Utilization of antenatal care services by Sudanese women in their reproductive age

Objectives: To describe the current antenatal care situation in Sudan with regard to routine utilization of antenatal health care services and application of tetanus toxoid (TT) vaccination in urban and rural areas. Methods: The study was conducted in Khartoum State, Sudan, between August and December 2002. Interviews were held among a representative sample of 400 married women aged 15-49 years from both urban and rural localities. Utilization of antenatal care and TT vaccine for pregnant women were used as dependent variables while socio-economic status, place of resident, women's education, quality of care and walk-time were applied as independent variables. Results: Utilization of routine antenatal health care services was approximately 5 times and application of TT-vaccination was 3.7 times higher in urban women as compared to women in rural areas. A higher quality of care (odds-ratio 5.8) and shorter walk-time (odds-ratio 3.1) were significantly associated with more utilization of routine antenatal care services. Mother's education showed a nearly significant positive relationship both with the use of routine antenatal health care service (odds-ratio 2.1). Conclusion: Results suggest that public health care policy should focus on 1. developing more high quality primary health care facilities for routine antenatal care and TT-vaccination in rural areas, and 2. development and implementation of mass-media and community education for pregnant women on the need for routine antenatal care and TT-vaccination.