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

clinics situated on or at the intersection of major public transport routes attracted a large number of
patients (Tanser et al. 2001).
Another study in rural Northern KwaZulu Natal also found that health utilisation level is significantly
associated with geographical distance. The results show that women who were classified as low users
and began prenatal care late were more likely to be residing far from the clinic than high users of
antenatal care (McCray 2004).
These results are consistent with findings from other developing countries. A study in rural Nepal
shows that the use of antenatal and child immunization services was much higher when the health
facility was located in the community (Acharya and Cleland 2000). In addition, a study in Kenya found
that the frequency of antenatal visits was also affected by the accessibility of antenatal care services,
with increased distance causing lower frequency of antenatal care visits (Magadi et al. 2000).
2.5 The effect of antenatal care on birth outcomes
Studies have shown a connection between antenatal care attendance and birth outcomes. According to
Overbosch et al. (2002), expectant mothers with sufficient antenatal care generally have better
pregnancy outcomes than those who lack such care, both in terms of their own health condition and that
of their babies.
Magadi, et al. (2001) analyzing data from the Kenya Demographic surveillance cross-sectional study
on the timing and frequency of antenatal care attendance of pregnant women found that women with no
antenatal care attendance were more likely to experience adverse birth outcomes than those women
who had attended antenatal care. The highest proportion of premature births and small size babies was
observed among those who did not receive any antenatal care compared to those who completed at
least one visit. According to Magadi, et al. (2000), fewer antenatal visits may lead to undesirable birth
outcomes because they limit the amount and quality of care that a pregnant woman receives.
A study conducted in India showed that women with a higher number of antenatal care visits were
more likely to use safe delivery care, as compared to those with fewer antenatal visits. According to
this study, women with high levels of antenatal care had greater odds of using health professionals
during delivery than women with lower levels of antenatal care (Bloom et al. 1999). These studies
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