an examination of the role of antenatal care attendance in ...

The model also states that socio-demographic factors such as education, economic status, and type of
residence have a direct effect on birth order. Women with less education, low household socioeconomic
status and living in rural are more likely to have a higher number of children born compared
to women with high education, high socio-economic status and living in urban areas. Also, the model
shows that marital status directly affect birth order and desirability of pregnancy, as married women are
more likely to be more willing to be pregnant and may have higher number of children compared to
never married women.
The model states that birth order may have a direct effect on maternal care and nutritional status of the
pregnant woman. Women with two or more previous pregnancies may be less likely to seek medical
attention when pregnant due to the fact that they have, for example, successfully delivered without any
complications, and as a result, do not perceive any risks related to the present pregnancy. However, it
may also be possible that older women with experience of adverse birth outcome may seek medical
attention when pregnant due to their previous difficult experiences with pregnancy.
Studies show that women who are pregnant for the first time are more likely to utilize maternal health
care compared to women with more than one previous pregnancy (Morrison et al. 1989). This could be
due to the fact that most women will use maternal health facilities for the confirmation of their
pregnancy. In addition, due to their lack of experience, they may consider themselves at risk of an
adverse birth outcome and may decide to utilize maternal health care services.
The availability and accessibility of services will determine if women receive antenatal care services.
In this instant, distance becomes the most important determinant influencing access to health care.
Several studies have shown that distance to the health facility is significantly associated with use of
health services (Tanser et al. 2005; McCray 2004; Magadi et al. 2000). Literature has shown that
women who reside far from health facilities may, for example, lack transport to the health care facility
or they may lack money to pay for transport. In some developing countries, user fees in the health
facilities are still in operation; as a result some women may lack enough money to pay for the services
rendered to them (Tanser et al. 2005). However, it is important to note that South Africa has health
policies that allow pregnant women and children less than six years of age to access health facilities
free of charge.
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