Adequacy of Antenatal Care and Its Determinants in Assiut District


Cross sectional study on women who gave birth and attend immunization session for their children in Assiut District to assess the adequacy of ANC, its determinants and knowledge and attitude of antenatal care among the studied women

Study Type

  • Study Type: Observational
  • Study Design
    • Time Perspective: Cross-Sectional
  • Study Primary Completion Date: February 1, 2023

Detailed Description

The World health organization (WHO) estimated that worldwide in 2021, about 211 women died per 100,000 live birth from pregnancy related causes and increasing to 415 on average in the poorest countries (1)Globally in 2020, nearly 2.4 million babies died during the first 28 days of life (2). High coverage of quality Antenatal Care (ANC) can play a crucial role to decrease maternal and child mortality rates and achieve national and global targets related to maternal and child health. ANC received from skilled provider increases maternal and newborn survival and reduces the risk of pregnancy complications and adverse pregnancy outcomes(3) . New WHO guidelines on antenatal care for a positive pregnancy experience include: 1. A minimum of eight contacts are recommended. 2. Counselling about healthy eating and keeping physically active during pregnancy. 3. Daily oral iron and folic acid supplementation 4. Tetanus toxoid vaccination is recommended. 5. One ultrasound scan before 24 weeks' gestation. 6. Health-care providers should ask all pregnant women about their use of alcohol and other substances(4). The 2016 WHO prenatal care guidelines for a healthy pregnancy experience reflect a change from the centered ANC model with a prescribed minimum of 4 ANC visits (ANC4+) to a more expanded model that emphasizes contact number, timing, and services(5). At the global and national levels, most currently available data indicate that women receive at least 4 antenatal care visits. There is very limited data on the adequacy of ANC based and their correlates on updated WHO recommendations for antenatal care(5, (6),(7)). The current study is conducted in accordance with the research plan of Public Health and Community Medicine Department- Faculty of Medicine, Assiut University.


  • Other: no intervention
    • the study will not apply on intervention

Clinical Trial Outcome Measures

Primary Measures

  • Adequacy of ANC
    • Time Frame: 2 years
    • ): Adequacy of ANC among women who gave birth and attend immunization sessions for their children in Assiut District and its determinants based on receiving all the following 11 ANC items at least once: adequate number of ANC visits (at least 8 ANC visits) early ANC use (1st ANC booking during 1st trimester) Provision of ANC by a skilled provider (doctor or trained nurse). Measurement of blood pressure A blood sample was taken urine sample was taken Receiving tetanus toxoid Weight measurement Ultrasound was performed Being informed about danger signs of pregnancy And receiving health education about nutrition and prescription oral iron and folic acid supplements.

Participating in This Clinical Trial

Inclusion Criteria : women of reproductive age who gave birth - Exclusion Criteria:

Pregnant and menopaused women

Gender Eligibility: Female

women of reproductive age who gave birth

Minimum Age: 15 Years

Maximum Age: 49 Years

Are Healthy Volunteers Accepted: Accepts Healthy Volunteers

Investigator Details

  • Lead Sponsor
    • Assiut University
  • Provider of Information About this Clinical Study
    • Principal Investigator: Marwa Fazzaa Hassan Farag, Physician at Egyptian Ministry of Health and Population – Assiut University
  • Overall Official(s)
    • Mahmoud Attia, Professor, Principal Investigator, Assiut Universiyy
  • Overall Contact(s)
    • Marwa Fazzaa, physician, 01091434853,

Citations Reporting on Results

Osterman MJK, Martin JA. Timing and Adequacy of Prenatal Care in the United States, 2016. Natl Vital Stat Rep. 2018 May;67(3):1-14.

Pugliese-Garcia M, Radovich E, Hassanein N, Campbell OMR, Khalil K, Benova L. Temporal and regional variations in use, equity and quality of antenatal care in Egypt: a repeat cross-sectional analysis using Demographic and Health Surveys. BMC Pregnancy Childbirth. 2019 Jul 26;19(1):268. doi: 10.1186/s12884-019-2409-1.

El Aty MA, Meky FA, Morsy M, El Sayed MK. Overall adequacy of antenatal care in Oman: secondary analysis of national reproductive health survey data, 2008. East Mediterr Health J. 2015 Feb 2;20(12):781-8.

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