Utilization and determinants of antenatal care services among women in rural hilly regions of Kalimpong and Darjeeling, India: In light of the revised WHO guideline

Antenatal care (ANC) is a critical component of maternal and child health, as it enhances outcomes for both the mother and her newborn. We assessed ANC utilization and its key determinants in the rural hilly districts of Kalimpong and Darjeeling, focusing on ANC visits, ANC quality, and complete ANC. A cross-sectional study of 660 women aged 15-49 was analyzed using descriptive, bivariate, and logistic regression analyses. The results of the authors' analysis reveal a substantial gap in both the frequency and quality of ANC. Women's education emerged as a key determinant, positively influencing all ANC outcomes, while distance to health facilities and alcohol use during pregnancy reduced utilization. Higher income and ASHA counseling increased optimal ANC visits, whereas health care autonomy and frequent ASHA visits were associated with adequate ANC quality. We emphasized that comprehensive ANC requires enhancing socioeconomic strategies, improving facility access, ASHA support, and addressing pregnancy-related behavioral risks.