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A multilevel modelling approach to understanding antenatal care utilisation in Uganda
Moses Festo Towongo1, Kannan Navaneetham2, Gobopamang Letamo2
1School of Social and Economic Studies, Department of Statistics and Demography, University of Juba, Juba, South Sudan. mtowongo@yahoo.com.
BMC Pregnancy and Childbirth
|June 25, 2026
Summary
Adequate antenatal care (ANC) service utilization remains low in Uganda. Employment, region, and media exposure significantly influence ANC use, highlighting areas for targeted health interventions.
Area of Science:
- Public Health
- Maternal Health
- Health Services Research
Background:
- Uganda faces high maternal mortality rates, exacerbated by underutilization of antenatal care (ANC) services.
- This underutilization hinders progress towards Sustainable Development Goal 3.1 for reducing maternal deaths.
Purpose of the Study:
- To investigate factors influencing adequate antenatal care service utilization among Ugandan women.
- To identify individual and community-level determinants of ANC service uptake.
Main Methods:
- Secondary data from the 2016 Uganda Demographic and Health Survey (UDHS) were analyzed.
- The study included women aged 15-49 who had given birth in the preceding five years.
- Univariate, bivariate, and multilevel binary logistic regression models were employed.
Main Results:
- Only 6.4% of women utilized antenatal care services adequately.
- Employed women showed higher odds of adequate ANC utilization (AOR=1.53).
- Women in Northern and Western regions and those in media-saturated communities had increased odds of adequate ANC use.
Conclusions:
- Antenatal care service utilization in Uganda is critically low.
- Employment status, region of residence, and community media saturation are key determinants of adequate ANC utilization.
- Strengthening community media campaigns in underutilizing regions is recommended to improve ANC service quality and access.
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