Main Article Content
Abstract
This review explores the knowledge and utilization of antenatal care (ANC) services among pregnant women, highlighting the factors that shape their awareness and engagement. Adequate knowledge of ANC services is crucial for maternal and fetal health, as it enables timely health monitoring, promotes early detection of complications, and facilitates informed healthcare decisions during pregnancy. However, various socioeconomic, cultural, and geographic barriers continue to limit ANC knowledge and utilization, particularly in low-resource settings. This review synthesizes current literature on the factors influencing ANC awareness, including educational level, income, urban versus rural residence, and community-based healthcare outreach. Cultural beliefs also play a pivotal role, often shaping perceptions and practices around pregnancy that impact ANC engagement. The importance of health education as an intervention is emphasized, with evidence suggesting that tailored educational programs, community health worker involvement, and mobile health (mHealth) applications improve ANC awareness and uptake, particularly among vulnerable populations. Policy reforms and healthcare provider training are also recognized as essential strategies to bridge existing knowledge gaps. The findings underscore the need for multi-faceted, context-sensitive interventions to address the diverse needs of pregnant women globally, thereby promoting equitable access to ANC and improving maternal and neonatal health outcomes.
Keywords
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This work is licensed under a Creative Commons Attribution 4.0 International License.
References
- Abubakar, A., Wanjala, S., & Nasambu, C. (2020). Cultural factors affecting utilization of maternal healthcare services in Kenya: A qualitative study. BMC Pregnancy and Childbirth, 20 (1), 150. https://doi.org/10.1186/s12884-020-2832-1
- Adebowale, S. A., & Oladipo, F. T. (2020). Cultural influence and antenatal care attendance in Nigeria: Insights from a qualitative study. Journal of Biosocial Science, 52 (4), 558-571. https://doi.org/10.1017/S0021932020000241
- Adekanbi, A. O., Olaleye, A. O., & Akinyemi, A. I. (2021). Socioeconomic determinants of antenatal care utilization in sub-Saharan Africa: A review of literature. Journal of Public Health in Africa, 12 (1), 97-103. https://doi.org/10.4081/jphia.2021.1611
- Adedokun, S. T., & Yaya, S. (2021). The role of socioeconomic factors in antenatal care utilization in Sub-Saharan Africa: A cross-sectional study. BMC Public Health, 21 (1), 185. https://doi.org/10.1186/s12889-020-10155-4
- Adu-Gyamfi, E., Adjei, S., & Owusu-Ampomah, Y. (2020). Impact of health education on antenatal care utilization in Ghana: A community-based intervention. BMC Health Services Research, 20, 935. https://doi.org/10.1186/s12913-020-05826-6
- Afulani, P. A., Phillips, B., & Kalwago, G. (2018). Community health worker programs to increase antenatal care uptake in rural Uganda. BMC Pregnancy and Childbirth, 18, 121. https://doi.org/10.1186/s12884-018-1738-4
- Anaba, U., Aluko, O. O., & Ojewale, E. A. (2021). Accessibility to maternal health services in rural Kenya: A qualitative analysis. African Journal of Reproductive Health, 25 (4), 48-56. https://doi.org/10.29063/ajrh2021/v25i4.5
- Atuhaire, S., & Mugisha, J. F. (2020). Community-based health education and utilization of antenatal care in Uganda: A qualitative analysis. BMC Health Services Research, 20, 36. https://doi.org/10.1186/s12913-019-4867-6
- Atukunda, E. C., Musiimenta, A., & Musinguzi, N. (2019). Community health workers improve access to maternal health services in rural Uganda: A case study. BMC Pregnancy and Childbirth, 19 (1), 121. https://doi.org/10.1186/s12884-019-2260-8
- Ayele, G. S., Melaku, Y. A., & Tesfaye, D. J. (2018). Barriers to antenatal care utilization among rural women in Ethiopia: A qualitative study. BMC Health Services Research, 18, 789. https://doi.org/10.1186/s12913-018-3597-4
- Bohren, M. A., Hunter, E. C., Munthe-Kaas, H. M., Souza, J. P., & Vogel, J. P. (2021). Facilitators and barriers to antenatal care for pregnant women: A systematic review. Health Policy and Planning, 36(4), 496-508. https://doi.org/10.1093/heapol/czaa147
- Carroli, G., Rooney, C., & Villar, J. (2018). How effective is antenatal care in preventing maternal morbidity and mortality? Paediatric and Perinatal Epidemiology, 15(S1), 1-42. https://doi.org/10.1046/j.1365-3016.2001.00001.x
- Chen, H. Y., Bauhoff, S., & Roberts, E. T. (2019). Health disparities in prenatal care knowledge in underserved communities in the United States. American Journal of Public Health, 109(5), 678-684. https://doi.org/10.2105/AJPH.2018.304988
- Chukwuma, A., Okafor, C., & Ezeh, A. (2020). The impact of traditional beliefs on antenatal care utilization in sub-Saharan Africa. Journal of Ethnobiology and Ethnomedicine, 16(1), 52. https://doi.org/10.1186/s13002-020-00405-9
- Diala, U. M., Ibeh, C. C., & Anya, S. E. (2020). Traditional beliefs and antenatal care utilization in sub-Saharan Africa: A systematic review. African Journal of Reproductive Health, 24(3), 29-39. https://doi.org/10.29063/ajrh2020/v24i3.4
- Fagbamigbe, A. F., Olajide, L. O., & Idemudia, E. S. (2022). Impact of education on ANC knowledge and utilization in sub-Saharan Africa. Women’s Health, 18, 1-13. https://doi.org/10.1177/17455065211066932
- Feroz, A., Perveen, S., & Aftab, W. (2021). Role of mobile health applications in improving antenatal care knowledge among rural women in Pakistan: A randomized controlled trial. Reproductive Health, 18(1), 58. https://doi.org/10.1186/s12978-021-01130-w
- Gage, A. J., & Guirlène Calixte, M. (2019). Socioeconomic disparities in antenatal care uptake among women in Haiti: Insights from the 2016 survey. International Journal of Gynecology & Obstetrics, 144(1), 73-80. https://doi.org/10.1002/ijgo.12640
- Gebreyesus, S. H., Berhe, K. M., & Gebremariam, B. A. (2019). Cultural factors influencing the use of antenatal care services in rural Ethiopia. Health Care for Women International, 40(2), 207-219. https://doi.org/10.1080/07399332.2018.1558386
- Gichuhi, J. W., Temu, A. A., & Nyaga, L. M. (2020). Mobile health interventions for maternal health education in rural Kenya: Challenges and successes. Global Health Action, 13(1), 1770912. https://doi.org/10.1080/16549716.2020.1770912
- Gupta, R., & Sharma, V. (2021). Enhancing healthcare provider training to improve maternal health outcomes: A focus on communication and cultural competence in India. Journal of Public Health Policy, 42(4), 576-588. https://doi.org/10.1057/s41271-021-00288-6
- Jiang, H., Qian, X., & Li, M. (2021). Barriers and facilitators to antenatal care utilization among rural-to-urban migrant pregnant women in China: A qualitative study. International Journal of Environmental Research and Public Health, 18(5), 2456. https://doi.org/10.3390/ijerph18052456
- Johnson-Agbakwu, C. E., Helm, T., Killawi, A., & Padela, A. I. (2019). Healthcare barriers and ANC knowledge gaps among African migrant women in the United States. Journal of Immigrant and Minority Health, 21(2), 307-316. https://doi.org/10.1007/s10903-018-0741-5
- Kiplagat, J., Mwangi, M., & Kimani, E. (2018). The role of community health workers in promoting antenatal care in Kenya: A review. African Journal of Reproductive Health, 22(3), 112-121. https://doi.org/10.29063/ajrh2018/v22i3.13
- Kumar, R., Das, V., & Tripathi, V. (2021). Impact of visual aids in antenatal health education among pregnant women in rural India. Journal of Community Health, 46(5), 935-944. https://doi.org/10.1007/s10900-021-00991-y
- Lincetto, O., Mothebesoane-Anoh, S., Gomez, P., & Munjanja, S. (2021). Antenatal care. In Opportunities for Africa’s Newborns. World Health Organization. https://doi.org/10.2147/OAJC.S28750
- Lund, S., Nielsen, B. B., & Hemed, M. (2019). Mobile health (mHealth) for improved antenatal care and health literacy in Tanzania: A cluster-randomized trial. Global Health Action, 12(1), 1582932. https://doi.org/10.1080/16549716.2019.1582932
- Maina, J., Kimani-Murage, E., & Muindi, K. (2021). Antenatal care services in rural Kenya: A cross-sectional analysis of barriers and enablers. Reproductive Health, 18, 159. https://doi.org/10.1186/s12978-021-01208-6
- Mujuru, M., Chipato, T., & Mutsvangwa, T. (2018). The impact of government policies on antenatal care service utilization in Zimbabwe. African Journal of Reproductive Health, 22(1), 98-105. https://doi.org/10.29063/ajrh2018/v22i1.10
- Mugo, N. S., Dibley, M. J., & Agho, K. E. (2019). The association between urbanization and knowledge of antenatal care services in Sub-Saharan Africa. PLOS ONE, 14(8), e0220097. https://doi.org/10.1371/journal.pone.0220097
- Nyamtema, A. S., Jong, A., & Urassa, D. P. (2019). Health education and utilization of antenatal care in low-income settings: A systematic review. Maternal and Child Health Journal, 23(4), 459-468. https://doi.org/10.1007/s10995-018-2657-9
- Odetola, T. D., Adegoke, A. O., & Aluko, A. A. (2020). Impact of free maternal health policy on antenatal care utilization in Nigeria. International Journal of Health Policy and Management, 9(11), 474-482. https://doi.org/10.34172/ijhpm.2020.80
- Olowokere, A. E., & Okanlawon, F. A. (2018). Effect of a health education program on perceived and actual knowledge of prenatal care among pregnant women in selected rural communities in Nigeria. African Health Sciences, 18(4), 957-965. https://doi.org/10.4314/ahs.v18i4.16
- Olusanya, B. O., Solarin, A. G., & Olawale, S. A. (2020). Health education and antenatal care utilization in Nigeria: Evidence from a population-based study. Journal of Community Health, 45(2), 328-334. https://doi.org/10.1007/s10900-019-00774-7
- Ononokpono, D. N., & Odimegwu, C. O. (2020). The effect of education on antenatal care attendance among women in Nigeria. African Population Studies, 34(1), 11-21. https://doi.org/10.11564/34-1-1526
- Qureshi, Z., Saleem, S., & Tikmani, S. S. (2021). Barriers to ANC access and knowledge in rural Southeast Asia: A multi-country analysis. Global Health Action, 14(1), 1841782. https://doi.org/10.1080/16549716.2021.1841782
- Rahman, A., Haque, S. E., & Zaman, S. (2019). The effectiveness of community health workers in improving antenatal care knowledge in rural Bangladesh. Health Promotion International, 34(3), 593-602. https://doi.org/10.1093/heapro/day098
- Rahman, M. M., Haque, S. E., & Zahan, M. S. (2018). Factors affecting ANC knowledge and utilization in South Asia: A systematic review. Public Health, 158, 110-120. https://doi.org/10.1016/j.puhe.2018.01.012
- Sanni, B. S., Ojo, O. F., & Lawal, A. A. (2019). Traditional beliefs and antenatal care utilization among pregnant women in Nigeria. Journal of Ethnobiology and Ethnomedicine, 15(1), 33. https://doi.org/10.1186/s13002-019-0308-9
- Sharma, B., Khatri, R., & Dhungana, G. (2019). Socioeconomic determinants of antenatal care services utilization in Nepal: A cross-sectional study based on data from the Nepal Demographic and Health Survey. BMC Public Health, 19(1), 1378. https://doi.org/10.1186/s12889-019-7650-6
- Singh, K., Ranjan, R., & Shrivastava, R. (2020). Enhancing healthcare provider-patient communication in antenatal care settings: Evidence from rural India. BMC Pregnancy and Childbirth, 20, 853. https://doi.org/10.1186/s12884-020-03386-6
- Tsawe, M., & Susuman, A. S. (2018). Determinants of antenatal care utilization among African women. Health & Place, 49, 79-87. https://doi.org/10.1016/j.healthplace.2017.12.001
- World Health Organization. (2016). WHO recommendations on antenatal care for a positive pregnancy experience. https://doi.org/10.1787/9789264265554-en
- World Health Organization. (2020). WHO antenatal care guidelines: Gaps and challenges in knowledge dissemination. https://doi.org/10.1787/9789264265554-en
- Yeoh, P. L., Hornetz, K., & Tey, N. P. (2016). Socioeconomic disparities in ANC knowledge and access among pregnant women in Malaysia. BMC Pregnancy and Childbirth, 16, 203. https://doi.org/10.1186/s12884-016-0974-6
- Yadav, M., Pandey, P., & Singh, P. (2020). Training healthcare providers to enhance antenatal care knowledge among pregnant women in rural India. Maternal and Child Health Journal, 24(2), 209-217. https://doi.org/10.1007/s10995-019-02830-9
References
Abubakar, A., Wanjala, S., & Nasambu, C. (2020). Cultural factors affecting utilization of maternal healthcare services in Kenya: A qualitative study. BMC Pregnancy and Childbirth, 20 (1), 150. https://doi.org/10.1186/s12884-020-2832-1
Adebowale, S. A., & Oladipo, F. T. (2020). Cultural influence and antenatal care attendance in Nigeria: Insights from a qualitative study. Journal of Biosocial Science, 52 (4), 558-571. https://doi.org/10.1017/S0021932020000241
Adekanbi, A. O., Olaleye, A. O., & Akinyemi, A. I. (2021). Socioeconomic determinants of antenatal care utilization in sub-Saharan Africa: A review of literature. Journal of Public Health in Africa, 12 (1), 97-103. https://doi.org/10.4081/jphia.2021.1611
Adedokun, S. T., & Yaya, S. (2021). The role of socioeconomic factors in antenatal care utilization in Sub-Saharan Africa: A cross-sectional study. BMC Public Health, 21 (1), 185. https://doi.org/10.1186/s12889-020-10155-4
Adu-Gyamfi, E., Adjei, S., & Owusu-Ampomah, Y. (2020). Impact of health education on antenatal care utilization in Ghana: A community-based intervention. BMC Health Services Research, 20, 935. https://doi.org/10.1186/s12913-020-05826-6
Afulani, P. A., Phillips, B., & Kalwago, G. (2018). Community health worker programs to increase antenatal care uptake in rural Uganda. BMC Pregnancy and Childbirth, 18, 121. https://doi.org/10.1186/s12884-018-1738-4
Anaba, U., Aluko, O. O., & Ojewale, E. A. (2021). Accessibility to maternal health services in rural Kenya: A qualitative analysis. African Journal of Reproductive Health, 25 (4), 48-56. https://doi.org/10.29063/ajrh2021/v25i4.5
Atuhaire, S., & Mugisha, J. F. (2020). Community-based health education and utilization of antenatal care in Uganda: A qualitative analysis. BMC Health Services Research, 20, 36. https://doi.org/10.1186/s12913-019-4867-6
Atukunda, E. C., Musiimenta, A., & Musinguzi, N. (2019). Community health workers improve access to maternal health services in rural Uganda: A case study. BMC Pregnancy and Childbirth, 19 (1), 121. https://doi.org/10.1186/s12884-019-2260-8
Ayele, G. S., Melaku, Y. A., & Tesfaye, D. J. (2018). Barriers to antenatal care utilization among rural women in Ethiopia: A qualitative study. BMC Health Services Research, 18, 789. https://doi.org/10.1186/s12913-018-3597-4
Bohren, M. A., Hunter, E. C., Munthe-Kaas, H. M., Souza, J. P., & Vogel, J. P. (2021). Facilitators and barriers to antenatal care for pregnant women: A systematic review. Health Policy and Planning, 36(4), 496-508. https://doi.org/10.1093/heapol/czaa147
Carroli, G., Rooney, C., & Villar, J. (2018). How effective is antenatal care in preventing maternal morbidity and mortality? Paediatric and Perinatal Epidemiology, 15(S1), 1-42. https://doi.org/10.1046/j.1365-3016.2001.00001.x
Chen, H. Y., Bauhoff, S., & Roberts, E. T. (2019). Health disparities in prenatal care knowledge in underserved communities in the United States. American Journal of Public Health, 109(5), 678-684. https://doi.org/10.2105/AJPH.2018.304988
Chukwuma, A., Okafor, C., & Ezeh, A. (2020). The impact of traditional beliefs on antenatal care utilization in sub-Saharan Africa. Journal of Ethnobiology and Ethnomedicine, 16(1), 52. https://doi.org/10.1186/s13002-020-00405-9
Diala, U. M., Ibeh, C. C., & Anya, S. E. (2020). Traditional beliefs and antenatal care utilization in sub-Saharan Africa: A systematic review. African Journal of Reproductive Health, 24(3), 29-39. https://doi.org/10.29063/ajrh2020/v24i3.4
Fagbamigbe, A. F., Olajide, L. O., & Idemudia, E. S. (2022). Impact of education on ANC knowledge and utilization in sub-Saharan Africa. Women’s Health, 18, 1-13. https://doi.org/10.1177/17455065211066932
Feroz, A., Perveen, S., & Aftab, W. (2021). Role of mobile health applications in improving antenatal care knowledge among rural women in Pakistan: A randomized controlled trial. Reproductive Health, 18(1), 58. https://doi.org/10.1186/s12978-021-01130-w
Gage, A. J., & Guirlène Calixte, M. (2019). Socioeconomic disparities in antenatal care uptake among women in Haiti: Insights from the 2016 survey. International Journal of Gynecology & Obstetrics, 144(1), 73-80. https://doi.org/10.1002/ijgo.12640
Gebreyesus, S. H., Berhe, K. M., & Gebremariam, B. A. (2019). Cultural factors influencing the use of antenatal care services in rural Ethiopia. Health Care for Women International, 40(2), 207-219. https://doi.org/10.1080/07399332.2018.1558386
Gichuhi, J. W., Temu, A. A., & Nyaga, L. M. (2020). Mobile health interventions for maternal health education in rural Kenya: Challenges and successes. Global Health Action, 13(1), 1770912. https://doi.org/10.1080/16549716.2020.1770912
Gupta, R., & Sharma, V. (2021). Enhancing healthcare provider training to improve maternal health outcomes: A focus on communication and cultural competence in India. Journal of Public Health Policy, 42(4), 576-588. https://doi.org/10.1057/s41271-021-00288-6
Jiang, H., Qian, X., & Li, M. (2021). Barriers and facilitators to antenatal care utilization among rural-to-urban migrant pregnant women in China: A qualitative study. International Journal of Environmental Research and Public Health, 18(5), 2456. https://doi.org/10.3390/ijerph18052456
Johnson-Agbakwu, C. E., Helm, T., Killawi, A., & Padela, A. I. (2019). Healthcare barriers and ANC knowledge gaps among African migrant women in the United States. Journal of Immigrant and Minority Health, 21(2), 307-316. https://doi.org/10.1007/s10903-018-0741-5
Kiplagat, J., Mwangi, M., & Kimani, E. (2018). The role of community health workers in promoting antenatal care in Kenya: A review. African Journal of Reproductive Health, 22(3), 112-121. https://doi.org/10.29063/ajrh2018/v22i3.13
Kumar, R., Das, V., & Tripathi, V. (2021). Impact of visual aids in antenatal health education among pregnant women in rural India. Journal of Community Health, 46(5), 935-944. https://doi.org/10.1007/s10900-021-00991-y
Lincetto, O., Mothebesoane-Anoh, S., Gomez, P., & Munjanja, S. (2021). Antenatal care. In Opportunities for Africa’s Newborns. World Health Organization. https://doi.org/10.2147/OAJC.S28750
Lund, S., Nielsen, B. B., & Hemed, M. (2019). Mobile health (mHealth) for improved antenatal care and health literacy in Tanzania: A cluster-randomized trial. Global Health Action, 12(1), 1582932. https://doi.org/10.1080/16549716.2019.1582932
Maina, J., Kimani-Murage, E., & Muindi, K. (2021). Antenatal care services in rural Kenya: A cross-sectional analysis of barriers and enablers. Reproductive Health, 18, 159. https://doi.org/10.1186/s12978-021-01208-6
Mujuru, M., Chipato, T., & Mutsvangwa, T. (2018). The impact of government policies on antenatal care service utilization in Zimbabwe. African Journal of Reproductive Health, 22(1), 98-105. https://doi.org/10.29063/ajrh2018/v22i1.10
Mugo, N. S., Dibley, M. J., & Agho, K. E. (2019). The association between urbanization and knowledge of antenatal care services in Sub-Saharan Africa. PLOS ONE, 14(8), e0220097. https://doi.org/10.1371/journal.pone.0220097
Nyamtema, A. S., Jong, A., & Urassa, D. P. (2019). Health education and utilization of antenatal care in low-income settings: A systematic review. Maternal and Child Health Journal, 23(4), 459-468. https://doi.org/10.1007/s10995-018-2657-9
Odetola, T. D., Adegoke, A. O., & Aluko, A. A. (2020). Impact of free maternal health policy on antenatal care utilization in Nigeria. International Journal of Health Policy and Management, 9(11), 474-482. https://doi.org/10.34172/ijhpm.2020.80
Olowokere, A. E., & Okanlawon, F. A. (2018). Effect of a health education program on perceived and actual knowledge of prenatal care among pregnant women in selected rural communities in Nigeria. African Health Sciences, 18(4), 957-965. https://doi.org/10.4314/ahs.v18i4.16
Olusanya, B. O., Solarin, A. G., & Olawale, S. A. (2020). Health education and antenatal care utilization in Nigeria: Evidence from a population-based study. Journal of Community Health, 45(2), 328-334. https://doi.org/10.1007/s10900-019-00774-7
Ononokpono, D. N., & Odimegwu, C. O. (2020). The effect of education on antenatal care attendance among women in Nigeria. African Population Studies, 34(1), 11-21. https://doi.org/10.11564/34-1-1526
Qureshi, Z., Saleem, S., & Tikmani, S. S. (2021). Barriers to ANC access and knowledge in rural Southeast Asia: A multi-country analysis. Global Health Action, 14(1), 1841782. https://doi.org/10.1080/16549716.2021.1841782
Rahman, A., Haque, S. E., & Zaman, S. (2019). The effectiveness of community health workers in improving antenatal care knowledge in rural Bangladesh. Health Promotion International, 34(3), 593-602. https://doi.org/10.1093/heapro/day098
Rahman, M. M., Haque, S. E., & Zahan, M. S. (2018). Factors affecting ANC knowledge and utilization in South Asia: A systematic review. Public Health, 158, 110-120. https://doi.org/10.1016/j.puhe.2018.01.012
Sanni, B. S., Ojo, O. F., & Lawal, A. A. (2019). Traditional beliefs and antenatal care utilization among pregnant women in Nigeria. Journal of Ethnobiology and Ethnomedicine, 15(1), 33. https://doi.org/10.1186/s13002-019-0308-9
Sharma, B., Khatri, R., & Dhungana, G. (2019). Socioeconomic determinants of antenatal care services utilization in Nepal: A cross-sectional study based on data from the Nepal Demographic and Health Survey. BMC Public Health, 19(1), 1378. https://doi.org/10.1186/s12889-019-7650-6
Singh, K., Ranjan, R., & Shrivastava, R. (2020). Enhancing healthcare provider-patient communication in antenatal care settings: Evidence from rural India. BMC Pregnancy and Childbirth, 20, 853. https://doi.org/10.1186/s12884-020-03386-6
Tsawe, M., & Susuman, A. S. (2018). Determinants of antenatal care utilization among African women. Health & Place, 49, 79-87. https://doi.org/10.1016/j.healthplace.2017.12.001
World Health Organization. (2016). WHO recommendations on antenatal care for a positive pregnancy experience. https://doi.org/10.1787/9789264265554-en
World Health Organization. (2020). WHO antenatal care guidelines: Gaps and challenges in knowledge dissemination. https://doi.org/10.1787/9789264265554-en
Yeoh, P. L., Hornetz, K., & Tey, N. P. (2016). Socioeconomic disparities in ANC knowledge and access among pregnant women in Malaysia. BMC Pregnancy and Childbirth, 16, 203. https://doi.org/10.1186/s12884-016-0974-6
Yadav, M., Pandey, P., & Singh, P. (2020). Training healthcare providers to enhance antenatal care knowledge among pregnant women in rural India. Maternal and Child Health Journal, 24(2), 209-217. https://doi.org/10.1007/s10995-019-02830-9