title: Factors associated with antenatal and delivery care in Sudan: analysis of the 2010 Sudan household survey.
abstract: BACKGROUND
  Every day, globally approximately a thousand women and girls needlessly die as a result of complications during pregnancy, childbirth or the 6 weeks following delivery. The majority of maternal deaths are avoidable and could be prevented with proven interventions to prevent or manage complications during pregnancy and child birth. The aim of this study was to examine factors associated with underutilization of maternal health services in Sudan.
  
  
  METHODS
  Data was obtained from the Sudan Household Health Survey 2010(SHHS). The SHHS collected data from 5730 women, aged 15-49 years and who were pregnant in the last 2 years preceding the survey. The selection of the respondents was through a multi-stage cluster sampling technique. Interviews were conducted with respondents to collect data about their demographic characteristics, reproductive history, pregnancy and child delivery. Univariate analysis and logistic regression were used to analyze the data.
  
  
  RESULTS
  The factors associated with receiving antenatal care were, higher educational level (odds ratio (OR) = 3.428, 95% CI 2.473-4.751 - p value 0.001), higher household wealth (OR 1.656, 95% CI: 1.484-1.855 - p value 0.001) and low parity (OR =1.214, 95% CI: 1.035-1.423 - p value 0.017). The factors associated with institutional delivery were higher educational level (OR = 1.929, 95% CI: 1.380-2.697 - p value 0.001), high household wealth (OR = 2.293, 95% CI: 1.988-2.644 p value 0.001), urban residence (OR = 1.364, 95% CI: 1.081-1.721 p value 0.009), low parity (OR = 2.222, 95% CI: 1/786-2.765 p value 0.001), receiving ANC (OR = 3.342, 95% CI: 2.306-4.844 p value 0.001) and complications during pregnancy (OR = 1.606, 95% CI: 1.319-1.957 p value 0.001).
  
  
  CONCLUSIONS
  The factors associated with both antenatal care use and institutional delivery are similar and interventions to target these include expanding female education and improving coverage and affordability of health services.
authors.affiliation: Faculty of Medicine, International University of Africa, Khartoum, 12223, Sudan. mhmhs67@hotmail.com.
authors.forename: Muna Hassan
authors.initials: MH
authors.lastname: Mustafa
authors.affiliation: Department of Family and Community Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia. moniem.mukhtar@gmail.com.|Research Office, Public Health Institute, Khartoum, Sudan. moniem.mukhtar@gmail.com.
authors.forename: Abdel Moniem
authors.initials: AM
authors.lastname: Mukhtar
mesh_terms: D000293:Adolescent; D000328:Adult; D036861:Delivery, Obstetric / Q000706:statistics & numerical data; D005191:Family Characteristics; D005260:Female; D006268:Health Facilities / Q000706:statistics & numerical data; D006306:Health Surveys; D006801:Humans; D007407:Interviews as Topic; D016015:Logistic Models; D008875:Middle Aged; D010298:Parity; D036801:Parturition; D011247:Pregnancy; D011295:Prenatal Care / Q000706:statistics & numerical data*; D036301:Qualitative Research; D013397:Sudan; D011795:Surveys and Questionnaires; D055815:Young Adult