginal State Region, Ethiopia. Sci J Clin Med. 2022;11(2):45-56. doi: 10.11648/j.sjcm.20221102.12

Copy | Download

@article{10.11648/j.sjcm.20221102.12,
  author = {Sebwedin Surur Jemal and Nejat Mehammed Aseffa and Hagos Mekonen},
  title = {Determinants of the Number of Antenatal Care Visits During Pregnancy Period: The Case of Tigray Reginal State Region, Ethiopia},
  journal = {Science Journal of Clinical Medicine},
  volume = {11},
  number = {2},
  pages = {45-56},
  doi = {10.11648/j.sjcm.20221102.12},
  url = {https://doi.org/10.11648/j.sjcm.20221102.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.sjcm.20221102.12},
  abstract = {Antenatal care could be a preventive obstetric health care program geared toward optimizing maternal fetal outcome through regular monitoring of pregnancy. Whether or not world health organization (WHO) recommends a minimum of 4 antenatal care service (ANC) visits for normal pregnancy, existing evidence from developing countries including Ethiopia indicates there are few women who utilize it thanks to different reasons. 3711 pregnant women from Ethiopia demographic health survey (EDHS) of 2013 were used to analyze the determinants of the barriers in number of antenatal care service visits among pregnant women in Tigray regional state. The data were found to have no excess zeros since the number of zero visits less than non-zero visit of ANC and the variance (7.64) is much higher than its mean (2.46). This study provides numerical and graphical methods for checking the adequacy of the proportional odds regression model. Thus several count models such as Poisson, negative binomial (NB), zero inflated Poisson (ZIP), and zero inflated negative binomial (ZINB) regression models were fitted to select the model which best fits the data. Each of these models was compared using Statistical Package for the Social Sciences (SPSS ver. 16) by their likelihood ratio test (LR), Akaki and Bayesian information criteria and the model that have small Akaki and Bayesian information criteria’s was good fit the data. Negative binomial regression model was found to be better fitted with data which is characterized by non-excess zeros and high variability in the non-zero outcome. Through the analysis, access to modern ANC visits during pregnancy was low in Tigray regional state. Rural residence, absence of ANC, NGO medical institution, absence of education, lack of governmental hospital or medical institution, poverty, and never union with partner was significantly related to not attending ANC visits. The finding of this study indicates that the minimum ANC service within the region is mostly because the results of direct effect with absence of health post available. Policies and plans must improve visit of ANC service of pregnant women by arising health post available in rural residence and creating awareness on ANC for the society.},
 year = {2022}
}

Copy | Download

TY  - JOUR
T1  - Determinants of the Number of Antenatal Care Visits During Pregnancy Period: The Case of Tigray Reginal State Region, Ethiopia
AU  - Sebwedin Surur Jemal
AU  - Nejat Mehammed Aseffa
AU  - Hagos Mekonen
Y1  - 2022/05/19
PY  - 2022
N1  - https://doi.org/10.11648/j.sjcm.20221102.12
DO  - 10.11648/j.sjcm.20221102.12
T2  - Science Journal of Clinical Medicine
JF  - Science Journal of Clinical Medicine
JO  - Science Journal of Clinical Medicine
SP  - 45
EP  - 56
PB  - Science Publishing Group
SN  - 2327-2732
UR  - https://doi.org/10.11648/j.sjcm.20221102.12
AB  - Antenatal care could be a preventive obstetric health care program geared toward optimizing maternal fetal outcome through regular monitoring of pregnancy. Whether or not world health organization (WHO) recommends a minimum of 4 antenatal care service (ANC) visits for normal pregnancy, existing evidence from developing countries including Ethiopia indicates there are few women who utilize it thanks to different reasons. 3711 pregnant women from Ethiopia demographic health survey (EDHS) of 2013 were used to analyze the determinants of the barriers in number of antenatal care service visits among pregnant women in Tigray regional state. The data were found to have no excess zeros since the number of zero visits less than non-zero visit of ANC and the variance (7.64) is much higher than its mean (2.46). This study provides numerical and graphical methods for checking the adequacy of the proportional odds regression model. Thus several count models such as Poisson, negative binomial (NB), zero inflated Poisson (ZIP), and zero inflated negative binomial (ZINB) regression models were fitted to select the model which best fits the data. Each of these models was compared using Statistical Package for the Social Sciences (SPSS ver. 16) by their likelihood ratio test (LR), Akaki and Bayesian information criteria and the model that have small Akaki and Bayesian information criteria’s was good fit the data. Negative binomial regression model was found to be better fitted with data which is characterized by non-excess zeros and high variability in the non-zero outcome. Through the analysis, access to modern ANC visits during pregnancy was low in Tigray regional state. Rural residence, absence of ANC, NGO medical institution, absence of education, lack of governmental hospital or medical institution, poverty, and never union with partner was significantly related to not attending ANC visits. The finding of this study indicates that the minimum ANC service within the region is mostly because the results of direct effect with absence of health post available. Policies and plans must improve visit of ANC service of pregnant women by arising health post available in rural residence and creating awareness on ANC for the society.
VL  - 11
IS  - 2
ER  -

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