Antenatal care utilisation in Tanzania: A Poisson regression analysis of the Tanzania Demographic Health Survey 2022

Abstract

Background: Antenatal care (ANC) is essential for ensuring maternal and child health. Despite efforts to improve maternal healthcare in Tanzania, many women still fail to complete the recommended number of ANC visits. This study examines the socioeconomic and demographic determinants influencing ANC utilisation using data from the 2022 Tanzania Demographic and Health Survey (TDHS). Design and methods: This study employed a retrospective cross-sectional approach using secondary data from the 2022 TDHS, focussing on women aged 15–49 who had a live birth within 5 years preceding the survey. Poisson regression was applied to identify factors associated with the number of ANC visits. Model fit was assessed using Deviance and Pearson Goodness-of-Fit tests. Results: Approximately 89.26% of women attended at least one ANC visit, while only 61.26% completed the recommended minimum of four visits. The average number of visits was 4.00 (variance = 4.06). Poisson regression revealed that Higher maternal education (IRR = 1.3002, p < 0.001) and household wealth in the poorer (IRR = 1.0959, p < 0.001), middle (IRR = 1.1277, p < 0.001), richer (IRR = 1.1624, p < 0.001), and richest (IRR = 1.2514, p < 0.001) were positively associated with increased ANC visits, while larger household sizes negatively affected utilisation. Regional disparities were evident, with women in the Central, Southern, Eastern, and Zanzibar zones attending more ANC visits compared to those in the Western zone. Goodness-of-fit tests confirmed that the model adequately fit the data (Deviance p = 0.2679; Pearson p = 0.9901). Conclusion: Despite high initial contact with ANC services, a substantial proportion of women do not complete the full recommended visits. Socioeconomic, demographic, and regional factors significantly influence ANC utilisation. Policies aimed at promoting women’s education, economic empowerment, and equitable access to maternal healthcare, particularly in underserved regions, are essential to improve ANC coverage in Tanzania.