Socioeconomic factors influencing antenatal care utilization among pregnant women:  A cross-sectional study.

Dr. Sowmithri M.L; Dr. Karukula Gangadhara  Reddy; Dr. Yamini Satya  Nidadavolu; Kishore Babu  Mathi

doi:10.51168/sjhrafrica.v6i9.2132

Authors

Dr. Sowmithri M.L Associate Professor, Department of Community Medicine, MNR Medical College and Hospital, Sangareddy, Telangana, India.
Dr. Karukula Gangadhara Reddy Associate Professor, Department of Community Medicine, CMR Institute of Medical Sciences and Hospital, Kandlakoya, Medchal, Hyderabad, Telangana, India
Dr. Yamini Satya Nidadavolu Assistant Professor, Department of Community Medicine, MNR Medical College and Hospital, Sangareddy, Telangana, India.
Kishore Babu Mathi Professor, Department of Community Medicine, MNR Medical College and Hospital, Sangareddy, Telangana, India.

DOI:

https://doi.org/10.51168/sjhrafrica.v6i9.2132

Keywords:

antenatal care, socioeconomic status, maternal education, pregnancy, healthcare utilization

Abstract

Background:

Antenatal care (ANC) plays a pivotal role in improving maternal and neonatal outcomes. However, its utilization is often influenced by socioeconomic and demographic disparities. Understanding these determinants is crucial for strengthening maternal health services.

Objectives:

To assess the utilization of antenatal care services among pregnant women and to examine the association of socioeconomic factors with ANC utilization.

Methods:

This cross-sectional study was conducted among 100 pregnant women attending a tertiary care hospital. Data on demographic characteristics, socioeconomic status, education, occupation, and ANC utilization were collected using a pretested structured questionnaire. ANC utilization was categorized as adequate (≥4 visits) or inadequate (<4 trips). Statistical analysis was performed using chi-square tests to assess associations between socioeconomic factors and ANC utilization.

Results:

The mean age of participants was 24.8 years, with 46% aged 21–25 years. A majority (64%) resided in rural areas. Socioeconomic assessment revealed that 34% belonged to the middle class, while 18% of women were illiterate. Adequate ANC utilization was reported by 68% of participants, whereas 32% had inadequate visits. Education, socioeconomic class, and place of residence showed statistically significant associations with ANC utilization (p < 0.05). Women with secondary or higher education (82%) and those from upper socioeconomic strata (84%) reported greater ANC attendance compared to illiterate women (39%) and those from lower classes (52%). Employment status demonstrated a positive but non-significant association.

Conclusion:

Maternal education, socioeconomic class, and urban residence were significant predictors of ANC utilization. Targeted interventions focusing on disadvantaged groups are crucial to ensure equitable maternal healthcare access.

Recommendations:

Strengthen maternal health education, enhance rural healthcare access, subsidize antenatal services for disadvantaged groups, and implement targeted awareness campaigns to promote equitable ANC utilization.

Author Biographies

Dr. Sowmithri M.L, Associate Professor, Department of Community Medicine, MNR Medical College and Hospital, Sangareddy, Telangana, India.

is currently serving as an Associate Professor in the Department of Community Medicine at MNR Medical College and Hospital, Sangareddy, Telangana, India. She obtained her MBBS degree from MNR Medical College and Hospital, Sangareddy, under KNR University of Health Sciences, Telangana. She further pursued her MD in Community Medicine at the same institution. In addition, she holds certifications in ACME (Advanced Course in Medical Education) and AFIH (Associate Fellowship in Industrial Health). Dr. Sowmithri has actively contributed to the field of public health and community medicine, with five research publications in reputed national and international journals. Her academic interests include epidemiology, health education, preventive medicine, and occupational health. ORCID ID: https://orcid.org/0009-0000-3985-6584\

Dr. Karukula Gangadhara Reddy, Associate Professor, Department of Community Medicine, CMR Institute of Medical Sciences and Hospital, Kandlakoya, Medchal, Hyderabad, Telangana, India

is presently working as an Associate Professor in the Department of Community Medicine at CMR Institute of Medical Sciences and Hospital, Kandlakoya, Medchal, Hyderabad, Telangana, India. He completed his MBBS from Manipal College of Medical Sciences, Pokhara, Nepal, and pursued his MD in Community Medicine at MNR Medical College and Hospital, Sangareddy, affiliated with KNR University of Health Sciences, Telangana. He also holds an additional qualification of AFIH (Associate Fellowship in Industrial Health). Dr. Reddy has published two research articles in reputed national and international journals. His academic interests span epidemiology, public health research, preventive medicine, and occupational health. ORCID iD: https://orcid.org/0009-0009-3519-454X

Dr. Yamini Satya Nidadavolu, Assistant Professor, Department of Community Medicine, MNR Medical College and Hospital, Sangareddy, Telangana, India.

is currently serving as an Assistant Professor in the Department of Community Medicine at MNR Medical College and Hospital, Sangareddy, Telangana, India. She completed her MBBS from Dr. Pinnamaneni Siddhartha Institute of Medical Sciences & Research Foundation under NTR University of Health Sciences, Andhra Pradesh. She pursued her MD in Community Medicine at Vydehi Institute of Medical Sciences & Research Foundation, affiliated with Rajiv Gandhi University of Health Sciences, Karnataka. Dr. Nidadavolu has published one research article in a reputed national journal. Her academic interests include epidemiology, health promotion, preventive medicine, and medical education. ORCID iD: https://orcid.org/0009-0009-9530-3736

Kishore Babu Mathi, Professor, Department of Community Medicine, MNR Medical College and Hospital, Sangareddy, Telangana, India.

is currently working as a Professor in the Department of Community Medicine at MNR Medical College and Hospital, Sangareddy, Telangana, India. He obtained his MBBS degree from MNR Medical College and Hospital, Sangareddy, under KNR University of Health Sciences, Telangana, where he also completed his MD in Community Medicine. He holds an additional qualification of AFIH (Associate Fellowship in Industrial Health). Dr. Mathi has published five research articles in reputed national and international journals. His key academic interests include epidemiology, occupational health, preventive medicine, and public health education. ORCID iD: https://orcid.org/0009-0008-5594-8428

References

Pandey S, Karki S. Socio-economic and Demographic Determinants of Antenatal Care Services Utilization in Central Nepal. Int J MCH AIDS. 2014;2(2):212-9. PMID: 27621975; PMCID: PMC4948147. https://doi.org/10.21106/ijma.27

Sabo A, Alzoubi MM, Saidu AY, Usman US, Saulawa IM, Al-Mugheed K, Farghaly Abdelaliem SM, Saeed Alabdullah AA. Determinants of Utilization of Antenatal Care Services Among Women of Childbearing Age in Jigawa State, Nigeria. Int J Public Health. 2024 Sep 17;69:1607385. doi: 10.3389/ijph.2024.1607385. PMID: 39355757; PMCID: PMC11442287. https://doi.org/10.3389/ijph.2024.1607385

Al-Mamun M, Kalam A, Uzzal NI. Factors affecting maternal health and antenatal care services of working mothers in Southwestern Coastal Bangladesh: a cross-sectional study. Ann Med Surg (Lond). 2025 Jan 7;87(2):487-496. doi: 10.1097/MS9.0000000000002895. PMID: 40110323; PMCID: PMC11918579. https://doi.org/10.1097/MS9.0000000000002895

Mahamud Tohan M, Islam MA, Rahman MA. Exploring the factors behind socioeconomic inequalities in Antenatal Care (ANC) utilization across five South Asian nations: A decomposition approach. PLoS One. 2024 Aug 7;19(8):e0304648. doi: 10.1371/journal.pone.0304648. PMID: 39110696; PMCID: PMC11305544. https://doi.org/10.1371/journal.pone.0304648

Sharma A, Khapre M, Meshram R, Gupta A. Determinants of utilization of antenatal care services among recently delivered women residing in urban poor areas of Rishikesh, Uttarakhand, India-a cross-sectional study. J Rural Med. 2023 Apr;18(2):87-95. doi: 10.2185/jrm.2022-030. Epub 2023 Apr 5. PMID: 37032991; PMCID: PMC10079463. https://doi.org/10.2185/jrm.2022-030

Alibhai KM, Ziegler BR, Meddings L, Batung E, Luginaah I. Factors impacting antenatal care utilization: a systematic review of 37 fragile and conflict-affected situations. Confl Health. 2022 Jun 11;16(1):33. doi: 10.1186/s13031-022-00459-9. PMID: 35690840; PMCID: PMC9188725. https://doi.org/10.1186/s13031-022-00459-9

Hijazi HH, Alyahya MS, Sindiani AM, Saqan RS, Okour AM. Determinants of antenatal care attendance among women residing in highly disadvantaged communities in northern Jordan: a cross-sectional study. Reprod Health. 2018 Jun 7;15(1):106. doi: 10.1186/s12978-018-0542-3. PMID: 29879992; PMCID: PMC5992715. https://doi.org/10.1186/s12978-018-0542-3

Mouhoumed HM, Mehmet N. Utilization pattern of antenatal care and determining factors among reproductive-age women in Borama, Somaliland. J Prev Med Hyg. 2021 Jul 30;62(2):E439-E446. Doi: 10.15167/2421-4248/jpmh2021.62.2.1882. PMID: 34604585; PMCID: PMC8451356.

Tesfay N, Kebede M, Asamene N, Tadesse M, Begna D, Woldeyohannes F. Factors determining antenatal care utilization among mothers of deceased perinates in Ethiopia. Front Med (Lausanne). 2023 Nov 8;10:1203758. Doi: 10.3389/fmed. 2023.1203758. PMID: 38020089; PMCID: PMC10663362. https://doi.org/10.3389/fmed.2023.1203758

Alemu Anshebo A, Markos Y, Behera S, Gopalan N. Factors associated with antenatal care utilization among women with disabilities in Ethiopia: Using Andersen's Behaviour Model of Health Service Use. PLOS Glob Public Health. 2025 Jun 16;5(6):e0004759. Doi: 10.1371/journal.pgph.0004759. PMID: 40522932; PMCID: PMC12169558. https://doi.org/10.1371/journal.pgph.0004759

Maitanmi BT, Adelaja AA, Okunola DR, Maitanmi JO, Tola YO, Akingbade O. Association between Socioeconomic Status and the Utilization of Maternal Health Services in Nigeria. Iran J Nurs Midwifery Res. 2023 Sep 8;28(5):514-519. doi: 10.4103/ijnmr.ijnmr_61_22. PMID: 37869684; PMCID: PMC10588924. https://doi.org/10.4103/ijnmr.ijnmr_61_22

Adhikari T, Sahu D, Nair S, Saha KB, Sharma RK, Pandey A. Factors associated with utilization of antenatal care services among tribal women: A study of selected States. Indian J Med Res. 2016 Jul;144(1):58-66. doi: 10.4103/0971-5916.193284. PMID: 27834327; PMCID: PMC5116899. https://doi.org/10.4103/0971-5916.193284