Effects of planned, mistimed and unwanted pregnancies on the use of prenatal health services in sub-Saharan Africa: a multicountry analysis of Demographic and Health Survey data.
We analysed the extent of planned, mistimed and unwanted pregnancies and how they predict optimal use of prenatal (timing and number of antenatal) care services in 30 African countries.



We pooled data from Demographic and Health Surveys conducted in 30 African countries between 2006 and 2015. We described the extent of mistimed and unwanted pregnancies and further used mixed effects logistic and Poisson regression estimation techniques to examine the impacts of planned, mistimed and unwanted pregnancies on the use of prenatal health services.



In total, 73.65% of pregnancies in all countries were planned. Mistimed pregnancy ranged from 7.43% in Burkina Faso to 41.33% in Namibia. Unwanted pregnancies were most common in Swaziland (39.54%) and least common in Niger (0.74%). Timely (first trimester) initiation of ANC was 37% overall in all countries; the multicountry average number of ANC visits was optimal [4.1; 95% CI: 4.1-4.2] but with notable disparities between countries. Overall, mistimed and unwanted pregnancies were strongly associated with late ANC attendance and fewer visits women made in the pooled analysis.



Unintended pregnancies are critical risks to achieving improved maternal health in respect of early and optimal ANC coverage for women in Africa. Programmes targeted at advancing coverage of ANC in Africa need to deploy contextually appropriate mechanisms to prevent unintended pregnancies.
African Population and Health Research Center, Nairobi, Kenya.|Department of Population and Health, University of Cape Coast, Cape Coast, Ghana.
Joshua
J
Amo-Adjei
Department of Community Medicine, School of Medical Sciences, University of Cape Coast, Cape Coast, Ghana.
Derek
D
Anamaale Tuoyire
D000328:Adult; D017954:Africa South of the Sahara; D003710:Demography; D005260:Female; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D000068097:Maternal Health; D010342:Patient Acceptance of Health Care; D011247:Pregnancy; D049168:Pregnancy, Unplanned; D011275:Pregnancy, Unwanted; D011295:Prenatal Care / Q000706:statistics & numerical data*
Africa; Afrique; destiempo; embarazo; grossesse; indésiré; inopportun; mistimed; no deseado; planeado; planifié; planned; pregnancy; prenatal; prénatal; unwanted; África