Inadequate receipt of ANC components and associated factors among pregnant women in Northwest Ethiopia, 2020–2021: a community-based cross-sectional study

(2023) 20:69 Gelagay et al. Reproductive Health https://doi.org/10.1186/s12978-023-01612-0 Reproductive Health Open Access COMMENT Inadequate receipt of ANC components and associated factors among pregnant women in Northwest Ethiopia, 2020–2021: a community‑based cross‑sectional study Abebaw Addis Gelagay1, Tadele Biresaw Belachew2, Desale Bihonegn Asmamaw1, Desalegn Anmut Bitew1, Elsa Awoke Fentie1, Abebaw Gebeyehu Worku1, Debrework Tesgera Bashah3, Nigusie Birhan Tebeje1, Mignote Hailu Gebrie3, Hedija Yenus Yeshita1, Endeshaw Adimasu Cherkose4, Birhanu Abera Ayana5, Ayenew Molla Lakew6 and Wubshet Debebe Negash2* Abstract Background Women’s health and pregnancy outcomes are directly depends on the extent of ANC components received during their ANC visits. There are limited information about the components of ANC and associated factors. Therefore, the aim of this study was to assess the magnitude of inadequate recipient of ANC components and associated factors in northwest Ethiopia. Methods This is a community based cross sectional survey conducted in Dabat Demographic and health survey from December 10/2020 to January 10/2021 among women who gave birth within two years before the survey. This study applied a census method to identify and select eligible pregnant women. A structured and pretested questionnaire was used to collect the data. The data was entered into Epi-data version 3.1 and exported to STATA version 14 for analysis purpose. Adjusted Odds Ratio at 95% confidence interval was used to show the association between dependent and independent variables. Statistical significance was declared at a P value less than 0.05. Results A total of 871 pregnant women were identified from the survey and included in this study. Overall, 96.67% (95% CI: 95.24, 97.67) had not get adequate (all components) ANC. The components of ANC services were increased from 3.35 to 32.34%, 2.52 to 46.33% 1.96 to 55.8%, 2.31 to 46.53%, 3.54 to 55.75%, 2.46 to 44.62%, 1.18 to 45.96%, and 2.45 to 54.6% for tetanus toxoid Vaccine, HIV/AIDS testing and counseling, danger sign, place of delivery, deworming, iron folic acid, family planning, and breast feeding counseling, from first ANC visit to fourth ANC visit, respectively. Rural residence (AOR = 4.89, 95% CI: 1.21, 19.86), and less than four number of ANC visit (AOR = 5.15, 95% CI: 2.06, 12.86) were significantly associated with inadequate uptake of ANC components. Conclusion Only three in hundred pregnant women were received adequate ANC components in the study area. Rural residence and less than four number of ANC visit were factors significantly associated with inadequate ANC uptake. Therefore, the district health department managers and program implementers need to train the health care *Correspondence: Wubshet Debebe Negash Full list of author information is available at the end of the article © The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativeco mmons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. Gelagay et al. Reproductive Health (2023) 20:69 Page 2 of 9 providers about the components of ANC. As well, increasing community and facility awareness of WHO recommendations on ANC visits focusing on rural women is needed. Keywords Antenatal care, Inadequate ANC, Dabat, Ethiopia Background During pregnancy, women and teens receive care from health professionals to ensure the best outcomes for themselves and for their babies [1, 2]. Additionally, it is possible to minimize the risk of maternal death by providing comprehensive maternal health care, throughout their pregnancy, delivery, and afterwards [1, 3]. This is because in Ethiopia the focus ANC is still recommended [4, 5]. The focus of ANC is on maternal care continuum framed as care for the mother, infant, and child based on the following recommended basic packages: The detection and treatment of disorders (such as anemia, abnormal lying, hypertension, diabetes, tuberculosis, syphilis, malaria, and hypertension); the provision of preventive interventions (like tetanus vaccinations and insecticide-treated bed nets); as well as the advice on diet, hygiene, HIV status, birth, emergency preparedness, and baby care and feeding [6, 7]. There have been an estimated 295,000 pregnancies and childbirth related deaths since 2017, with 94% of those deaths occurring in low and lower middle-income countries [8]. An estimated 14,000 maternal deaths occurred in Ethiopia in 2017, contributing to a maternal mortality rate of 401 deaths per 100,000 live births [8]. Increased ANC coverage and quality of healthcare can avert 71% of neonatal mortality, 33% of stillbirths, and 54% of maternal mortality in low and middle-income countries (LMICs) [9]. There is considerable evidence that the effectiveness of ANC is strongly influenced by the essential services covered during visits [10, 11]. Despite improved access to ANC, maternal and neonatal mortality rates continue to rise in developing nations. Negative health outcomes are still prevalent even when coverage is high [12]. Undoubtedly needs an improved ANC services with an attention for the contents of the services [10, 11]. In Ethiopia, ANC visits are at least four times during pregnancy, although eight is the minimum recommended by the World Health Organization (WHO). As part of this visit, every woman should receive all ANC components, including blood pressure measurements, fetal heartbeat, and lying tests, urine tests for infection and protein, syphilis screening, deworming, and nutrition counseling, iron/folic acid supplementation, insecticidetreated bed nets, and tetanus toxoid vaccination [13, 14]. The timing and number of ANC visits were the focus of studies at national and subnational levels rather than the content and associated factors of ANCs [15–19]. Additionally, studies in Ethiopia, were tried to assess components of ANC services, However, almost all of them were not included important packages such as HIV, malaria, as well as the provision of preventive interventions, s (...truncated)