Comparing the timeliness and adequacy of antenatal care uptake between women who married as child brides and adult brides in 20 sub-Saharan African countries

• Published in: PloS one Vol. 17; no. 1; p. e0262688
• Main Authors: Adedini, Sunday A, Abatan, Sunday Matthew, Ogunsakin, Adesoji Dunsin, Alex-Ojei, Christiana Alake, Babalola, Blessing Iretioluwa, Shittu, Sarafa Babatunde, Odusina, Emmanuel Kolawole, Ntoimo, Lorretta Favour C
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 13.01.2022; Public Library of Science (PLoS)
• Subjects: Adequacy; Adolescent; Africa South of the Sahara - epidemiology; Age; Age Factors; Births; Bivariate analysis; Care and treatment; Child marriage; Childrens health; Comparative analysis; Demographic aspects; Demographics; Demography; Economics; Education; Family; Female; Fertility; Gender; Health care; Health risks; Health services utilization; Humans; Marriage; Marriage - psychology; Marriage - statistics & numerical data; Maternal & child health; Maternal mortality; Medicine and Health Sciences; Mothers; Patient Acceptance of Health Care - ethnology; Patient Acceptance of Health Care - psychology; Patient Acceptance of Health Care - statistics & numerical data; Patient outcomes; People and Places; Pregnancy; Pregnant women; Prenatal care; Prenatal Care - psychology; Prenatal Care - statistics & numerical data; Prenatal Care - trends; Prevalence; Public health; Regression analysis; Social Sciences; Socioeconomic Factors; Socioeconomics; Womens health; Young Adult; Africa South of the Sahara; Sub-Saharan Africa; Nigeria; South Asia
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0262688

Considering the persistent poor maternal and child health outcomes in sub-Saharan Africa (SSA), this study undertook a comparative analysis of the timing and adequacy of antenatal care uptake between women (aged 20-24 years) who married before age 18 and those who married at age 18 or above. Data came from Demographic and Health Surveys of 20 SSA countries. We performed binary logistic regression analysis on pooled data of women aged 20-24 (n = 33,630). Overall, the percentage of child brides in selected countries was 57.1%, with the lowest prevalence found in Rwanda (19.1%) and the highest rate in Chad (80.9%). Central and West African countries had the highest prevalence of child marriage compared to other sub-regions. Bivariate results indicate that a lower proportion of child brides (50.0%) had 4+ ANC visits compared to the adult brides (60.9%) and a lower percentage of them (34.0%) initiated ANC visits early compared to the adult brides (37.5%). After controlling for country of residence and selected socio-economic and demographic characteristics, multivariable results established significantly lower odds of having an adequate/prescribed number of ANC visits among women who married before age 15 (OR: 0.63, CI: 0.57-0.67, p<0.001), and women who married at ages 15-17 (OR: 0.81, CI: 0.75-0.84, p<0.001) compared to those who married at age 18+. Similar results were established between age at first marriage and timing of first ANC visit. Other interesting results emerged that young women who married earlier than age 18 and those who married at age 18+ differ significantly by several socio-economic and demographic characteristics. Efforts to improve maternal and child health outcomes in SSA must give attention to address the underutilization and late start of antenatal care uptake among child brides.