Determinants of adequate antenatal care utilization (four or more visits) among women in Uganda.

Abstract

This study examined the determinants of adequate ANC utilization, defined as attending four or more ANC visits, among women in Uganda using data from UDHS 2022. Although antenatal care coverage in Uganda is nearly universal at initiation, completion of the recommended number of visits remains a public health concern. The study aimed to identify the socioeconomic, demo- graphic, and regional factors associated with adequate ANC utilization. A cross-sectional study design was used based on secondary data from 7,513 women aged 15–49 years who had a live birth within two years preceding the survey. Data were analyzed using STATA version 15. Descriptive statistics, Chi-square tests, and binary logistic regression were employed to examine associations between ANC utilization and selected explanatory variables. Results showed that 72.6% of women completed at least four ANC visits. Bivariate analysis revealed significant associations between ANC utilization and age, education level, marital status, and region, while wealth status and place of residence were not significant. Multivariate logistic regression showed that several factors significantly influenced the likelihood of completing four or more ANC visits. Place of residence was not statistically significant after controlling for other variables. Women with higher education had about 1.5 times the odds of completing at least four ANC visits as compared to those with no education (OR = 1.46, 95% CI: 1.03-2.05). Region was a strong predictor with women residing in West Nile having about 2.3 times the odds of completing atleast four ANC visits as compared with those in Kampala (OR = 2.26, 95% CI:1.62-3.15). Women aged 40-44 years had about 1.8 times the odds of completing atleast four ANC visits as compared to those aged 15-19 years (OR = 1.75, 95% CI: 1.21-2.53). For every additional child ever born, the odds of completing at least four ANC visits decreased by approximately 11% (OR = 0.89, 95% CI: 0.86-0.93). The study concludes that ANC utilization in Uganda is influenced mainly by demographic, socio-economic and regional factors. It recommends strengthening female education, addressing regional disparities and improving economic empowerment to enhance maternal health service utilization.