Factors That Affect Utilization of Antenatal Care Among Recently Pregnant Women in Three Southern African Countries: Focus on the Role of Intimate Partner Violence

Intimate partner violence (IPV) has significant negative reproductive health consequences for pregnant women and, may affect the utilization of antenatal care. The objective of this study is to identify the relationship between the use of antenatal care (ANC) and IPV among women age 15 to 49. Cross-sectional data from the most recent Demographic and Health Survey of three countries—Malawi, Zambia, and Zimbabwe—were analyzed. Data were obtained from 3,479 women age 15–49 who answered the domestic violence module. The study found the following: Zimbabwe had the highest percentage of women who received the recommended number of ANC visits (70.4%), while Malawi had the lowest percentage (47.6%). The highest percentages of women with the recommended number of visits were found among the 20–24-year-age group in all three countries: Malawi (33.3%), Zambia (28.9%), and Zimbabwe (27.6%). Zimbabwean women with autonomy had 2.5 times the odds of having the recommended ANC visits compared to those without autonomy (OR: 2.5, 95% CI [1.64, 3.91], p < .001). Women who reside in rural areas in Malawi had 50% lower odds of having the recommended ANC visits (OR: 0.5, 95% CI [0.32, 0.82], p < .01). Women with four or more children had lower odds of having the recommended ANC visits in all countries. In Zambia, women who had experienced IPV in the previous 12 months had lower odds of having the recommended ANC visits (OR: 0.66, 95% CI [0.50, 0.88], p < .01). The study concludes that although the experience of IPV does not appear to influence the utilization of the recommended ANC visits in two of the three countries, it is important to identify context-specific factors that may impede ANC utilization and to address unnecessary complications that are directly associated with minimum use of ANC services.