Assessment of antenatal care utilization and client satisfaction of women in rural and urban areas of Kathmandu District of Nepal

Abstract

Background: Antenatal care is an important determinant of high maternal mortality rate and one of the basic components of maternal health care and is also a key strategy for reducing maternal mortality. In South East Asia Region, MMR is still higher in Nepal therefore SLTHP targets to increase in the percentage of pregnant women attending a minimum of four ANC visit to 80%. This study aimed to assess the antenatal care utilization and client satisfaction in rural and urban areas of Kathmandu district of Nepal. Methods: A Cross-sectional study was carried out in two randomly selected urban (Dhapasi VDC) and rural (Jhormahankal VDC) areas of Kathmandu district of Nepal. All delivered women (urban = 188 and rural = 104) with child less than 12 months of age was interviewed with pretested questionnaire to assess the ANC utilization and client satisfaction in both areas. Results: Overall ANC utilization was 84.6% (urban 83% and rural 87.5%) and Complete ANC utilization was 58% (urban 59.6% and rural 56%) and overall satisfaction was 43.7 % (urban 44.2% and rural 42.9%). Education, occupation, food security, income, facilitation, perception, information, distance (time factor), gender, availability of medicine had significant association with ANC utilization and client satisfaction (P < 0.05). Age, ethnicity, parity and family type, Social support, social barriers, household barriers had significant association with ANC utilization and place of ANC visit also had significant association with client satisfaction (P < 0.05). Conclusions: The study shows that socio-demographic characteristics, social support, family support, household barriers, gender, availability of medicine are the major influencing factors for ANC utilization and client satisfaction in urban and rural areas of Kathmandu district of Nepal. Therefore, improvement of socioeconomic status, education and awareness about pregnancy are required to increase antenatal care utilization and client satisfaction. The information regarding to the association with Antenatal care Utilization and Client Satisfaction are useful for further studies especially about the different aspects of social support and barriers of ANC utilization.