title: Factors affecting maternal healthcare utilization in Afghanistan: secondary analysis of Afghanistan Health Survey 2012.
abstract: This study, a secondary analysis of data from Afghanistan Health Survey 2012, aimed to identify factors affecting maternal healthcare utilization in Afghanistan. Subjects were 5,662 women aged 15-49 years who had had one delivery in the two years preceding the survey. Odds ratio (OR) and 95% confidence interval (CI) were estimated by logistic regression analysis. The study found that 54.0% of mothers used antenatal care (ANC) at least one time, and 47.4% of births were assisted by skilled birth attendants (SBA). Adjusted OR of ANC use was 2.74 (95% CI, 2.08-3.60) for urban residency, 1.69 (95% CI, 1.26-2.27) for primary education relative to no education, 3.94 (95% CI, 3.51-4.42) for knowledge on danger signs of pregnancy, and 1.78 (95% CI, 1.47-2.15) for television and radio relative to no exposure. Adjusted OR of SBA utilization was 3.71 (95% CI, 2.65-5.18) for urban residency, 0.67 (95% CI, 0.48-0.91) for age <20 years relative to age 34-49 years, 1.43 (95% CI, 1.03-1.97) for secondary and higher education relative to no education, 1.83 (95% CI, 1.47-2.27) for para 1 relative to para ≥5, 6.66 (95% CI, 5.43-8.15) for ≥4 ANC visits relative to no visit, 1.37 (95% CI, 1.21-1.57) for knowledge of danger signs of pregnancy, 1.62 (95% CI, 1.38-1.90) for radio relative to no exposure, and 2.71 (95% CI, 2.25-3.27) for rich households relative to poor ones. Since women's education and knowledge about danger signs of pregnancy were significant factors of both ANC and SBA, educating women may be an effective step in promoting safe maternal health.
authors.affiliation: Master's Degree Student in Healthcare Administration at Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Muhammad Shuaib
authors.initials: MS
authors.lastname: Shahram
authors.affiliation: Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Hamajima
authors.affiliation: Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Joshua A
authors.initials: JA
authors.lastname: Reyer
keywords: Afghanistan; antenatal care; maternal healthcare; maternal mortality; skilled birth attendant