title: [Social factors associated with use of prenatal care in Ecuador].
abstract: OBJECTIVE
  Prenatal care is a pillar of public health, enabling access to interventions including prevention of mother-to-child transmission of HIV and congenital syphilis. This paper describes social factors related to use of prenatal care in Ecuador.
  
  
  METHODS
  In 2011 and 2012, participant clinical history and interview information was analyzed from a national probability sample of 5 998 women presenting for delivery or miscarriage services in 15 healthcare facilities in Ecuador, to estimate prevalence of HIV, syphilis, and Chagas disease, and prenatal care coverage.
  
  
  RESULTS
  The study found that 94.1% of women had attended at least one prenatal visit, but that attendance at no less than four visits was 73.1%. Furthermore, lower educational level, greater number of pregnancies, occupation in the agriculture or livestock sector, and membership in ethnic indigenous, Afro-Ecuadorian, or other minority groups were factors associated with lack of use (no prenatal visits) or insufficient use of prenatal care (fewer than four visits or first visit at >20 weeks gestation) in Ecuador.
  
  
  CONCLUSIONS
  These results point to persistence of marked inequalities in access to and use of prenatal health services attributable to socioeconomic factors and to the need to strengthen strategies to address them, to reach the goal of universal prenatal care coverage.
authors.affiliation: Organización Panamericana de la Salud, Quito, Ecuador.
authors.forename: Amaya
authors.initials: A
authors.lastname: Sánchez-Gómez
authors.affiliation: Centro de Biomedicina, Carrera de Medicina, Universidad Central del Ecuador, Quito, Ecuador.
authors.forename: William
authors.initials: W
authors.lastname: Cevallos
authors.affiliation: Tropical Disease Institute, Department of Biomedical Sciences, Heritage College of Osteophathic Medicine, Universidad de Ohio, Ohio, Estados Unidos.
authors.forename: Mario J
authors.initials: MJ
authors.lastname: Grijalva
authors.affiliation: Escuela Nacional de Salud Pública, La Habana, Cuba.
authors.forename: Luis C
authors.initials: LC
authors.lastname: Silva-Ayçaguer
authors.affiliation: Estrategia Nacional de Salud Pública para VIH/Sida-ITS, Quito, Ecuador.
authors.forename: Susana
authors.initials: S
authors.lastname: Tamayo
authors.affiliation: Organización Panamericana de la Salud, Bogotá, Colombia.
authors.forename: Jerry O
authors.initials: JO
authors.lastname: Jacobson
authors.affiliation: Tropical Disease Institute, Department of Biomedical Sciences, Heritage College of Osteophathic Medicine, Universidad de Ohio, Ohio, Estados Unidos.
authors.forename: Jaime A
authors.initials: JA
authors.lastname: Costales
authors.affiliation: Universidad Rey Juan Carlos, Madrid, España.
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Jiménez-Garcia
authors.affiliation: Universidad Rey Juan Carlos, Madrid, España.
authors.forename: Valentín
authors.initials: V
authors.lastname: Hernández-Barrera
authors.affiliation: Centro Latinoamericano de Perinatología, Salud de la Mujer y Reproductiva, Organización Panamericana de la Salud, Brasilia, Brasil.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Serruya
authors.affiliation: Organización Panamericana de la Salud, Quito, Ecuador.
authors.forename: Celia
authors.initials: C
authors.lastname: Riera
mesh_terms: D004484:Ecuador; D005006:Ethnicity; D005260:Female; D015658:HIV Infections / Q000635:transmission; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D011247:Pregnancy; D011295:Prenatal Care / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D013590:Syphilis, Congenital / Q000635:transmission