Analysis of factors that affect the utilization of antenatal care in developing countries: A systematic review

Objective: To explain the factors related to the implementation of antenatal care in developing countries. Methods: The systematic review was conducted in June 2020 and comprised literature search on Scopus, Cumulated Index to Nursing and Allied Health Literature, PubMed and Garba Rujukan Digital databases for cross-sectional, survey-based, prospective, mixed-method, correlational, experimental, longitudinal, cohort and case-control studies published after 2015 in either English or Indonesian. The studies included involved pregnant women and discussed the factors of implementing antenatal care in developing countries, and explained the factors related to the implementation of antenatal care in accordance with the World Health Organisation recommendation. The Population, Intervention, Comparison, Outcomes and Study framework was used, and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were followed. Data was analysed using descriptive statistics with a narrative approach. Results: Of the 9,733 studies initially found, 50(0.005%) were shortlisted for full-text review, and, of them, 15(30%) were reviewed and analysed. There were 3(20%) each from Pakistan and Ghana, 2(13.3%) each from Nepal and India, and 1(6.66%) each from Jordan, Egypt, Yemen, South Africa and Vietnam. Overall, 10(66.6%) were cross-sectional studies. There were five factors identified regarding antenatal care; behaviour intention, social support, accessibility of information, personal autonomy, and action situations, including economic status, availability of facility and transportation. Conclusion: Antenatal care in pregnant women in developing countries is influenced by several factors, and economic status and the availability of facilities and infrastructure optimise the use of such services.