Beyond Numbers: Patterns and Barriers of Eight-Contact Antenatal Care in Northern Sudan
1
University of Khartoum, Faculty of Medicine, Khartoum, Sudan
2
Department of Public Health, Faculty of Medicine, Ankara Medipol University, Ankara, Turkey
3
Faculty of Medicine, Merowe University of Technology, Merowe, Sudan
4
Faculty of Medicine, Ahfad University for Women, Omdurman, Sudan
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
BACKGROUND:
The World Health Organisation (WHO) recommends a minimum of eight antenatal care (ANC) contacts to improve birth outcomes. In Sudan, conflict and displacement have disrupted maternal health services, raising concerns about ANC coverage and quality. This study examined ANC utilisation, quality, and perceived barriers in Northern Sudan.
METHODS:
This is a secondary analysis of a cross-sectional study [1] conducted among 267 postpartum women in three public hospitals and one private clinic in Merowe, Northern Sudan. Structured interviews were used to collect data on socioeconomic characteristics, ANC utilisation patterns, and perceived barriers. Descriptive and bivariate analyses were performed using SPSS.
RESULTS:
Most women initiated ANC in the first trimester (73.0%) and received ANC in private clinics (80.1%). Overall, 82.4% of women attended ≥4 ANC visits, and 25.8 % completed ≥ 8 visits. Displaced women were more likely to achieve ≥ 8 visits compared to non-displaced (40.5% vs 22.0%). Completion of ≥8 visits was also associated with husband’s formal employment and stable income (p<0.05). Coverage of core ANC components was high for laboratory investigations and ultrasound imaging (>90%), blood pressure measurement (88.4%), and iron and folic acid supplementation (83.9% and 75.3%, respectively). However, nutritional counselling was provided to fewer than half of women, and 39.7% did not receive tetanus vaccination. Among women with <4 visits, the most frequently reported barriers were unavailable facilities (48.9%), ignorance and visits costs (31.9%), and out-of-pocket expenditures (23.4%).
CONCLUSIONS:
Although early ANC initiation and attendance of ≥4 visits were common, completion of the eight-contact model remained limited and socially patterned. Displacement was associated with higher ANC utilisation but also with increased hypertensive complications, indicating other interacting factors. High reliance on private-sector services, suboptimal counselling, and financial barriers underscore the need to prioritise quality and equity rather than focusing solely on increasing contact numbers in low-resourced settings.
The World Health Organisation (WHO) recommends a minimum of eight antenatal care (ANC) contacts to improve birth outcomes. In Sudan, conflict and displacement have disrupted maternal health services, raising concerns about ANC coverage and quality. This study examined ANC utilisation, quality, and perceived barriers in Northern Sudan.
METHODS:
This is a secondary analysis of a cross-sectional study [1] conducted among 267 postpartum women in three public hospitals and one private clinic in Merowe, Northern Sudan. Structured interviews were used to collect data on socioeconomic characteristics, ANC utilisation patterns, and perceived barriers. Descriptive and bivariate analyses were performed using SPSS.
RESULTS:
Most women initiated ANC in the first trimester (73.0%) and received ANC in private clinics (80.1%). Overall, 82.4% of women attended ≥4 ANC visits, and 25.8 % completed ≥ 8 visits. Displaced women were more likely to achieve ≥ 8 visits compared to non-displaced (40.5% vs 22.0%). Completion of ≥8 visits was also associated with husband’s formal employment and stable income (p<0.05). Coverage of core ANC components was high for laboratory investigations and ultrasound imaging (>90%), blood pressure measurement (88.4%), and iron and folic acid supplementation (83.9% and 75.3%, respectively). However, nutritional counselling was provided to fewer than half of women, and 39.7% did not receive tetanus vaccination. Among women with <4 visits, the most frequently reported barriers were unavailable facilities (48.9%), ignorance and visits costs (31.9%), and out-of-pocket expenditures (23.4%).
CONCLUSIONS:
Although early ANC initiation and attendance of ≥4 visits were common, completion of the eight-contact model remained limited and socially patterned. Displacement was associated with higher ANC utilisation but also with increased hypertensive complications, indicating other interacting factors. High reliance on private-sector services, suboptimal counselling, and financial barriers underscore the need to prioritise quality and equity rather than focusing solely on increasing contact numbers in low-resourced settings.
| eISSN: | 2654-1459 |
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