Application of Count Regression Models for Factors of Antenatal Care (ANC) Utilization in Ethiopia

Abstract

Adequate antenatal care is necessary to improve the health status of peoples in a country as it contributes the reduction of infant and maternal mortalities. The coverage and the quality of antenatal care plays significant role in maternal health. Ethiopia has witnessed an encouraging improvement in the ANC coverage (at least one visit) in the last decade from 62% in 2016 to 74% in 2019. But only 43% of women had at least four ANC visits during their last pregnancy. The purpose of this study is to identify factors that affect antenatal care visits based on 2019 Ethiopia Mini Demographic and Health Survey (EMDHS) dataset using count regression model. A total of 8,885 women aged 15-49 years were asked for the EMDHS-2019 out of which 3,927 women were illegible and asked for their ANC experiences for their last pregnancy. This empirical study aimed at investigating the impacts of the socioeconomic and demographic characteristics on the utilization of antenatal care. To investigate the impacts of the factors on the number of ANC visits, count models such as Poisson, Negative Binomial (NB), Zero Inflated Poisson (ZIP) and Zero-inflated negative binomial (ZINB) models were examined to select the best fitted model. The selection criterion Akaike information criterion (AIC), Bayesian information criterion (BIC) and Log Likelihood were applied to select the best model. The ZIP model was found to be the best fitted model for the data. Based on ZIP model, the explanatory variables region, age, place of residence, education, religion, wealth index and marital status were statistically significant factors on the frequency of ANC visits. Hence, efforts are still required to put on creating and expanding awareness on the utilization of ANC. The policy makers along with both private sectors and civil societies have to facilitate the increase of awareness and the experiences of the utilization of ANC in consideration of households within different groups of a society.

Keywords: EMDHS-2019, antenatal care, Count Regression model

DOI: 10.7176/JHMN/101-02

Publication date:June 30^th 2022