Individual and community level determinants of unmeet pregnancy complication education among pregnant ANC visitor women in Sub-Saharan Africa: a multilevel analysis of the recent demographic and health survey.

BACKGROUND

Unmet pregnancy complication education(UPCE) refers to the lack of information provided to pregnant mothers about potential pregnancy-related complications, which can lead to adverse outcomes. This issue is prevalent in developing countries and significantly impacts maternal health. This study aims to examine the prevalence rates and risk factors associated with UPCE in three Sub-Saharan Africa (SSA) countries.

METHODS

Data for this study were sourced from the recent DHS conducted between 2015 and 2022 in three SSA countries, encompassing 20,467 pregnant women with weighted sample sizes for representativeness. A secondary data analysis was performed to examine the prevalence of UPCE and associated risk factors. A multilevel mixed-effects logistic regression model was used to analyze hierarchical data structures, accounting for individual and contextual variables. Independent variables included demographic factors, socioeconomic status, and healthcare access. Significance was determined at p-values < 0.05, with results interpreted through AOR &CI.

RESULT: In SSA, two out of five pregnant mothers experience UPCE. Individual-level factors associated with this issue include education (AOR = 1.85, 95% CI: 1.65-2.1), wealth status (AOR = 1.4, 95% CI: 1.27-1.55), number ANC visits (AOR = 1.14, 95% CI: 1.0-1.28), distance from health facilities (AOR = 0.77, 95% CI: 0.7-0.84), and marital status (AOR = 1.15, 95% CI: 1.0-1.27). At the community level, ANC utilization (AOR = 1.2, 95% CI: 1.1-1.35), as well as country-specific factors, showed significant associations: Gabon (AOR = 0.57, 95% CI: 0.5-0.65) and Senegal (AOR = 0.28, 95% CI: 0.28-0.3) were notably linked to the prevalence of UPCE among pregnant women.

CONCLUSIONS AND RECOMMENDATIONS: The study reveals a high prevalence of unmet pregnancy complication education among pregnant women in Sub-Saharan Africa. Policymakers and health ministries must prioritize addressing these needs, especially for those without formal education, low-income individuals, and those far from health facilities. Health providers should utilize waiting times to educate clients, and investments in provider training and multimedia resources can enhance information dissemination. Targeted strategies that consider these factors are essential for improving maternal health outcomes.