Publication: Evolution and determinants of antenatal care services utilization among women in Rwanda: a rapid review
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2024-09-16
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Research Square
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Abstract
Background: Maternal and child health remains a global priority, with antenatal care (ANC) recognized as
essential for ensuring positive pregnancy outcomes. Despite significant improvements, ANC utilization in
low and middle-income countries, particularly in Sub-Saharan Africa, remains low, contributing to high
maternal and neonatal mortality rates. This paper highlighted significant progress in Rwanda's maternal
health services since 2000. It further explored the evolution of ANC utilization in Rwanda, identifying key
determinants and trends over the past two decades.
Methods: Following a traditional maternal and child health services contextualization in Rwanda, a rapid
review was conducted, searching databases such as PubMed, Google Scholar, and Scopus, alongside
grey literature and reference lists. The review focused on studies published between 2010 and 2024,
examining factors associated with ANC utilization in Rwanda. The screening was independently
conducted by two reviewers with the assistance Rayyan application, followed by full-text screening and
data synthesis. The results were presented using the forest plots to display the significant odd ratios of
ANC services utilization across different predictor variables.
Results: The review included 11 studies and 1 report revealing a significant improvement in ANC
utilization in Rwanda. By 2019-2020, 47% of women received ANC in the first trimester, and 59% had four
or more visits, compared to 35% and 38%, respectively, in 2010.
Factors positively associated with adequate ANC included higher education levels, better wealth status,
health insurance coverage, and small household size. Conversely, significant distance to health facilities
and unwanted pregnancies were associated with lower odds of adequate ANC utilization. Delayed ANC
was more likely among women with higher parity, those who lack social support, and those with no or
only primary education.
Conclusion: The findings indicate that Rwanda has made considerable strides in improving ANC
utilization. Addressing barriers such as distance to healthcare facilities, education, and economic
disparities is crucial for further enhancing maternal and child health outcomes. The review underscores
the need for targeted interventions to achieve WHO recommendations of 8 ANC visits and Sustainable
Development Goals (SDGs) related to maternal and child health in Rwanda.
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Keywords
Evolution, Determinants, Utilizations, Antenatal Care, Women, Rwanda