Perceived need on incomplete utilization of recommended antenatal care visits in Nepal using Nepal Demographic and Health Survey 2022

Antenatal care (ANC) visits are crucial for maternal and child health; however, many women in Nepal miss the recommended visits, often reporting they “did not feel the need”. This study aims to examine this perception for improving ANC utilization. We utilized data from the Demographic and Health Survey (DHS) 2022 of Nepal. Complex sample analysis was utilized to adjust for the stratified and cluster design of the study, with sampling weights. Crosstabulation and multivariable logistic regression were used to identify the factors associated with incomplete utilization reporting “did not feel the need”. Among 1931 women aged 15–49, 189 reported incomplete ANC visits, reporting they “did not feel the need”. Women from Madhesh Province (AOR:10.478, 95% CI:3.372–32.554, p < 0.001), those from Madhesi ethnic group (AOR:3.274, 95% CI:1.281–8.367, p < 0.050), women from male-headed households (AOR:1.870, 95% CI:1.038–3.366, p < 0.050), absence of health program exposure (AOR:3.631, 95% CI:1.449–9.103, p < 0.010), and multiparous women (AOR:2.083, 95% CI:1.101–3.943, p < 0.050) were significantly more likely to have incomplete utilization of recommended ANC visits, reporting “did not feel the need”. Incomplete utilization of recommended ANC visits was often reported as “did not feel the need” and is shaped by provincial disparities, inequalities in caste/ethnic group, households with male-headed, higher birth order, and absence of health program exposure. These findings highlight structural, socio-cultural, and information barriers rather than individual preference. Strengthening equity-oriented intervention, enhancing women’s autonomy, and expanding health program outreach are essential to dispel misconceptions about “did not feel the need” for utilization of recommended ANC visits.