Determinants of Antenatal Care Utilisation in India: A Count Data Modelling Approach

 Journal of Development Policy and Practice

The article explores the micro-level factors (social, economic and demographic) that determine the utilisation of antenatal care (ANC) services in India using the Bayesian count data regression model. The primary purpose is to rectify the methodological loopholes in the existing literature using a count data regression model that overcomes the problems of overdispersion in the data. Using data from ‘National Family Health Survey’ (NFHS) data on women of reproductive age (15–49 years)it finds that about 33% of pregnant women have not availed ANC during their pregnancy. The factors such as women’s education and partner/husband’s education, children’s birth order, household income, availability of basic amenities, like clean drinking water, media exposure, holding of bank accounts and use of mobile phones are statistically significant and positively affect ANC utilisation. Therefore, the study calls for prioritisation of and special attention to uneducated or less educated rural pregnant women. They should be incentivised adequately to utilise ANC services, which may drastically reduce inadequacy in ANC utilisation and improve mothers’ health before and after delivery. Awareness camps should be organised in every village in rural areas about pregnancy-related complications and the benefits of ANC check-ups. Massive infrastructure in the form of primary health centres or community health centres is the need of the hour in rural India.


Adequate facilities of maternal healthcare services and their proper utilisation at the time of pregnancy may considerably improve the health conditions of both mothers and children. Inadequacy of antenatal care (ANC) utilisation leads to premature delivery, which causes a catastrophic rise in infant and maternal mortality and also many postnatal complications. A robust direct association between ANC visits and maternal mortality rate (MMR) and infant mortality rate (IMR) has been well evidenced in empirical research concerning children’s and mothers’ health. The studies have found countries with a low rate of ANC utilisation among pregnant mothers having a high MMR. Thus, identifying factors that encourage ANC visits at the time of pregnancy is vital, because it provides adequate information to policymakers. This, in turn, helps adopt proper strategies to improve maternal and child health. Several studies have explored various determinants of ANC visits at the individual, household and community levels in developing countries. The health sector’s efficiency is influenced by such factors as hygiene and sanitation, nutrition, education and skills, poverty and deprivation, social practices, environment and pollution and many others. Distance to healthcare services is the main obstacle to ANC visits at times of urgency. The status of women in society is greatly influenced and undervalued by religious beliefs and the practices that restrict the use of modern contraceptives. This, in turn, causes a high incidence of unintended pregnancies among teenagers, a major source of underutilisation/practice of maternal healthcare services. The marginalisation of women’s status in society is another important factor contributing to the low utilisation of ANC. It affects their autonomy and ability to seek healthcare services.

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  2. Overall, the findings of this research contribute to the understanding of factors influencing ANC utilization in India and mapquest provides recommendations for policymakers to address gaps in ANC coverage and improve maternal health outcomes.


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