|Prenatal care utilization in rural areas and urban areas of Haiti
|Alexandre, P.K., G. Saint-Jean, L. Crandall, E. Fevrin
|Revista Panamericana de Salud Publica, 18(2):84-92
|Objectives. This study is based on the 2000 Demographic and Health Survey (DHS) conducted
in Haiti. Using the DHS information on women aged 15 to 49 who had given birth during
the three years preceding the survey interview, this study was intended to: (1) examine the
determinants of the likelihood of the women using prenatal care in the rural areas and in the
urban areas of the country and (2) for the women who made at least one prenatal care visit, examine
the determinants of the number of prenatal visits in the rural areas and the urban areas.
Methods. The multivariate analysis used logistic models to identify which factors explained the
decision to seek prenatal care, and negative binomial models were used to determine how many
prenatal visits were conducted by the subgroup of women who did make prenatal care visits.
Results. Estimated at the mean values of the control variables, the expected probability of
using prenatal care services in rural Haiti was 77.16%, compared to 85.83% in urban Haiti.
Among users of prenatal care services, mothers in rural areas made an expected number of 3.78
prenatal care visits, compared to 5.06 visits for the women in urban areas.
Conclusions. A substantial percentage of pregnant women have access to prenatal care services
in Haiti, but mothers in rural areas who decided to seek care still fell slightly below the
four visits recommended by the World Health Organization. The education levels of both
mothers and their partners is a dominant predictor of prenatal care use. Longer travel times
and greater distances to health centers in rural areas constituted barriers to repeated visits.
Policymakers and health care providers need to take these findings into consideration as they
decide on the delivery and management of health care services in Haiti.