Abstract：
BACKGROUND: Insufficient use of antenatal care (ANC) services and institutional births services can elevate the maternal mortality risk in limited resource settings. Hence, the key objective of this study was to evaluate the potential association between the frequency of ANC visits and institutional birth services in Afghanistan, while also identifying other sociodemographic factors that may exert influence. Furthermore, we explored factors associated with the attendance of women at ANC visits during their pregnancy.
METHODS: We employed data from the most recent Multiple Indicator Cluster Survey conducted in Afghanistan in 2022 to 2023 with a total of 8096 women aged 15 to 49. A complex survey weight-adjusted logistic regression model was used to examine factors related to institutional births, and a multinomial logistic regression model was fitted to assess the relationships between sociodemographic factors and ANC visits, adjusting for survey weights, cluster effects, and strata.
RESULTS: Approximately 40% of the sample (n = 3247) had undergone 4 or more ANC visits, and 74.4% (n = 6,022) had opted for institutional birth. Women\'s higher education was found to be associated with ANC visits. The area of residence, wealth index, education levels of women, ownership of mobile phones, number of children, and number of ANC visits were associated with institutional births. Compared with women with no or one ANC visit, those with more than 3 visits had 31% higher odds (adjusted odds ratio, 1.31; 95% CI, 1.10-1.57) of accessing institutional births.
CONCLUSIONS: Our findings indicate a significant association between ANC visits and use of institutional birth care. These findings carry implications for advancing safe motherhood and childbirth by enhancing women\'s social status.
METHODS: We employed data from the most recent Multiple Indicator Cluster Survey conducted in Afghanistan in 2022 to 2023 with a total of 8096 women aged 15 to 49. A complex survey weight-adjusted logistic regression model was used to examine factors related to institutional births, and a multinomial logistic regression model was fitted to assess the relationships between sociodemographic factors and ANC visits, adjusting for survey weights, cluster effects, and strata.
RESULTS: Approximately 40% of the sample (n = 3247) had undergone 4 or more ANC visits, and 74.4% (n = 6,022) had opted for institutional birth. Women\'s higher education was found to be associated with ANC visits. The area of residence, wealth index, education levels of women, ownership of mobile phones, number of children, and number of ANC visits were associated with institutional births. Compared with women with no or one ANC visit, those with more than 3 visits had 31% higher odds (adjusted odds ratio, 1.31; 95% CI, 1.10-1.57) of accessing institutional births.
CONCLUSIONS: Our findings indicate a significant association between ANC visits and use of institutional birth care. These findings carry implications for advancing safe motherhood and childbirth by enhancing women\'s social status.
摘要：
背景：在有限的资源环境中，产前护理（ANC）服务和机构分娩服务的使用不足会增加孕产妇死亡风险。因此，这项研究的主要目的是评估阿富汗ANC访问频率与机构分娩服务之间的潜在关联，同时还确定可能发挥作用的其他社会人口因素。此外，我们探讨了与女性在怀孕期间参加ANC就诊相关的因素.
方法：我们采用了2022年至2023年在阿富汗进行的最新多指标类集调查的数据，共有8096名15至49岁的女性。使用复杂的调查权重调整逻辑回归模型来检查与机构出生有关的因素，并拟合多项逻辑回归模型来评估社会人口统计学因素与ANC访问之间的关系，调整测量重量，集群效应，和地层。
结果：大约40％的样本（n=3247）经历了4次或更多的ANC访问，74.4%(n=6022)选择机构分娩。女性的高等教育被发现与ANC访问有关。居住区,财富指数，妇女的教育水平，拥有手机，儿童数量,ANC访视次数与机构分娩相关.与没有或一次非国大访问的女性相比，访问次数超过3次的人的赔率高出31%(调整后的赔率比，1.31；95%CI，1.10-1.57)。
结论：我们的研究结果表明，ANC访视与机构分娩护理的使用之间存在显著关联。这些发现对通过提高妇女的社会地位来促进安全孕产和分娩具有重要意义。
方法：我们采用了2022年至2023年在阿富汗进行的最新多指标类集调查的数据，共有8096名15至49岁的女性。使用复杂的调查权重调整逻辑回归模型来检查与机构出生有关的因素，并拟合多项逻辑回归模型来评估社会人口统计学因素与ANC访问之间的关系，调整测量重量，集群效应，和地层。
结果：大约40％的样本（n=3247）经历了4次或更多的ANC访问，74.4%(n=6022)选择机构分娩。女性的高等教育被发现与ANC访问有关。居住区,财富指数，妇女的教育水平，拥有手机，儿童数量,ANC访视次数与机构分娩相关.与没有或一次非国大访问的女性相比，访问次数超过3次的人的赔率高出31%(调整后的赔率比，1.31；95%CI，1.10-1.57)。
结论：我们的研究结果表明，ANC访视与机构分娩护理的使用之间存在显著关联。这些发现对通过提高妇女的社会地位来促进安全孕产和分娩具有重要意义。
