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

There are a number of factors that may contribute to this relationship between antenatal care attendance
and education. According to Overbosch, et al. (2002), the education of a woman might lead to more
decision making power within the household. Furthermore, it may increase her knowledge of modern
health care and its effectiveness. In addition, education might lead to a higher living standard because
of her or her partner's increased earnings. As a result, the education of the mother might also be
correlated with several other factors that may influence the use of antenatal care.
However there are some studies that have reported no linear relationship between level of education
and antenatal care seeking behaviour. A study conducted recently in the Ubombo area in rural Northern
KwaZulu-Natal found that a substantial number of women (48 percent) classified as high utilizers of
antenatal care services only had a primary school education. This study found that education was not
associated with the use of antenatal care. Instead, the utilization of prenatal care was found to be
significantly associated with attendance at the nearest residential clinic (McCray 2004).
Studies have also shown a linear relationship between income and health care utilization, including
antenatal and delivery care. MacKian (2003) found that the level of income also influenced the type of
health care sought. He suggests that as income increases, people are more likely to seek care from
professional western medical doctors. In rural KwaZulu-Natal, it was found that asset ownership was
associated with at least seven-tenths of a percentage point increase in the probability of seeing a
medical doctor. Those who owned more assets were more likely to visit a doctor when ill than those
with fewer assets (Case et al. 2005).
A study in Cape Town found that lack of income might lead to no antenatal care attendance. The
results show that one of the main reasons women did not attend the antenatal care clinic were lack of
transport money to get to the clinic (Jewkes et al. 1998). Another study conducted in Bangladesh
indicates that a higher proportion of working women (35.4 percent) had sought help from a medical
professional compared to those who did not work (Chakraborty et al. 2003).
In some parts of the world, health care is not free. In addition to the knowledge of the importance of
health care utilization, women need to have enough income to pay for these services. Women with no
income are more likely to be dependant on their partners or other family members such as in-laws for
their income and therefore lack decision-making powers. As a result, women with an income are more
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