Introduction Inadequate use of maternal health services among the youth remains a serious health challenge in Uganda. The low use of maternal health services among youth partly explains the persistence high maternal mortality rate in the country. Yet, improved use of maternal health services by the youth would help reduce maternal deaths in the country. Therefore, this study examines predisposing and enabling factors associated with the timing and the number of antenatal care visits among unmarried compared to married youth aged 15-24 years between 1995 and 2011 in Uganda.
Methodology Two-level binary logistic and linear regression models with district as a second level of analysis were conducted on pooled data of the 1995, 2000/01, 2006 and 2011 Uganda Demographic and Health Surveys. This analysis was among 581 unmarried, compared to 5,437 married youth, aged 15-24 years.
Results Only 16% of unmarried youth and 18% of married youth had ANC in the first trimester. Education was the only factor that was significantly associated with early use of antenatal care among unmarried youth. Whereas high education was associated with higher odds of using antenatal care in the first trimester among married youth (OR=1.30, 95%CI=1.08-1.57), it was associated with late start among unmarried youth (OR=0.56, 95%CI=0.31-0.98). Higher parity, protestant membership and residence in eastern region were associated with late start of antenatal care, while access to radio and television, and education level of the husband were associated with higher odds of early use of antenatal care among married youth. Overall, married youth were more likely to have more frequent antenatal care visits than unmarried youth. Among both groups, higher educational attainment and greater access to radio were associated with frequent antenatal care use. Residing in western region was associated with fewer antenatal care visits among both married and unmarried youth. Access to newspaper was associated with more antenatal care visits among married youth only.
Conclusion This study presents the individual level predisposing and enabling factors that are important predictors of the use of antenatal health care services among youth that will guide policy to reduce maternal deaths among youth in Uganda.