Background. In 2016, the World Health Organization (WHO) introduced a minimum of eight antenatal care (ANC) visits for positive pregnancy outcomes. This study examined the prevalence of noncompliance with 8+ ANCvisits and its associated factors in sub-Saharan Africa (SSA). Methods. We used data from the Demographic and Health Surveys of eight countries in SSA. A pooled sample of 63,266 pregnant women aged 15-49 years who had given birth to children within 5 years prior to the surveys was included in this study. To examine the factors associated with noncompliance with ANC 8+ visits, multilevel binary logistic regression analysis was conducted, and the results were reported using odds radios at 95% confidence interval (CI). Results. The pooled prevalence of noncompliance with ANC 8+ visits was 92.3% (95% CI: 91.1%-93.3%) with the highest and lowest prevalence in Zambia (98.7%, 95% CI: 98.3%-99.1%) and Libya (73.4%, 95% CI: 70.4%-76.2%), respectively. With the individual level factors, women’s age (44-49 years-, 9% CI: 0.14-0.78), health insurance registration, (yes-, 95% CI: 0.29-0.98), and economic status (richest-, 95% CI: 0.05-0.49) were negatively associated with noncompliance with 8+ ANC visits, while parity (five or more children-, 95% CI: 1.12-2.52) was positively associated with noncompliance with 8+ ANC visit. With the community level factors, community level literacy was negatively associated with noncompliance with 8+ ANC visit (high-, 95% CI: 0.32-0.99). Conclusion. About eight out of ten pregnant women did not comply with the WHO’s recommended minimum of eight ANC visits for positive pregnancy outcomes in SSA. Empowering the economic status of women , enhancing health insurance and education coverage, and giving more attention to young pregnant women and those with more children are crucial for improving the coverage of ANC 8+ visits in the region.

中文翻译：

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撒哈拉以南非洲地区孕妇不遵守世界卫生组织建议的八次产前护理的情况：多层次分析


背景。 2016 年，世界卫生组织 (WHO) 规定至少进行 8 次产前护理 (ANC)，以获得积极的妊娠结果。本研究调查了撒哈拉以南非洲地区 (SSA) 不遵守 8 次以上 ANC 访问的情况及其相关因素。方法。我们使用了撒哈拉以南非洲八个国家的人口和健康调查数据。本研究纳入了 63,266 名 15-49 岁孕妇的汇总样本，她们在调查前 5 年内生育过孩子。为了检查与 ANC 8+ 就诊不依从相关的因素，进行了多级二元 Logistic 回归分析，并使用 95% 置信区间 (CI) 的比值无线电报告结果。结果。 ANC 8+ 就诊不依从的汇总患病率为 92.3%（95% CI：91.1%-93.3%），患病率最高和最低的是赞比亚（98.7%，95% CI：98.3%-99.1%）和利比亚（73.4%）。 %，95% CI：70.4%-76.2%）。随着个人水平因素的影响，女性的年龄（44-49岁- ， 9% CI：0.14-0.78），健康保险登记，（是的- ， 95% CI：0.29-0.98）和经济状况（最富有的- ， 95% CI：0.05-0。49）与 8 次以上 ANC 就诊的不依从性呈负相关，而胎次（五个或更多儿童 - ， 95% CI：1.12-2.52）与 8+ ANC 就诊不依从呈正相关。就社区层面的因素而言，社区层面的识字率与 8 岁以上 ANC 就诊的不依从性呈负相关（高- ， 95% CI：0.32-0.99）。结论。大约十分之八的孕妇没有遵守世界卫生组织建议的 SSA 至少进行 8 次 ANC 就诊以获得积极妊娠结果的建议。提高妇女的经济地位、提高医疗保险和教育覆盖率以及更多地关注年轻孕妇和多子女妇女对于提高该地区 ANC 8+ 就诊覆盖率至关重要。