Antenatal Care Visits, Institutional Births, and Associated Risk Factors in Afghanistan: Insights from the Multiple Indicator Cluster Survey 2022-2023.
Jahar Bhowmik, Lakma Gunarathne, Sunil Bhar and 2 others
PMID 38997800WHAT IT FOUND
In Afghanistan, only 40% of surveyed women had 4 or more antenatal visits, and 4 or more visits were linked with facility birth.
Rural, low-wealth, and less educated women were less likely to give birth in facilities.
Key findings
01In the analytic sample, 40% (n = 3,247) had 4 or more ANC visits, and 74.4% (n = 6,022) chose institutional births.
02Having 4 or more ANC visits was significantly associated with institutional birth; these participants had 31% higher odds of accessing institutional birth compared with women with no or only one ANC visit (aOR, 1.31; 95% CI, 1.10-1.57).
03Women with secondary or higher education had 73% higher odds of institutional birth after adjusting for ANC visits compared with those with primary or lower education (aOR, 1.73; 95% CI, 1.31-2.29).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study is cross-sectional, so it cannot show that antenatal visits caused facility birth or that increasing visits would increase facility birth. The analysis used existing survey data, so some variables of interest were not examined. The quality of care inside facilities was not included in the models because the survey did not provide that information. The analytic sample was limited to married women with a live birth in the previous 2 years, and women with missing or incomplete data were omitted. The association between secondary or higher education and 4 or more ANC visits was marginal, with a confidence interval that reached 1.00 (aOR, 1.27; 95% CI, 1.00-1.62).
Declared interests
The paper does not report funding sources or conflicts of interest. It states that de-identified secondary data were provided upon request by the MICS program authority and that permission was obtained to use the survey.
The easy way to misread this
Do not conclude that more antenatal visits cause facility birth or reduce maternal deaths. This survey is cross-sectional and reports association, and the quality of facility care was not measured.