Abstract:
Antenatal care visit is the service given to pregnant women in order to have a safe pregnancy and
a healthy baby. Recently the technical working group of World Health Organization has
recommended a minimum level of care to be eight visits throughout the pregnancy to reduce the
maternal morbidity and mortality. The main objectives of this study was assessing the regional
variation of number of ANC service visits per woman and identifying the factors influencing
number of antenatal care visits based on 2016 EDHS dataset. The survey collected information
from a total of 15,683 women aged 15-49 years out of which 7174 women were considered in this
study. Multilevel count regression models were used to explore the major risk factors and regional
differentials in number of antenatal care service visits per a child bearing woman in Ethiopia.
Descriptive statistics results show that nationally about 2481(35%) of mothers did not take any
antenatal care, which indicates excess zero and less percentage of non-zero counts and only
255(3.6%) attended ANC service follow-up eight times and above. From several multilevel count
regression models (Poisson, NB, ZIP, ZINB, HP, HNB), multilevel hurdle Poisson model was
selected using model comparison criteria like AIC, BIC and Deviance. Among multilevel hurdle
regression models (null model, random intercept with fixed coefficient and random coefficient
model), it was found that the random intercept with fixed coefficient model is the best model to
describe the data set. At the stage of multilevel, HP model showed that predictor variables age,
type of place of residence, wealth index, Mother educational level, husband educational level,
frequency of watching television, distance from health facility, wantedness of pregnancy and
pregnancy complication were found to be related with the antenatal care service follow-up. The
multilevel analysis further showed that there are within and between regional variations per
mother regarding to ANC service visits in Ethiopia. The findings of this study might help in
planning and developing strategies for utilization of ANC visits among pregnant women in
Ethiopia.
