Factors affecting antenatal care utilization in South Sudan : evidence from 2010 South Sudan house survey.

Abstract

Maternal mortality in South Sudan was estimated to be as high as 2054 per 100,000 live births, amongst the highest mortality in the world. The utilisations of antenatal care (ANC) services, which provide the opportunity for early diagnoses and preventions of complications during pregnancy, are crucial to reducing maternal mortality. This study is meant to identify the factors that affect the utilization of ANC services among pregnant women aged 15 – 49 years in South Sudan using the Second South Sudan Households Survey (SSHHS II). Methods The Second South Sudan Households Survey was conducted using the UNICEF’s Multiple Indicator Cluster Survey (MICS) methodology. The population used in this study is the 4,067 women who gave birth in the last two years before the survey. The dependent variables in this study were any ANC and adequate ANC utilisation, defined as the proportion of pregnant women who had attended ANC, and were seen by a skilled professional (a doctor, a nurse or skilled midwife) at least once during their pregnancy. The second indicator was the proportion of pregnant women who had attended ANC at least four times during their pregnancy, and were seen by any health provider. The explanatory variables were the women's age, age at first marriage, marital status, parity, maternal educational level, household wealth quintile, geographical location (states) and place of residence (urban or rural).

Results More than half 56% of the women did not use ANC services at all during their pregnancy, and only 18% used ANC adequately, while 26% of the selected women used it inadequately. Multivariate analysis shows that most of the explanatory variables were strong predictors to ANC utilization at least once, while household wealth seems to be the only variable predicting the utilization of ANC services by women of South Sudan at least four times. However, pregnant women with primary and secondary level of education were 2.04 and 2.32 times, respectively, more likely to use ANC than women with no education. Likewise, women in the fourth and the richest (fifth) quintiles were twice and three times, respectively, more likely to utilize ANC than those in the poorest quintile.

Conclusions In conclusion the utilization of ANC in South Sudan was inadequate and far from satisfactory. The findings show a high level of illiteracy among women of South Sudan, but education variables were shown to be significantly associated with at least one ANC utilization. This result implies that providing women with at least primary education will enhance the likelihood of ANC utilization, and may increase with improved education. Nevertheless, this study has proved household wealth is the only variable that has influence on the mother’s utilization of ANC services at least four times or more.