Predictors of antenatal care utilization among women of reproductive age in Somalia include maternal education and residence.
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Key Takeaway
Note that maternal education, residence, and household wealth index consistently predict ANC utilization in Somalia.
A systematic review examined predictors of antenatal care (ANC) utilization among women of reproductive age in Somalia. The analysis synthesized data from nine studies on antenatal care utilization in Somalia.
Consistently reported predictors across the included studies included maternal education, place of residence, household wealth index, marital status, pregnancy intention, maternal age, and exposure to mass media. Additional significant predictors identified were early gestational age at the first visit, gravida status, knowledge of ANC, distance to health facilities, accessibility of services, and perceived health worker attitudes. The review did not report specific effect sizes, absolute numbers, or p-values for these associations.
Safety and tolerability data were not reported in the included studies. Key limitations of this evidence include the observational nature of the underlying studies, which precludes causal inference regarding the identified predictors. Furthermore, the review did not provide specific quantitative effect estimates or confidence intervals for the associations observed.
The practice relevance of these findings indicates that targeted interventions focusing on female education, community awareness, early ANC initiation, and improved access to quality maternal health services are critical to increasing ANC utilization and improving maternal and neonatal outcomes in this population.
View Original Abstract ↓
PurposeAntenatal care (ANC) is a cornerstone of maternal and neonatal health, yet its utilization remains suboptimal in Somalia, contributing to high maternal and perinatal morbidity and mortality. Understanding the predictors of ANC utilization is essential for designing effective interventions. This systematic review aimed to identify predictors of antenatal care service utilization among women of reproductive age in Somalia.Materials and methodsA systematic search of PubMed, Google Scholar, Medline, CINAHL, EMBASE, and African Journals Online was conducted for studies published between 2010 and 2025. Quantitative studies reporting predictors of ANC utilization using multivariable analysis were included. Study selection and reporting followed PRISMA guidelines. Methodological quality was assessed using standardized appraisal tools. The review protocol was registered in PROSPERO (registration number: CRD420251244002).ResultsNine studies met the inclusion criteria. ANC utilization in Somalia was influenced by a combination of sociodemographic, obstetric, knowledge-related, and health system factors. Consistently reported predictors included maternal education, place of residence, household wealth index, marital status, pregnancy intention, maternal age, and exposure to mass media. Early gestational age at first visit, gravida status, knowledge of ANC, distance to health facilities, accessibility of services, and perceived health worker attitudes were also significant predictors.ConclusionAntenatal care utilization in Somalia is shaped by complex and interrelated individual, socioeconomic, and health system factors. Targeted interventions focusing on female education, community awareness, early ANC initiation, and improved access to quality maternal health services are critical to increasing ANC utilization and improving maternal and neonatal outcomes.Systematic Review Registrationhttps://www.york.ac.uk/inst/crd, PROSPERO registration number, CRD420251244002.
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