Optimal antenatal care visit and associated factors among pregnant women in Mozambique: a multilevel analysis

Optimal antenatal care (ANC) visits is defined as receiving at least four ANC visits, a tetanus toxoid injection and taking 100 iron-folic acid tablets or syrup during pregnancy. Proper antenatal care visit implementation significantly contribute to the reduction of mother and infant mortality. Of the estimated 254,000 maternal deaths worldwide in 2017, 86% occurred in Sub-Saharan Africa (SSA) and South Asia. Most of these deaths (94%) took place in low and middle-income nations which could have been prevented in most cases. Therefore, the objective of our study was to assess the prevalence of optimal ANC visits and associated factors among pregnant women’s in Mozambique using recent Demographic and Health Surveys (DHS). A cross-sectional study was conducted from secondary data DHS from 2022/2023 in Mozambique. A total weighted sample of 13,183 women were included in this study. Data processing and analysis were done using STATA 14 software. Multilevel logistic regression model was fitted. Model comparison was done based on deviation information criteria (DIC). Variables with a p-value ≤ 0.05 were declared as significant determinants of ANC utilization. The prevalence of optimal antenatal care visit among pregnant women in Mozambique were found to be 78.6% (95% CI: (77.9%:79. %). In multivariable multilevel logistic regression, individual level factors and community level factors such as maternal age, women’s education status, household wealth status, marital status, number of under-five child in the house hold, place of delivery, community poverty and community literacy were determinants of optimal antenatal care visit among pregnant women’s in Mozambique. Although the utilization of optimal ANC visits has improved compared with the 2011 survey, further progress is still needed. The study identified that factors like maternal age, maternal education, marital status, number of under five children at home, wealth index, place of delivery as individual and community maternal poverty and community maternal literacy as community-level determinants of optimal ANC visit. Therefore, improving mothers and community awareness towards optimal ANC visit benefits and its complication are recommended to enhance optimal ANC visit.