A decomposition of differences in antenatal care attendance in the first trimester in East Central Uganda between 2006 and 2011

Abstract

The objective of this study was to assess the differences in Antenatal Care (ANC) attendance in the first trimester between 2006 and 2011 in East Central Uganda. The changes were decomposed into components attributed to variations in characteristics of women and variations in the effect of predictors (coefficient). The assessment was based on data sourced from Uganda Demographic and Health Survey of 2006 and 2011 where 1,031 women aged 15-49 years were considered for the survey. The investigation was made using women’s predisposing factors, enabling factors and need factors which determine their attendance of ANC in the first trimester. The analysis was done in frequency distribution using a pooled logistic regression and a non-linear Oaxaca’s Blinder multivariate decomposition logistic regression.

In the results, ANC attendance in the first trimester increased from 17% in 2006 to 23% in 2011. The difference in the characteristics of women were significantly (p<0.05) noted in the factors namely; knowledge on pregnancy complication, total children ever born and female headed household. Results show that 68.8% of the gap in ANC attendance in the first trimester was attributed to differences in the characteristics of women. The gap in ANC attendance in the first trimester would respectively be increased by 36.2%, 17.3% and 12.1% if women in 2006 had similar composition to that of their counter parts in 2011 with regard to knowledge on pregnancy complication, total children ever born and female headed household.

The findings of this study indicate that overall, the gap in ANC attendance in the first trimester is attributed to variation in total children ever born, knowledge on pregnancy complication and household head. In order to reduce this gap, government and other development partners need to scale up ANC attendance in the first trimester by increasing knowledge on pregnancy complication through community outreaches, setting information, education, and communication (IEC) strategies designed to increase the awareness of danger signs in pregnancy, and encouraging women to attend ANC in the first trimester irrespective of the number of children they have because each pregnancy has its own complication.