Determinants of quality Antenatal Care utilization in Kenya: insights from the 2022 Kenya Demographic and Health Survey

Abstract

Introduction: One of the most important strategies to lower mother and newborn fatalities worldwide is providing quality Antenatal care (ANC). The utilization of quality ANC by women of reproductive age and associated factors remains unclear in many developing countries. Therefore, the purpose of this study was to determine the factors associated with the utilization of quality ANC in Kenya. Methods: We analyzed Secondary data from the Kenya Demographic Health Survey (KDHS) 2022, which included 11,863 women. Participants were selected using a two-stage stratified sampling design. Using SPSS, version 20, univariate and multivariable logistic regression was used to analyze the data. Results: Of the 11,863 women, 61.2% (95% CI: 59.7-62.6) received quality ANC. Older mothers (aged 20–34) had a 1.82 (95%CI: 1.15-2.87) times higher likelihood of receiving quality ANC when compared with younger mothers (15–19 years old). Participating mothers who had attended 4 or more ANC visits were 1.42 (95%CI: 1.14-1.79) times more likely to receive quality ANC than those who attended 3 or fewer visits. Comparing participants with and without media access, those with media access were 1.47 (95%CI: 1.06-2.03) times more likely to receive quality ANC. Furthermore, the likelihood of receiving quality ANC was 1.93 (95%CI: 1.21-3.08) and 1.44 (95%CI: 1.01-2.06) times higher for participants in the richest and richer quintiles, respectively, than for those in the poorest quintile. On the contrary, the odds of receiving quality ANC were 0.25 (95%CI: 0.15-0.31) to 0.64 (95%CI: 0.44-0.92) times lower for participating mothers from all other Kenyan regions than for those from the coastal region. Participants whose husbands or partners made decisions for them to seek healthcare, compared with those who made decisions independently were 0.74 (95%CI: 0.58-0.95) times less likely to receive quality antenatal care. Conclusion: The study revealed that about 60% of mothers received quality ANC. Several factors associated with quality ANC were identified: age, region, maternal education, health-seeking decision-making, access to media (TV), time to the health facility, ANC visits, and ANC providers (doctor and nurse/midwife/clinical officer). Maternal health improvement programs should prioritize promoting access to education for girls. Additionally, interventions should focus on promoting shared decision-making and autonomy in healthcare-seeking behaviors among pregnant women and their partners, increasing access to care provided by skilled health workers, and addressing regional disparities in healthcare delivery.