Washington D.C., USA, 22-27 July 2012www.aids2012.org

Factors associated with non-utilisation of antenatal care services by women delivering with an unbooked status at the four polyclinics in Chitungwiza.

V.Makani1, S.Rusakaniko¹ ,W. Chandisarewa1, A.Mushavi², B.Makunike-Chikwinya³, A.Shetty4

¹Zimbabwe AIDS Prevention Project-University of Zimbabwe, Department of Community Medicine,

Harare, Zimbabwe

²Ministry of Health and Child Welfare, Harare, Zimbabwe

³Elizabeth Glaser Paediatric AIDS Foundation Zimbabwe Country Office

⁴Wake Forest University Health Sciences, North Carolina, USA

Washington D.C., USA, 22-27 July 2012www.aids2012.org

Statement of the problem• The number of women presenting in

labour without prior ANC and

unknown HIV status continued to

increase in Chitungwiza despite:

• Community awareness through

the ZAPP-UZ drama group

• National programmes on

maternal and child health.

• Little was known regarding the

factors associated with non-

utilisation of antenatal care services

by pregnant women

Distribution of women delivering with an unbooked status at Chitungwiza municipal clinics by year

Washington D.C., USA, 22-27 July 2012www.aids2012.org

Demographics

Variable Cases (N=232) %

Controls (N=232) %

P-value

Marital status         <0.01Married 213 91.8 207 89.2  Single, Divorced 19 8.2 25 10.8  

Parity         0.031 or 2 144 62.1 164 70.7  3 or more 88 37.9 68 29.3  Employment         <0.01 Employed 39 16.8 63 27.2   Unemployed

193 83.2 169 72.8  

Median age in yrs. 25 Q1:22; Q3: 29.5 Q1: 22; Q3: 29.5 0.97

Washington D.C., USA, 22-27 July 2012www.aids2012.org

Risk FactorsVariable Unbooked Booked OR 95%CI

N=232

% N=232

%

Unaffordability of user fees Y

25 10.8 7 3 3.8 (1.39-10.46)

  N

207 89.2 225 97.0  

Seek TBA ANC with current pregnancy Y

69 29.7 27 11.6 3.2(1.16-8.85)

  N 163 70.3 205 88.4  

Religion Apostolic/Pentecostal

171 73.7 141 60.8 1.5 (1.22-2.68)

Catholic / Protestants/Other

61 26.3 91 39.2  

Washington D.C., USA, 22-27 July 2012www.aids2012.org

Protective factors

Variable UnbookedN=232 %

BookedN=232 %

OR 95%CI

HIV test before booking Y

10 4.7 26 11.2 0.4 (0.25-0.76)

N

201 95.3 206 88.8

 

Death of a child Y 11 4.7 25 10.8 0.4 (0.19-0.86)

  N

221 95.3 207 89.2  

Washington D.C., USA, 22-27 July 2012www.aids2012.org

Multivariate Analysis on Antenatal care utilisationVariable AOR 95% CI

Unaffordability of ANC fees 3.0 1.15-7.69

Religion 1.8 1.09-2.98

Testing for HIV before pregnancy 0.39 0.23-0.64

Received information on ANC with previous pregnancy 0.16 0.10-0.26

Death of a child 0.4 0.19-0.93

Washington D.C., USA, 22-27 July 2012www.aids2012.org

Conclusion and recommendation

• Cost of antenatal care services was the main reason for non utilisation of antenatal care services

• Municipality of Chitungwiza and Ministry of Health and child should ensure that pregnant women access antenatal care services through affordable ANC fees.

Washington D.C., USA, 22-27 July 2012www.aids2012.org

ACKNOWLWDGEMENTS

• Zimbabwe Ministry of Health and Child Welfare• Elizabeth Glaser Pediatric AIDS Foundation

(EGPAF) • United States Agency for International Development

(USAID) • Chitungwiza Municipality Health Department• Chitungwiza Central Hospital. • Community Mobilisers and the nurses at the health

institutions