Trends of delayed first antenatal care visit among pregnant women in Ethiopia based on the EDHS 2000-2016 data: Multivariate decomposition analysis

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Abstract Background: Timing of first antenatal care visiting is crucial for women and fetus health. However, most of the women had delayed antenatal care visits and lacked early detection of existing complications. Hence, this study aimed to assess the trends and magnitude of delayed first antenatal care visits among pregnant women in Ethiopia.Method: This study used cross-sectional data analysis on Ethiopian Demographic and Health Surveys. A total weighted sample of 2146 in 2000, 2051 in 2005, 3368 in 2011, and 4740 in 2016 women who received at least one antenatal care visit in the past five years before each survey were included. Stata 14.1 software was used for data management and further analysis. Trends and multivariate logistic decomposition analyses were employed to examine the change in delayed first antenatal care visits with sampling weighting for the survey data. The 95% confidence interval was used for considering statistical significance.Results: The proportion of delayed first antenatal care visit was declined from 76.8 (95%CI: 75.1−78.6) in 2000 to 67.3 (95%CI: 65.9−68.6) in 2016. The decomposition analysis showed that 39% of the overall change in delayed first antenatal care visit over time was due to differences in characteristics whereas about 61% was due to the effect of characteristics. The significant contributing factors for the decline of delayed first antenatal care visit were the place of residence, husband’s education, women occupation, told about pregnancy complications, caesarean delivery, and family size. Conclusion: The proportion of delayed first antenatal care visits has been declined over time in Ethiopia, but still it remains high. More of the overall change in delayed first antenatal care visit was attributed to a change in health behavior among pregnant women. Public health interventions or programs such as health education and behavioral change communication targeting the rural residents, lower economic status, and family size would be suggested to decline delayed first antenatal care visit.

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