Objectives: This study was designed to examine predisposing, enabling, need and health care system factors of two patterns of prenatal care use (frequent prenatal care, early prenatal care) among women in reproductive age in Peru.
Background: Prenatal care is a basic component of the maternal care services. Prenatal care alone may not solve all health care complications and mortalities related to pregnancy; however major efforts have been made especially in developing countries to assure that pregnant women have access to adequate prenatal care and contribute to the achievement of the fifth millennium development goal.
Methods: Data from the 2004 Demographic and Health Survey (DHS), women’s questionnaire was used to assess the women’s use of prenatal care. The sample for this study was based on women who had their last child born alive during the five years prior to the interview date. All data was weighted, resulting in a sample of n=1771 women who had a live birth since January 1999. Bivariate chi square analysis and logistic regression were used to analyze the effects of the predisposing, enabling, need and healthcare systems factors on prenatal care use.
Results: Speaking an indigenous language, having secondary or higher education, and high socioeconomic status (SES) were significantly associated to frequent prenatal care (four prenatal care visits or over). Women having five children or more, not being a member of the Maternal and Health Insurance, and having a mistimed pregnancy were significantly less likely to have frequent prenatal care. Women who were currently unmarried, who never had a history of abortions or stillbirths, and whose last pregnancy was mistimed and unwanted were significantly less likely to have early prenatal care (first visit in the first to third month). Using a modern contraceptive method was positively related to early prenatal care.
Conclusion: Although the Peruvian government made significant improvements in the health sector such as implementing Insurance for pregnant women free of charge for the poorest population, there are still efforts to be made in order to increase health services among underserved women such as: women with five children or more, with elementary or no education, unmarried, of low SES, of risk for an unwanted or mistimed pregnancy, of risk for abortion or stillbirths, not using a modern contraceptive method, not being a member of the maternal and health insurance. It is our hope that these changes will lead to improvement in health as those who are advantaged.