Barrier of Utilization of ANC Services in Rural Communities, Nepal

Abstract

In Nepal, the levels of maternal and infant morbidity and mortality
are among the highest in the world. Antenatal care (ANC) is one of the key
preventive health services used to prevent maternal mortality and morbidity
around the world. Therefore, to reduce maternal mortality and morbidity,
increasing use of reproductive and maternal health services is essential. This
study was conducted with the objectives of determining the prevalence of
utilization of maternal health care services and identifying factors affecting it.
A community-based, cross-sectional study was conducted in Banke District in the
Mid-Western Development Region (one of the five development regions of the
country) from April to May 2016. A multi-stage sampling technique was used to
select the study population in six village development communities (VDC). A
total of 364 women in the age range 15-49 years were interviewed. The
author used bivariate statistics and multivariate logistic regression. Overall,
over half (56%) of the women had at least four ANC visits; 39% had one to
three ANC visits and 5% had no ANC visits during their last pregnancy. The
study found that religion, family support, information from TV, quality of
service, travel and service cost, satisfaction with the ANC service and negative
perception were significant barriers to utilization of ANC services. In particular,
women who were not Hindus and incurred a high travel and service cost had
statistically significant higher barriers to ANC services utilization compared to
those who were Hindu and experienced low travel and service cost. Based
on the findings of this study, reducing the barriers to ANC services utilization
will require targeting women in the rural areas and non-Hindus, in addition to
creating demand for delivery at a health facility. Improving ANC use by
making it available and accessible will have a multiplier effect of improving
facility-based deliveries and reducing barriers to ANC services utilization.