Predictors of Antenatal Care Utilization Among the Rohingya Population in the Refugee Camps of Cox's Bazar, Bangladesh

Predictors of Antenatal Care Utilization Among the Rohingya Population in the Refugee Camps of Cox's Bazar, Bangladesh | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Predictors of Antenatal Care Utilization Among the Rohingya Population in the Refugee Camps of Cox's Bazar, Bangladesh Daniel Simon, Duja Michael, M Sajjadur Rahman, Mary Caroline Hiott, and 4 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6475112/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 03 Dec, 2025 Read the published version in Conflict and Health → Version 1 posted 11 You are reading this latest preprint version Abstract Background While studies in both high- and low-income settings have demonstrated the importance of early and regular antenatal care (ANC) utilization, evidence from crisis-affected populations remains limited. Rohingya refugees in Cox’s Bazar, Bangladesh, face unique barriers to healthcare; previous studies have found low rates of ANC utilization. This study examines the predictors of number of visits and timing of initiation of ANC among pregnant Rohingya women in Cox’s Bazar. Methods Data come from a prenatal birth cohort study of "Intergenerational Risk and Resilience of Rohingya in Displacement" (iRRRd). A total of 2,322 pregnant Rohingya women were recruited between February 2023 and March 2024. ANC utilization was assessed via surveys at the birth follow-up visit. Primary outcomes included the number of ANC visits and the timing of the first visit. Predictors were categorized using the Andersen-Newman model (predisposing, enabling, and need factors). We used Poisson regression for number of visits, and logistic regression to analyze timing of first visit. Results The average number of ANC visits was 6.9 (SD = 2.6), with 80.5% of women initiating care within the first trimester. Women with one to three children reported fewer visits (IRR = 0.94, p = 0.004), as did those with more than three (IRR = 0.90, p = 0.015). Higher self-rated health predicted delayed initiation (OR = 1.21, p = 0.004). More years of formal education reduced the odds of delayed initiation (OR = 0.88, p = 0.048) but did not affect the number of visits. Greater mobility was linked to earlier initiation (OR = 0.84, p = 0.010). Socioeconomic indicators and education of relatives were not associated with ANC use. Receiving information via radio was unexpectedly associated with delayed initiation (OR = 1.52, p = 0.038). Location of residence explained minimal variance (2%). Conclusions ANC coverage in the Rohingya camps appears high, yet some groups remain at risk for delayed care. Feeling healthy, high parity, and restricted mobility contributed to late initiation. Conventional predictors like formal education and SES showed limited relevance in this context. Findings point to the need for tailored health communication strategies and deeper examination of the quality of ANC services and associations with maternal and neonatal outcomes. antenatal care Rohingya maternal health forced displacement humanitarian settings Bangladesh South Asia Background The UN Sustainable Development Goal 3.2. aims to reduce neonatal and under-5 mortality worldwide 1 . Deaths of young children have been linked to adverse birth outcomes, like preterm delivery or low birth weight 2 , 3 . Studies in high-income countries show that many of those adverse outcomes could be prevented with early and regular antenatal care (ANC) 4 , 5 . Antenatal care (ANC), as stipulated by the World Health Organization (WHO), refers to care provided by skilled professionals to pregnant women to ensure the best outcomes for both mother and baby. ANC includes regular check-ups, screening for risk indicators, health education, and interventions to prevent and manage pregnancy and birth complications. Similarly, literature in low-income countries shows the importance of adequate ANC utilization to avoid low birth weight 6 , 7 . In such countries, nutritional and medical advice during pregnancy is particularly critical. Additionally, ANC serves as a vital factor in the effort to decrease maternal and infant mortality and to enhance the overall health of both mothers and infants 8 . Enhancing ANC utilization has the potential to benefit individuals and families by reducing suffering and improving livelihoods through decreased medical costs and increased productivity and learning 9 . These benefits of adequate ANC are of particular relevance in contexts of humanitarian crises and forced displacement, and understanding how to ensure timely initiation, sufficient frequency, and quality of ANC services has become paramount. The unique barriers faced in crisis settings—ranging from disrupted healthcare infrastructure to cultural and logistical constraints—demand targeted interventions 10 . The past decade has seen a push toward understanding ANC utilization behaviour and the effects of targeted community-based programs, including the training of community health workers, home visits, and peer-led educational campaigns on ANC utilization and facility-based deliveries in crisis settings 11 – 14 . Yet, the unique communal specificities of a crisis setting need to be understood to evaluate and adapt such approaches. ANC in humanitarian settings is usually provided free of cost, yet availability is not always sufficient. Predictors of antenatal care utilization According to the Anderson-Newman model, three types of factors influence healthcare utilization: predisposing, enabling, and need factors 15 . Predisposing factors include socio-cultural characteristics that exist before a person’s need for health services arose. In low-income countries and fragile and conflict areas, pregnant women's formal education 6 , 16 – 20 and their partner's education 18 , 19 , 21 significantly predicted adequate utilization of ANC. However, literacy showed mixed effects on ANC utilization in the literature 22 . Additionally, while some studies have shown that the younger a pregnant woman is, the less adequate 11 or later into her pregnancy her ANC utilization is 21 , others reported no effect of a women's age on ANC 23 , 24 . Interestingly, one study found that being over the age of 30 was a risk factor for late ANC initiation 6 . Enabling factors concern the logistics of receiving care 15 . Socioeconomic status (SES) conceptualizes access to resources and is often measured using the possession of assets and in low-income countries, access to basic sanitary facilities 25 . Studies show that SES or wealth enable people to utilize ANC 16 , 17 , 19 . Additionally, the quality of available ANC has been shown to predict its utilization 6 , 26 . The need factor is a person's perceived need to visit a healthcare professional 15 . A study in Bangladesh showed that with each additional child, pregnant women utilized ANC significantly less often 19 and Duodu and colleagues 17 found in one of their cohorts that multiparity was associated with fewer ANC visits compared to women who were pregnant for the first time; however, this finding was not replicated in recent data 17 . The study’s authors hypothesized that pregnant women who have experienced pregnancy before may feel able to handle issues in their current pregnancy independently. Overall, some predictors of ANC are well-established in different contexts, most importantly, formal education and SES. In contrast, others vary depending on the definitions of the variables or the specific population investigated. Adequate antenatal care utilization The differences in definitions of adequate ANC utilization complicate the comparison of many studies and may contribute to the discrepancies in their results. To simplify and make their studies comparable, many authors focus solely on the number of visits 19 , 27 – 29 . However, the adequacy of ANC utilization depends not only on the number of visits and the time of initiation, but also type and quality of services 30 . Until 2016, the World Health Organization recommended that pregnant women worldwide have at least 4 ANC visits. However, in specific resource-limited settings with strained services, it proves challenging to accommodate all elements of care within the confined 4 appointments. Hence, since 2016, the WHO started to recommend 8 visits while keeping up the recommendation of ANC initiation within the first trimester 8 . Objective of the Study This study aims to comprehensively examine how socio-cultural and demographic factors predict ANC utilization within the Rohingya population residing in refugee camps in Cox's Bazar, Bangladesh, utilizing data gathered from early 2023 through April 2024. The goal is to contribute essential insights into the barriers and facilitators influencing ANC, ultimately providing the groundwork for developing targeted, integrated interventions and policies designed to enhance maternal and infant health within this vulnerable population. Methods The Rohingya context in Bangladesh In 2017/2018 almost 700,000 Rohingya were violently displaced from Rakhine, Myanmar, bordering the southern tip of Bangladesh. As of 2024 almost 1 million Rohingya live in camps near Cox's Bazar, one of which now constitutes the largest and most densely populated refugee settlement in the world 31 , 32 . It has been shown that Rohingya in Bangladesh have an exceptionally high stillbirth rate 33 , and Rohingya displaced to Malaysia have on average higher rates of low birth weight babies than their host community 34 . Moreover, a third of all deaths of Rohingya women are reported to be related to pregnancy complications 35 . In a 2018 survey, more than half of the Rohingya women in Cox's Bazar who had given birth in the previous year reported that they had not received any ANC 36 . The situation of the Rohingya living in Cox's Bazar is unique since they have been systematically excluded from (reproductive) health services in their country of origin and find themselves in a refugee camp setting 37 . Specific guidance on the number of ANC visits for Cox's Bazar could not be found. However, the Bangladeshi government recommends a minimum of 4 ANC visits 19 . Similarly, the Inter-Agency Working Group on Reproductive Health in Crisis recommends at least 4 visits in humanitarian response settings 10 . Reports relying on health sector data show that ANC coverage and facility-based births have gradually increased since 2017 and rates of receiving at least 4 ANC visits are now around 77% 38 , while a study using self-report data finds over 47% of women did not receive ANC during their most recent pregnancy 39 . Understanding the considerations and barriers to take-up and timely initiation of adequate ANC can lead to targeted interventions to optimize ANC utilization. This could reduce maternal, neonatal and under-5 mortality rates, and address developmental delays observed in the Rohingya community 40 , 41 . Study design and sampling Data stems from the “intergenerational risk and resilience of Rohingya in displacement” (iRRRd) study, a longitudinal prenatal birth cohort study investigating how being gestated, born, and raised in a context of conflict and displacement affects child development 42 . Participants came from 11 purposively selected camps (accounting for differences in terrain reflecting more or less challenging locations) located near Ukhia, Cox's Bazar, Bangladesh. A total of 2,322 pregnant Rohingya women were recruited between February 2023 and March 2024. In collaboration with Rohingya volunteer enumerators, a team of data collectors spoke to community leaders and other community members to identify households with pregnant women. Trained enumerators conducted surveys after completing verbal consent procedures. Measures Data for this study were from the surveys conducted at recruitment and birth follow-up waves. Survey instruments were carefully translated to Bangla with special attention to Rohingya language particularities and piloted extensively in July and August of 2022. Primary outcomes Number of ANC Visits was the first variable of interest. It was defined as the total number of ANC visits reported at the post-birth survey, regardless of where (health clinic, home, etc.) ANC services were received. Time of ANC Initiation was the second variable of interest and was a dummy variable determining whether a pregnant woman who had at least one ANC visit initiated ANC within the first three months of her pregnancy. Predisposing factors Maternal Age was grouped into under 15, 15–19, 20–24, 25–29, 30–34 and above 34. School Type was grouped by no school, a government school, an NGO school or a madrassa (religious school). Maternal, Husband's, Father's, and Mother's Formal Level of Education described the level of formal, non-religious schooling in an NGO or government school (highest grade achieved). Hence, people who only attended a religious school were treated as having zero years of formal education. Self-Reported Literacy was defined by being unable to read a newspaper in any language, being able to read a newspaper in Burmese, or being able to read it only in a (another) foreign language. The variable was created from two questions with a 3-point scale asking participants about their Burmese and foreign language reading skills. In this study, SES is treated as a predisposing rather than an enabling factor, as ANC in the camps is free of cost. The factors related to SES were obtained using factor analysis that utilized items that identified how many of certain assets the household possesses (chairs, beds, fans, chicken, solar panels, gas cylinders, tables, trunks, plastic drums, grams of gold) and questions from the perceived refugee environment index (PREI), which was developed to assess the quality of the refugee environment 43 . From the PREI, only 20 out of 30 items were used that covered questions on livelihoods, basic needs, housing, family environment, access to services and community environment using a 4-point Likert scale (almost never; less than half of the time; more than half of the time; almost always). The 10 items on electricity, heat, protection from rain, sun, wind, and water, or access to the internet, texting, or phone calls had to be dropped from the survey per request of the Refugee Response and Repatriation Commissioner (RRRC)—the Bangladesh government entity that regulates activities in the camps. Enabling factors Agency and Mobility was defined as how often a woman could visit their family outside their block by themselves: almost never (0), less than half of the time (1), more than half of the time (2), or almost always (3). Camp was a categorical variable defined as the camp where the pregnant woman lives. Need factors Number of Children was grouped into 0, 1–3, and more than 3. Previous Adverse Pregnancy Outcomes is a binary variable defined as at least one prior miscarriage, abortion, or stillbirth. The variable Health Rating described how well someone rated their physical health on a 5-point scale ranging from very bad (0) to very good (4). Additional factors ANC Information Medium was a set of non-mutually exclusive dummy variables defined as whether information regarding the pregnancy was received on the radio, pamphlet, phone, online, and/or TV. ANC Conversations was a set of non-mutually exclusive dummy variables defined as whether a pregnant woman has talked about her pregnancy to her husband, mother-in-law, father-in-law, father, mother, sister, brother, friend, and/or sister-in-law. Gestational Length was a control variable defined as the total weeks of gestation at delivery, which was triangulated across data sources. Analysis plans Stata18 and MPlus were used for the analyses. First, a descriptive analysis was conducted. Most studies similar to this used principal component analysis (PCA) to construct wealth or SES indices, and then divided the population into quintiles or terciles relying on assets and some additional variables measuring basic living conditions 16 , 17 , 19 , 44 – 48 . This study additionally captures items from the perceived refugee environment index 43 . Exploratory factor analysis was used to examine the shared variance between these items and identify factors/sub-domains, and then use confirmatory factor analysis to obtain the factor scores. Factor analysis was preferred over PCA since the aim was to extract the latent common factors between the items and not merely reduce data 49 . The asset and PREI items went through this factor analysis process separately. In three of the camps, there was only one participant each. These single observations were dropped from the analyses. One case was dropped as the woman reported having been to medical school yet was not able to read. The Number of ANC Visits data was capped at 16 to reduce the impact of outliers on the analysis (this affected 14 observations). Previous literature has often focused on defining an adequate and inadequate number of visits using a binary logistic regression model with cut-off points of three or four 16 , 21 , 48 , or eight 50 visits. Others used Poisson regression models 51 , 52 . This paper uses Poisson regression to model ANC utilization in terms of the number of visits. Overdispersion was tested by comparing whether the variance exceeded the mean 53 . It is impossible to assess the explained variance of all predictors of a Poisson regression model, as pseudo R-squared only provides a measure of deviance, which can be interpreted in relation to other nested models 54 . Thus, the Poisson model was compared to an ordinary least square regression model. In case of similarity, conclusions about the amount of explained variance could be drawn. The Akaike Information Criterion (AIC) and the Bayesian Information Criterion (BIC) were used to assess the comparability of the models. Additionally, the change in R-squared observed when omitting the variable Camp from the model accounts for the explained variance by camp differences. The results of the Poisson regression model were presented as the Incidence Rate Ratio (IRR). IRR can be interpreted as the percent change in the event rate for a one-unit increase in the predictor variable. It is calculated by exponentiating the coefficient of the predictor from the Poisson regression model 55 . The Time of ANC Initiation was modelled using a binary logistic regression model. The results were presented as Odds Ratios (OR). Both the ANC utilization and the time of initiation models used robust standard errors to overcome the effects of potential clustering 56 and used complete cases only, which excluded 7% and 6% of the data points respectively. Results Model selection for constructs related to SES Best fit was found for a 1-factor model for assets ( Assets ), and a 3-factor model for the PREI ( Basic Needs Index , Support and Acceptance , Safety ). The asset scores were subsequently broken into quintiles when used in the regression analyses. The latter was done for comparability to other studies. Details on these analyses can be found in supplemental materials. Sample characteristics and descriptive statistics Table 1 presents an overview of the participants’ general characteristics. The sample consisted of 2045 pregnant women with a mean age of 21.1 years. However, individual variables have missing observations. Summary statistics are calculated based on the available data for each variable. Notably, two-thirds of the sample already had at least one child, and almost a fourth had previously experienced miscarriages, abortions, or stillbirths. That left 28% of the recruited pregnant women without any previous pregnancy experience. Almost three-quarters reported not being allowed to visit their family outside their block alone, while only 12% were almost always allowed. Regarding education, only 6% of the sample had never attended any type of school. On the other hand, 68% reported that they could not read the newspaper in any language. Almost half of the sample went to a religious school while the rest attended a more formal (public or NGO) school. When counting only having received religious education as zero years of formal schooling, the average pregnant woman had one and a half years of formal schooling and only 4% of the participants received more than 4 years of formal education. Husbands, on average, had nearly twice as many years of formal education as their pregnant wives. Fathers of pregnant women had similar average years of schooling compared to the pregnant women, but exhibited a greater standard deviation. This means that, on the one hand, fathers were nearly four times more likely to have completed four or more years of formal education than their daughters, while also one and a half times more likely to have had no schooling at all compared to their daughters. Lastly, mothers of pregnant women attained the lowest level of formal education. Only 11% received any schooling, and on average, they received only a third of the years of schooling their daughters received. Table 1 Sample Descriptives and Demographics Overall (N = 2045) Overall (N = 2045) Maternal Age Self-Reported Literacy under 15 61 (3%) No Reading 68.61 (1403) 15 to 19 945 (46.2%) Only Burmese 23.08 (472) 20 to 24 569 (27.8%) Only Foreign 8.31 (170) 25 to 29 296 (14.5%) 30 to 34 137 (6.7%) Agency and Mobility over 34 37 (1.8%) Almost Never 1511 (73.9%) Mean (SD) 21.1 (5.1) Less than Half of the Time 191 (9.3%) Number of Previous Children More than Half of the Time 91 (4.5%) Zero 641 (31.3%) Almost Always 252 (12.3%) One to Three 1160 (56.7) More than Three 244 (11.9) Health Rating Very Bad 74 (3.6%) Previous Adverse Pregnancy Outcomes Bad 435 (21.3%) No 1559 (76.2) Regular 419 (20.5%) Yes 485 (23.7) Good 996 (48.7%) Missing 1 (< 1%) Very Good 120 (5.9%) Missing 1 (< 1%) Pregnant Woman School Type No School 124 (6.1%) NGO School 220 (10.8) Camp Only Religious Studies (Madrasa) 909 (44.4) Camp 01E 263 (12.9%) Government Institution 788 (38.5) Camp 02W 231 (11.3%) Missing 4 (< 1%) Camp 03 392 (19.2%) Camp 04 219 (10.7%) Pregnant Woman Years of Schooling Camp 04 Ext 59 (2.9%) Mean (SD) 1.51 (1.90) Camp 07 423 (20.7%) Missing 25 (1.2%) Camp 08W 251 (12.3%) Camp 17 204 (10%) Husband’s Years of Schooling Missing 3 (< 1%) Mean (SD) 2.83 (3.40) Missing 29 (1.4%) Father's Years of Schooling 0.45 (1.48) Mean (SD) 1.52 (2.95) Mother's Years of Schooling Missing 43 (2.1%) Mean (SD) Missing .45 (1.48) 14 (< 1%) Table 2 depicts ANC-related details. Remarkably, only two participants did not receive any ANC care (< 1%) and only 4% of the sample were lagging behind the adequacy mark of four visits, while more than a third received at least eight visits. Moreover, four out of five women attended their first ANC visit within the initial three months of pregnancy. By the beginning of the third trimester, more than 99% had at least one ANC visit. Communication about pregnancy was common; nearly all pregnant women talked with someone (94%), most often husbands, mothers, or mothers- and sisters-in-law. Communication with male family members (brothers, fathers, father-in-law) was notably rare. Only a small percentage received pregnancy information via their phone or online. Most women received information about their pregnancy from pamphlets. Table 2 ANC Characteristics Overall (N = 2045) Overall (N = 2045) Number of ANC Visits Time of ANC Initiation Mean (SD) 6.93 (2.60) Within 3 Months of Pregnancy 1646 (80.5%) Range 0–16 After 3 Months of Pregnancy 393 (19.2%) Missing 4 (< 1%) Missing 6 (< 1%) Length of Pregnancy in Weeks Received Information about ANC via Mean (SD) 39.13 (1.50) None 111 (5.4) Range 21–42 Radio 604 (29.5) Missing 12 (< 1%) Leaflet/Pamphlet/Written Info 1456 (71) Phone 116 (5.7) Talked about the pregnancy with Online 143 (7) No One 125 (6.1%) TV 776 (38.9) Husband 1215 (59.4%) Speaker Announcements of Cars 533 (26.1) Mother-in-Law 1037 (50.7%) Father-in-Law 123 (6%) Father 215 (10.5%) Mother 1300 (63.6%) Sister 691 (33.8%) Brother 47 (2.3%) Friend 240 (11.7%) Sister-in-Law 759 (38.9%) Antenatal care utilization – Regression results We find no hint of overdispersion for the Poisson regression model; the variance did not deviate greatly from the mean in the Number of ANC Visits . A comparison of the Poisson to a linear regression model provided highly similar AIC and BIC. Table 3 presents the results from two regression models. Regarding Predisposing Factors , only the pregnant woman’s education was associated with earlier not, however, with more ANC visits. For each additional year in a formal school the odds of delaying ANC until after the first trimester decreased by 12%. The education of the participants’ husbands, mothers, or fathers did not predict the pregnant women’s ANC utilization behaviour, nor did the type of schooling of the pregnant women. None of the predictors derived from factor analysis and associated with SES was associated with ANC utilization behaviour. Regarding predictors that enable pregnant women to receive care ( Enabling Factors ), having a unit increase on the Agency and Mobility scale was linked to 16% lower odds of delaying ANC initiation until after the first trimester. However, the predictor had no association with the number of ANC visits. Assessing the perceived need to access ANC ( Need Factors ), compared to participants with zero children, those with one to three children reported 6% and those with more than three children reported 10% fewer ANC visits. No association between parity and the timing of ANC was found. For each unit increase of the pregnant women’s report on Health Rating, the odds of delaying ANC until after the first trimester increased by 21%. Similarly, Health Rating was approaching significance for the number of ANC visits. However, every unit increase was only associated with 1% fewer visits. Surprisingly the ANC-specific predictors ( Additional Factors ), such as to whom they talked about their pregnancy and where they received their information, were unrelated to the number or timing of ANC visits. Only speaking to their father-in-law about their pregnancy approached significance with women displaying 8% more ANC visits. Interestingly, having received information about the pregnancy on the radio was associated with 52% higher odds of attending ANC only after the first trimester. Overall, only a small proportion of the expected predictors of ANC utilization yielded a statistically significant relationship to the outcome, and with relatively small effect sizes, demonstrating modest individual effects of the found predictors. The comparable OLS regression model for the number of visits provided R 2 = .062, suggesting a highly limited amount of variance explained by the chosen predictors. Additionally, a sensitivity check omitting the variable Camp entirely from the model showed that the variance accounted for by Camp was only 2%. Table 3 Regression Results Number of ANC visits (Poisson) ANC Initiated within the first trimester (logistic) N = 1921 1 N = 1920 2 IRR P value OR P value Age of Pregnant Woman under 15 1.000 1.000 15–19 0.968 0.561 1.538 0.305 20–24 0.961 0.497 1.746 0.215 25–29 1.034 0.604 1.275 0.615 30–34 1.019 0.797 2.427 0.092 over 34 1.086 0.388 1.210 0.778 Pregnant Woman Education Type No School 1.000 1.000 NGO 0.966 0.460 1.611 0.199 Only Religious Studies 0.985 0.680 1.461 0.189 Government Institutions 1.001 0.977 1.469 0.250 Pregnant woman Years of Education 1.015 0.124 0.879 0.048 Husband Years of Education 1.000 0.925 1.012 0.547 Father Years of Education 1.001 0.766 1.035 0.132 Mother Years of Education 1.000 0.995 0.930 0.164 Literacy No Reading 1.000 1.000 Burmese 0.971 0.316 1.379 0.098 Other Language 1.009 0.783 0.733 0.243 Basic Needs Factor 0.955 0.129 1.000 0.998 Support and Acceptance Factor 0.983 0.482 0.796 0.193 Safety Factor 1.023 0.121 0.946 0.615 Asset Quintiles Poorest 1.000 1.000 Poorer 1.041 0.142 0.800 0.264 Middle 1.005 0.857 1.139 0.501 Richer 0.980 0.462 0.973 0.894 Richest 0.979 0.493 1.084 0.707 Camp Camp 01E 1.000 1.000 Camp 02W 0.940 0.068 0.809 0.378 Camp 03 0.923 0.008 0.536 0.004 Camp 04 1.022 0.507 0.959 0.863 Camp 04 Ext 1.029 0.481 0.173 0.006 Camp 07 0.871 0.000 1.408 0.077 Camp 08W 0.873 0.000 0.392 0.000 Camp 17 0.974 0.444 0.544 0.023 Agency and Mobility 0.999 0.904 0.843 0.010 Self Reported Health Rating 0.985 0.074 1.205 0.004 Number of Previous Children Zero 1.000 1.000 One to Three 0.935 0.004 0.919 0.619 More than Three 0.903 0.015 1.101 0.745 Previous miscarriages/ stillbirths/ abortions 1.014 0.483 1.338 0.039 Talked about the pregnancy with No One 1.002 0.970 1.243 0.576 Husband 1.009 0.685 0.754 0.099 Mother-in-law 0.978 0.341 1.043 0.819 Father-in-law 1.082 0.075 0.542 0.104 Father 0.983 0.627 0.937 0.822 Mother 1.005 0.799 0.955 0.782 Sister 0.997 0.876 0.923 0.621 Brother 0.987 0.801 1.114 0.794 Friend 0.973 0.328 0.989 0.959 Sister-in-law 1.013 0.501 0.838 0.175 Received Information about ANC via None Received 0.961 0.499 0.798 0.595 Radio 1.016 0.553 1.520 0.038 Leaflet/Pamphlet/Written Info 0.986 0.635 0.901 0.639 Phone 0.977 0.593 1.235 0.558 Online 1.046 0.305 1.132 0.717 TV 0.963 0.100 1.225 0.239 Speaker Announcements 1.018 0.442 1.146 0.431 Gestational Length 1.026 0.000 _cons 3.026 0.000 0.107 0.000 Notes: The lower number of participants in the regression models compared to the descriptives is due to listwise deletion. 2 Two participants with 0 ANC visits were excluded from this model, one of whom was already excluded in the first model due to missing data in another variable. Discussion This study examined predictors of the number and timing of ANC visits among forcibly displaced Rohingya refugees living in camps in Cox’s Bazar, Bangladesh. The average of 7 ANC visits was unexpected, as was the high rate of ANC initiation in the first trimester, practically meeting WHO’s global recommendation for ANC. Many of the factors identified in similar studies did not predict ANC utilization in this context. The significant predictors that were identified provided very small effect sizes. A sensitivity check revealed that only 6% of the variance of the number of ANC visits could be explained by this study’s predictors. However, some interesting factors associated with ANC utilization were identified. Higher self-reported health ratings significantly increased the odds of ANC initiation after the first trimester, leading potentially to women missing the critical early window for ANC. This better rated health was also trending an association with fewer ANC visits. Together these findings may reflect unmet pregnancy care needs among healthier-feeling women and could indicate the need for better sexual and reproductive health education. Based on evidence from Bangladesh more generally, it is not uncommon for women not to reveal their pregnancy to their family until after the first trimester, let alone going to a health service provider. Given some similarity in culture and norms between Rohingya and host communities, this could be a factor for later initiation if they deem their physical health to be good. The freedom to move alone was also significantly associated with ANC timing. Women who could not move freely without accompaniment had a lower likelihood of initiating ANC within the first trimester. However, this restriction did not significantly affect the total number of ANC visits. This suggests that while restricted mobility does not reduce the overall frequency of ANC visits, it may delay the critical initiation phase, possibly compromising the adequacy of care. In contrast, in the host community restricted movement play a significant role in seeking ANC. This could well be due to distances from clinics being larger for many host community members. Women for whom this was going to be the first child reported having more frequent ANC check-ups. This aligns with previous research in Bangladesh 19 , 57 . Duodu and colleagues 17 have argued that such an effect may reflect the confidence of women being able to handle another pregnancy on their own, especially if previous pregnancies and births occurred without complications. Primigravid women are at a higher risk of obstetric complications 58 . However, evidence also points to increased risks for women in their fourth pregnancy or higher 59 , 60 . Furthermore, maternal age is a critical factor in pregnancy outcomes, with adolescents and women aged 30 and above, facing higher risks of complications compared to those in their twenties 61 , 62 . Despite these risks, age did not demonstrate a significant association with ANC utilization behavior. However, first-time pregnancy is highly correlated with being under the age of 18 as age of marriage in this population is very young. While the slightly higher ANC utilization among primiparous women is encouraging, there remains a need to raise awareness about pregnancy complications associated with high parity and maternal age below 20 or above 30 years within the community. Interestingly, while only trending, the only person pregnant women discussed their pregnancy with that was associated with number of ANC visits was their fathers-in-law. This is surprising given the rather conservative beliefs around reproductive health in the Rohingya community, where husbands’ and mothers-in-law’s knowledge and opinions often shape reproductive decisions 7 , 37 . The association may reflect specific family structures or the women’s own beliefs and attitudes, leading to discussing these topics with their fathers-in-law. Links between knowledge, attitudes, and ANC utilization have been observed in other low-income countries 63 – 65 . These insights highlight the importance of further exploring Rohingya women’s knowledge, attitudes, and beliefs regarding ANC and how these are shaped. No reasonable explanation has been found as to why pregnant women who received information about ANC on the radio had 52% higher odds of initiating ANC only after the first trimester. This seems contradictory to a recent study that found that listening to the radio contributed to good STI and HIV knowledge in women in the Cox’s Bazar Refugee Camps 66 . Variance in both dependent variables was exhibited between different camps. However, no camp was associated with more than a 13% increase in ANC visits. Additionally, a sensitivity check omitting Camp entirely from the model showed that the variance accounted for by the location in the number of ANC visits was only 2%. The most widely cited predictors of ANC utilization in previous studies are education and SES 11 , 63 . Their lack of predictive power in the current study is noteworthy. Only a link between years of education and time of ANC initiation was found, suggesting a decrease of initiating ANC after the first three months by 12.1% for each additional year of schooling. On the other hand, no association was found with the number of ANC visits. These findings stand in contrast with comparable studies 6 , 16 , 18 , 19 , 44 , 45 , including a Bangladesh-wide study reporting that primary and secondary education was associated with 27% and 57% more ANC visits, respectively, compared to those without schooling 67 . Moreover, assets and basic living conditions predicted ANC utilization reliably in previous studies in African and South Asian countries 16 , 17 , 19 , 44 – 48 . However, the current study found no significant relationship between ANC timing or the number of ANC visits and the Asset Index or Basic Needs Index. The few studies on ANC utilizaiton predictors conducted in refugee camp settings have found mixed results regarding education and SES. In an Iraqi refugee camp, researchers found that among forcefully displaced Syrians, maternal education is not associated with ANC utilization, while maternal employment status is 68 . A study in camps for internally displaced people in Sudan reported that employment status is not related to ANC utilization but identified education as a predictor 20 . Several studies have shown a higher rate of ANC utilization for refugees than before their forced displacement and compared the refugee to the host population. For instance, 99% of Syrian refugees in Iraqi camps attended ANC at least once, and 65% reported at least four visits 68 . Additionally, 70% of Palestinian refugees in Jordanian camps attended ANC at least four times 29 . This is similar to the current study, which observed high ANC attendance rates among Rohingya compared to Bangladesh more generally 19 , 52 and other South Asian countries where most women receive no more than three ANC visits 19 , 26 , 44 . Fareed and Ismail 68 suggest that special proximity, free services, and incentives from NGOs to attend ANC impact the higher rates in refugee camps. The current study adds to this scarce body of research in refugee camp settings, suggesting that other (context-specific) factors in the camps alter the roles of SES and educational status as a predictor of ANC. Conducting research in the Rohingya context is incredibly difficult. The power differentials between data collectors from the local Bangladeshi community and the Rohingya community, the linguistic barriers, among other factors, can contribute to misunderstandings and biased responses. In addition, the humanitarian aid sector can distort and render meaningless factors that are well established in the literature. For instance, household assets may not be a meaningful indicator in predicting ANC usage where assets and services are provided fairly equitably and free of charge and are thus possibly not reflective of SES. Khan and colleagues 39 found that 47% of Rohingya women in Cox’s Bazar had not attended any ANC services, and were able to identify predictors in line with previous literature. This stands in stark contrast to our findings. Some of these differences could be of methodological nature including social desirability, sample, and recall biases. We know from official records and from our qualitative investigations that the ANC utilization rates in this context have changed over time. By 2019, the number of ANC visits and facility-based deliveries had already increased by 40% compared to two years earlier 31 . After assessing the quality and distribution of health services in 2019, over a third of health facilities were relocated or closed for better distribution and quality of services. This was accompanied by continued capacity building among health workers and community advocacy 69 . However, the COVID-19 pandemic led to a significant contraction of the health sector serving the camps which may be driving some of Khan and colleagues 39 findings using data collected in 2023 from women who had been pregnant in the preceding 2 years. We know that the pandemic led to a contraction in health services in the camps, likely affecting ANC services as well. The most recent official health sector bulletin reported that by February 2024, 77% of pregnant women had at least four ANC visits, and 90% of births were facility-based 38 . These numbers align with the findings in our work, establishing confidence in our data. That said, our data on assets, education, and literacy warrants further investigations. We were restricted in asking about literacy in certain languages by the RRRC, and we did not conduct any reading comprehension assessments. We know that formal schooling and literacy rates are very low in this population, but we also know that people use text messaging to communicate. Similarly, we suspect that our assets do not reflect the more nuanced socioeconomic characteristics that typically drive behaviours such as health care seeking. Conclusions Our study suggests a fairly well-functioning antenatal care system in the Rohingya camps in Cox’s Bazar, Bangladesh, in line with the official statistics from the health sector. Particular factors contributing to relatively early and high uptake of ANC services remain somewhat unclear and should be explored more carefully in order to target specific messaging addressing some of the gaps in care. Our study does not capture any ANC quality indicators which should be a focus of future investigations. In addition, maternal (295/ 100,000 live births) and under 5 (25.31/100,000 live births) mortality rates remain rather high in the Rohingya context 38 . Future research should thus investigate the links between ANC and adverse pregnancy and birth outcomes. This study contributes to a better understanding of ANC behaviours in the Rohingya context, which constitutes an important component in ensuring maternal and offspring health in a very vulnerable population. This research provides vital information for improvements in reproductive health care in humanitarian contexts. Abbreviations AIC Akaike Information Criterion ANC Antenatal care BIC Bayesian Information Criterion CXB Cox’s Bazar IRR Incidence rate ratio iRRRd intergenerational risk and resilience of Rohingya in displacement LMIC Low- and middle-income country OR Odds ratio PREI Perceived refugee environment index RRRC Refugee Response and Repatriation Commissioner SES Socioeconomic status WHO World Health Organization Declarations Ethics approval and consent to participate The study was approved by the ethical review committee of icddr,b (PR-22064) and from New York University (IRB-FY2021-4875). Consent for publication Not applicable. Availability of data and materials Upon request. Competing interests The authors declare that they have no competing interests. Funding Generous funding for this study was provided by the LEGO Foundation through the Play to Learn initiative. Authors' contributions DS contributed to conceptualization of this paper and led in analyses and first draft of manuscript. DM supported analyses and write up of methods and results. MSR supported analyses and provided details and background on field procedures. MCH and AKR supported survey preparation, and interpretation and contextualization of results. KIS contributed to the conceptualization and design of and provided scientific oversight to iRRRd, and reviewed and provided comments on the manuscript. FT co-led the conceptualization and design of iRRRd and reviewed and provided comments on the manuscript. AJW (senior author) co-led the conceptualization and design of iRRRd, supervised and mentored the lead-author on conceptualizing and executing this paper, provided guidance on analyses and substantial feedback and edits on the manuscript throughout the process. Acknowledgements We thank our partners from the LEGO Foundation funded Play to Learn initiative for their ongoing support in making this study happen. 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Meshram II, Rao KM, Krishna KS, Venkaiah K, Laxmaiah A, Brahmam GNV. Predictors of ante-natal care, delivery and infant feeding practices among rural women in Madhya Pradesh, India. Int J Med Public Health 2014; 4(4). Ferguson BD, Tandon A, Gakidou E, Murray CJ. Estimating permanent income using indicator variables. Health systems performance assessment: debates, methods and empiricism Geneva: World Health Organization 2003: 747 – 60. Feng Y, Ahuru RR, Anser MK, Osabohien R, Ahmad M, Efegber AH. Household economic wealth management and antenatal care utilization among business women in the reproductive-age. Afr J Reprod Health. 2021;25(6):143–54. Arefaynie M, Kefale B, Yalew M, Adane B, Dewau R, Damtie Y. Number of antenatal care utilization and associated factors among pregnant women in Ethiopia: zero-inflated Poisson regression of 2019 intermediate Ethiopian Demography Health Survey. Reproductive Health. 2022;19(1):36. Bhowmik KR, Das S, Islam MA. Modelling the number of antenatal care visits in Bangladesh to determine the risk factors for reduced antenatal care attendance. PLoS ONE. 2020;15(1):e0228215. Jamil SAM, Abdullah MAA, Kek SL, Nor ME, Mohamed M, Ismail N. Detecting overdispersion in count data: a zero-inflated Poisson regression analysis. Journal of Physics: Conference Series; 2017: IOP Publishing; 2017. p. 012170. Coxe S, West SG, Aiken LS. The analysis of count data: A gentle introduction to Poisson regression and its alternatives. J Pers Assess. 2009;91(2):121–36. Cameron AC, Trivedi PK. Regression analysis of count data. Cambridge University Press; 2013. Cameron AC, Trivedi PK. Microeconometrics using stata. Stata press College Station, TX; 2010. Islam MM, Masud MS. Determinants of frequency and contents of antenatal care visits in Bangladesh: Assessing the extent of compliance with the WHO recommendations. PLoS ONE. 2018;13(9):e0204752. Shah PS, Knowledge Synthesis Group on Determinants of LBW/PT births. Parity and low birth weight and preterm birth: a systematic review and meta-analyses. Acta Obstet Gynecol Scand. 2010;89(7):862–75. Bai J, Wong FW, Bauman A, Mohsin M. Parity and pregnancy outcomes. Am J Obstet Gynecol. 2002;186(2):274–8. Koullali B, Van Zijl MD, Kazemier BM, et al. The association between parity and spontaneous preterm birth: a population based study. BMC Pregnancy Childbirth. 2020;20:1–8. Sheen J-J, Wright JD, Goffman D, et al. Maternal age and risk for adverse outcomes. Am J Obstet Gynecol. 2018;219(4):390. e1-. e15. Vandekerckhove M, Guignard M, Civadier M-S, Benachi A, Bouyer J. Impact of maternal age on obstetric and neonatal morbidity: a retrospective cohort study. BMC Pregnancy Childbirth. 2021;21:1–7. Simkhada B, Teijlingen ERv, Porter M, Simkhada P. Factors affecting the utilization of antenatal care in developing countries: systematic review of the literature. J Adv Nurs. 2008;61(3):244–60. Singh DR, Sah RK, Simkhada B, Darwin Z. Understanding service users and other stakeholders’ engagement in maternal and newborn health services research: A systematic review of evidence from low-and middle-income countries. PLoS ONE. 2024;19(11):e0309888. Finlayson K, Downe S. Why do women not use antenatal services in low-and middle-income countries? A meta-synthesis of qualitative studies. PLoS Med. 2013;10(1):e1001373. Zakaria M, Exploring STIHIV. Knowledge and Effect of Communication Activities Among Rohingya Refugee Women: A Camp-based Cross-sectional Study in Bangladesh. J Psychosexual Health. 2024;6(1):55–65. Islam MA, Kabir MR, Talukder A. Triggering factors associated with the utilization of antenatal care visits in Bangladesh: An application of negative binomial regression model. Clin Epidemiol Global Health. 2020;8(4):1297–301. Fareed SM, Ismail KH. Utilization of antenatal care services in Syrian refugee camps in Erbil, Iraq. Zanco J Med Sci (Zanco J Med Sci). 2019;23(2):250–6. Jeffries R, Abdi H, Ali M, et al. The health response to the Rohingya refugee crisis post August 2017: Reflections from two years of health sector coordination in Cox’s Bazar, Bangladesh. PLoS ONE. 2021;16(6):e0253013. 10.1371/journal.pone.0253013 . Additional Declarations No competing interests reported. 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03:16:04","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"supplement","size":15486,"visible":true,"origin":"","legend":"","description":"","filename":"ModelselectionforconstructsrelatedtoSES.docx","url":"https://assets-eu.researchsquare.com/files/rs-6475112/v1/5518c7291356a1ef5d4a5d95.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Predictors of Antenatal Care Utilization Among the Rohingya Population in the Refugee Camps of Cox's Bazar, Bangladesh","fulltext":[{"header":"Background","content":"\u003cp\u003eThe UN Sustainable Development Goal 3.2. aims to reduce neonatal and under-5 mortality worldwide\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003e. Deaths of young children have been linked to adverse birth outcomes, like preterm delivery or low birth weight\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e,\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u003c/sup\u003e. Studies in high-income countries show that many of those adverse outcomes could be prevented with early and regular antenatal care (ANC) \u003csup\u003e\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e,\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u003c/sup\u003e. Antenatal care (ANC), as stipulated by the World Health Organization (WHO), refers to care provided by skilled professionals to pregnant women to ensure the best outcomes for both mother and baby. ANC includes regular check-ups, screening for risk indicators, health education, and interventions to prevent and manage pregnancy and birth complications. Similarly, literature in low-income countries shows the importance of adequate ANC utilization to avoid low birth weight\u003csup\u003e\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e,\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u003c/sup\u003e. In such countries, nutritional and medical advice during pregnancy is particularly critical. Additionally, ANC serves as a vital factor in the effort to decrease maternal and infant mortality and to enhance the overall health of both mothers and infants\u003csup\u003e\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u003c/sup\u003e. Enhancing ANC utilization has the potential to benefit individuals and families by reducing suffering and improving livelihoods through decreased medical costs and increased productivity and learning\u003csup\u003e\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eThese benefits of adequate ANC are of particular relevance in contexts of humanitarian crises and forced displacement, and understanding how to ensure timely initiation, sufficient frequency, and quality of ANC services has become paramount. The unique barriers faced in crisis settings\u0026mdash;ranging from disrupted healthcare infrastructure to cultural and logistical constraints\u0026mdash;demand targeted interventions\u003csup\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u003c/sup\u003e. The past decade has seen a push toward understanding ANC utilization behaviour and the effects of targeted community-based programs, including the training of community health workers, home visits, and peer-led educational campaigns on ANC utilization and facility-based deliveries in crisis settings\u003csup\u003e\u003cspan additionalcitationids=\"CR12 CR13\" citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e\u003c/sup\u003e. Yet, the unique communal specificities of a crisis setting need to be understood to evaluate and adapt such approaches. ANC in humanitarian settings is usually provided free of cost, yet availability is not always sufficient.\u003c/p\u003e\n\u003ch3\u003ePredictors of antenatal care utilization\u003c/h3\u003e\n\u003cp\u003eAccording to the Anderson-Newman model, three types of factors influence healthcare utilization: predisposing, enabling, and need factors\u003csup\u003e\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u003c/sup\u003e. Predisposing factors include socio-cultural characteristics that exist before a person\u0026rsquo;s need for health services arose. In low-income countries and fragile and conflict areas, pregnant women's formal education\u003csup\u003e\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e,\u003cspan additionalcitationids=\"CR17 CR18 CR19\" citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e\u003c/sup\u003e and their partner's education\u003csup\u003e\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e,\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e,\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e\u003c/sup\u003e significantly predicted adequate utilization of ANC. However, literacy showed mixed effects on ANC utilization in the literature\u003csup\u003e\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e\u003c/sup\u003e. Additionally, while some studies have shown that the younger a pregnant woman is, the less adequate\u003csup\u003e\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u003c/sup\u003e or later into her pregnancy her ANC utilization is\u003csup\u003e\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e\u003c/sup\u003e, others reported no effect of a women's age on ANC\u003csup\u003e\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e,\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e\u003c/sup\u003e. Interestingly, one study found that being over the age of 30 was a risk factor for late ANC initiation\u003csup\u003e\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eEnabling factors concern the logistics of receiving care\u003csup\u003e\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u003c/sup\u003e. Socioeconomic status (SES) conceptualizes access to resources and is often measured using the possession of assets and in low-income countries, access to basic sanitary facilities\u003csup\u003e\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e\u003c/sup\u003e. Studies show that SES or wealth enable people to utilize ANC\u003csup\u003e\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e,\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e,\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e\u003c/sup\u003e. Additionally, the quality of available ANC has been shown to predict its utilization\u003csup\u003e\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e,\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eThe need factor is a person's perceived need to visit a healthcare professional\u003csup\u003e\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u003c/sup\u003e. A study in Bangladesh showed that with each additional child, pregnant women utilized ANC significantly less often\u003csup\u003e\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e\u003c/sup\u003e and Duodu and colleagues\u003csup\u003e\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u003c/sup\u003e found in one of their cohorts that multiparity was associated with fewer ANC visits compared to women who were pregnant for the first time; however, this finding was not replicated in recent data\u003csup\u003e\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u003c/sup\u003e. The study\u0026rsquo;s authors hypothesized that pregnant women who have experienced pregnancy before may feel able to handle issues in their current pregnancy independently. Overall, some predictors of ANC are well-established in different contexts, most importantly, formal education and SES. In contrast, others vary depending on the definitions of the variables or the specific population investigated.\u003c/p\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eAdequate antenatal care utilization\u003c/h2\u003e \u003cp\u003eThe differences in definitions of adequate ANC utilization complicate the comparison of many studies and may contribute to the discrepancies in their results. To simplify and make their studies comparable, many authors focus solely on the number of visits\u003csup\u003e\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e,\u003cspan additionalcitationids=\"CR28\" citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e\u003c/sup\u003e. However, the adequacy of ANC utilization depends not only on the number of visits and the time of initiation, but also type and quality of services\u003csup\u003e\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eUntil 2016, the World Health Organization recommended that pregnant women worldwide have at least 4 ANC visits. However, in specific resource-limited settings with strained services, it proves challenging to accommodate all elements of care within the confined 4 appointments. Hence, since 2016, the WHO started to recommend 8 visits while keeping up the recommendation of ANC initiation within the first trimester\u003csup\u003e\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eObjective of the Study\u003c/h3\u003e\n\u003cp\u003eThis study aims to comprehensively examine how socio-cultural and demographic factors predict ANC utilization within the Rohingya population residing in refugee camps in Cox's Bazar, Bangladesh, utilizing data gathered from early 2023 through April 2024. The goal is to contribute essential insights into the barriers and facilitators influencing ANC, ultimately providing the groundwork for developing targeted, integrated interventions and policies designed to enhance maternal and infant health within this vulnerable population.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eThe Rohingya context in Bangladesh\u003c/h2\u003e \u003cp\u003eIn 2017/2018 almost 700,000 Rohingya were violently displaced from Rakhine, Myanmar, bordering the southern tip of Bangladesh. As of 2024 almost 1\u0026nbsp;million Rohingya live in camps near Cox's Bazar, one of which now constitutes the largest and most densely populated refugee settlement in the world\u003csup\u003e\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e,\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e\u003c/sup\u003e. It has been shown that Rohingya in Bangladesh have an exceptionally high stillbirth rate\u003csup\u003e\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e\u003c/sup\u003e, and Rohingya displaced to Malaysia have on average higher rates of low birth weight babies than their host community\u003csup\u003e\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e\u003c/sup\u003e. Moreover, a third of all deaths of Rohingya women are reported to be related to pregnancy complications\u003csup\u003e\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e\u003c/sup\u003e. In a 2018 survey, more than half of the Rohingya women in Cox's Bazar who had given birth in the previous year reported that they had not received any ANC\u003csup\u003e\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eThe situation of the Rohingya living in Cox's Bazar is unique since they have been systematically excluded from (reproductive) health services in their country of origin and find themselves in a refugee camp setting\u003csup\u003e\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e\u003c/sup\u003e. Specific guidance on the number of ANC visits for Cox's Bazar could not be found. However, the Bangladeshi government recommends a minimum of 4 ANC visits\u003csup\u003e\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e\u003c/sup\u003e. Similarly, the Inter-Agency Working Group on Reproductive Health in Crisis recommends at least 4 visits in humanitarian response settings\u003csup\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eReports relying on health sector data show that ANC coverage and facility-based births have gradually increased since 2017 and rates of receiving at least 4 ANC visits are now around 77%\u003csup\u003e38\u003c/sup\u003e, while a study using self-report data finds over 47% of women did not receive ANC during their most recent pregnancy\u003csup\u003e\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eUnderstanding the considerations and barriers to take-up and timely initiation of adequate ANC can lead to targeted interventions to optimize ANC utilization. This could reduce maternal, neonatal and under-5 mortality rates, and address developmental delays observed in the Rohingya community\u003csup\u003e\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e,\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eStudy design and sampling\u003c/h3\u003e\n\u003cp\u003eData stems from the \u0026ldquo;intergenerational risk and resilience of Rohingya in displacement\u0026rdquo; (iRRRd) study, a longitudinal prenatal birth cohort study investigating how being gestated, born, and raised in a context of conflict and displacement affects child development\u003csup\u003e\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e\u003c/sup\u003e. Participants came from 11 purposively selected camps (accounting for differences in terrain reflecting more or less challenging locations) located near Ukhia, Cox's Bazar, Bangladesh.\u003c/p\u003e \u003cp\u003eA total of 2,322 pregnant Rohingya women were recruited between February 2023 and March 2024. In collaboration with Rohingya volunteer enumerators, a team of data collectors spoke to community leaders and other community members to identify households with pregnant women. Trained enumerators conducted surveys after completing verbal consent procedures.\u003c/p\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eMeasures\u003c/h2\u003e \u003cp\u003eData for this study were from the surveys conducted at recruitment and birth follow-up waves. Survey instruments were carefully translated to Bangla with special attention to Rohingya language particularities and piloted extensively in July and August of 2022.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003ePrimary outcomes\u003c/h3\u003e\n\u003cp\u003e \u003cem\u003eNumber of ANC Visits\u003c/em\u003e was the first variable of interest. It was defined as the total number of ANC visits reported at the post-birth survey, regardless of where (health clinic, home, etc.) ANC services were received. \u003cem\u003eTime of ANC Initiation\u003c/em\u003e was the second variable of interest and was a dummy variable determining whether a pregnant woman who had at least one ANC visit initiated ANC within the first three months of her pregnancy.\u003c/p\u003e\n\u003ch3\u003ePredisposing factors\u003c/h3\u003e\n\u003cp\u003e \u003cem\u003eMaternal Age\u003c/em\u003e was grouped into under 15, 15\u0026ndash;19, 20\u0026ndash;24, 25\u0026ndash;29, 30\u0026ndash;34 and above 34. \u003cem\u003eSchool Type\u003c/em\u003e was grouped by no school, a government school, an NGO school or a \u003cem\u003emadrassa\u003c/em\u003e (religious school). \u003cem\u003eMaternal, Husband's, Father's, and Mother's Formal Level of Education\u003c/em\u003e described the level of formal, non-religious schooling in an NGO or government school (highest grade achieved). Hence, people who only attended a religious school were treated as having zero years of formal education. \u003cem\u003eSelf-Reported Literacy\u003c/em\u003e was defined by being unable to read a newspaper in any language, being able to read a newspaper in Burmese, or being able to read it only in a (another) foreign language. The variable was created from two questions with a 3-point scale asking participants about their Burmese and foreign language reading skills.\u003c/p\u003e \u003cp\u003eIn this study, \u003cem\u003eSES\u003c/em\u003e is treated as a predisposing rather than an enabling factor, as ANC in the camps is free of cost. The factors related to \u003cem\u003eSES\u003c/em\u003e were obtained using factor analysis that utilized items that identified how many of certain assets the household possesses (chairs, beds, fans, chicken, solar panels, gas cylinders, tables, trunks, plastic drums, grams of gold) and questions from the perceived refugee environment index (PREI), which was developed to assess the quality of the refugee environment\u003csup\u003e\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e\u003c/sup\u003e. From the PREI, only 20 out of 30 items were used that covered questions on livelihoods, basic needs, housing, family environment, access to services and community environment using a 4-point Likert scale (almost never; less than half of the time; more than half of the time; almost always). The 10 items on electricity, heat, protection from rain, sun, wind, and water, or access to the internet, texting, or phone calls had to be dropped from the survey per request of the Refugee Response and Repatriation Commissioner (RRRC)\u0026mdash;the Bangladesh government entity that regulates activities in the camps.\u003c/p\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eEnabling factors\u003c/h2\u003e \u003cp\u003e \u003cem\u003eAgency and Mobility\u003c/em\u003e was defined as how often a woman could visit their family outside their block by themselves: almost never (0), less than half of the time (1), more than half of the time (2), or almost always (3). \u003cem\u003eCamp\u003c/em\u003e was a categorical variable defined as the camp where the pregnant woman lives.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eNeed factors\u003c/h2\u003e \u003cp\u003e \u003cem\u003eNumber of Children\u003c/em\u003e was grouped into 0, 1\u0026ndash;3, and more than 3. \u003cem\u003ePrevious Adverse Pregnancy Outcomes\u003c/em\u003e is a binary variable defined as at least one prior miscarriage, abortion, or stillbirth. The variable \u003cem\u003eHealth Rating\u003c/em\u003e described how well someone rated their physical health on a 5-point scale ranging from very bad (0) to very good (4).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eAdditional factors\u003c/h2\u003e \u003cp\u003e\u003cem\u003eANC Information Medium\u003c/em\u003e was a set of non-mutually exclusive dummy variables defined as whether information regarding the pregnancy was received on the radio, pamphlet, phone, online, and/or TV. \u003cem\u003eANC Conversations\u003c/em\u003e was a set of non-mutually exclusive dummy variables defined as whether a pregnant woman has talked about her pregnancy to her husband, mother-in-law, father-in-law, father, mother, sister, brother, friend, and/or sister-in-law. \u003cem\u003eGestational Length\u003c/em\u003e was a control variable defined as the total weeks of gestation at delivery, which was triangulated across data sources.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003eAnalysis plans\u003c/h2\u003e \u003cp\u003eStata18 and MPlus were used for the analyses. First, a descriptive analysis was conducted. Most studies similar to this used principal component analysis (PCA) to construct wealth or SES indices, and then divided the population into quintiles or terciles relying on assets and some additional variables measuring basic living conditions\u003csup\u003e\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e,\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e,\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e,\u003cspan additionalcitationids=\"CR45 CR46 CR47\" citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e\u003c/sup\u003e. This study additionally captures items from the perceived refugee environment index\u003csup\u003e\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e\u003c/sup\u003e. Exploratory factor analysis was used to examine the shared variance between these items and identify factors/sub-domains, and then use confirmatory factor analysis to obtain the factor scores. Factor analysis was preferred over PCA since the aim was to extract the latent common factors between the items and not merely reduce data\u003csup\u003e\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e\u003c/sup\u003e. The asset and PREI items went through this factor analysis process separately.\u003c/p\u003e \u003cp\u003eIn three of the camps, there was only one participant each. These single observations were dropped from the analyses. One case was dropped as the woman reported having been to medical school yet was not able to read. The \u003cem\u003eNumber of ANC Visits\u003c/em\u003e data was capped at 16 to reduce the impact of outliers on the analysis (this affected 14 observations).\u003c/p\u003e \u003cp\u003ePrevious literature has often focused on defining an adequate and inadequate number of visits using a binary logistic regression model with cut-off points of three or four\u003csup\u003e\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e,\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e,\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e\u003c/sup\u003e, or eight\u003csup\u003e\u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e\u003c/sup\u003e visits. Others used Poisson regression models\u003csup\u003e\u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e,\u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e52\u003c/span\u003e\u003c/sup\u003e. This paper uses Poisson regression to model ANC utilization in terms of the number of visits. Overdispersion was tested by comparing whether the variance exceeded the mean\u003csup\u003e\u003cspan citationid=\"CR53\" class=\"CitationRef\"\u003e53\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eIt is impossible to assess the explained variance of all predictors of a Poisson regression model, as pseudo R-squared only provides a measure of deviance, which can be interpreted in relation to other nested models\u003csup\u003e\u003cspan citationid=\"CR54\" class=\"CitationRef\"\u003e54\u003c/span\u003e\u003c/sup\u003e. Thus, the Poisson model was compared to an ordinary least square regression model. In case of similarity, conclusions about the amount of explained variance could be drawn. The Akaike Information Criterion (AIC) and the Bayesian Information Criterion (BIC) were used to assess the comparability of the models. Additionally, the change in R-squared observed when omitting the variable \u003cem\u003eCamp\u003c/em\u003e from the model accounts for the explained variance by camp differences.\u003c/p\u003e \u003cp\u003eThe results of the Poisson regression model were presented as the Incidence Rate Ratio (IRR). IRR can be interpreted as the percent change in the event rate for a one-unit increase in the predictor variable. It is calculated by exponentiating the coefficient of the predictor from the Poisson regression model\u003csup\u003e\u003cspan citationid=\"CR55\" class=\"CitationRef\"\u003e55\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eThe \u003cem\u003eTime of ANC Initiation\u003c/em\u003e was modelled using a binary logistic regression model. The results were presented as Odds Ratios (OR). Both the ANC utilization and the time of initiation models used robust standard errors to overcome the effects of potential clustering\u003csup\u003e\u003cspan citationid=\"CR56\" class=\"CitationRef\"\u003e56\u003c/span\u003e\u003c/sup\u003e and used complete cases only, which excluded 7% and 6% of the data points respectively.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003eModel selection for constructs related to SES\u003c/h2\u003e \u003cp\u003eBest fit was found for a 1-factor model for assets (\u003cem\u003eAssets\u003c/em\u003e), and a 3-factor model for the PREI (\u003cem\u003eBasic Needs Index\u003c/em\u003e, \u003cem\u003eSupport and Acceptance\u003c/em\u003e, \u003cem\u003eSafety\u003c/em\u003e). The asset scores were subsequently broken into quintiles when used in the regression analyses. The latter was done for comparability to other studies. Details on these analyses can be found in supplemental materials.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec17\" class=\"Section2\"\u003e \u003ch2\u003eSample characteristics and descriptive statistics\u003c/h2\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e presents an overview of the participants\u0026rsquo; general characteristics. The sample consisted of 2045 pregnant women with a mean age of 21.1 years. However, individual variables have missing observations. Summary statistics are calculated based on the available data for each variable. Notably, two-thirds of the sample already had at least one child, and almost a fourth had previously experienced miscarriages, abortions, or stillbirths. That left 28% of the recruited pregnant women without any previous pregnancy experience. Almost three-quarters reported not being allowed to visit their family outside their block alone, while only 12% were almost always allowed.\u003c/p\u003e \u003cp\u003eRegarding education, only 6% of the sample had never attended any type of school. On the other hand, 68% reported that they could not read the newspaper in any language. Almost half of the sample went to a religious school while the rest attended a more formal (public or NGO) school. When counting only having received religious education as zero years of formal schooling, the average pregnant woman had one and a half years of formal schooling and only 4% of the participants received more than 4 years of formal education.\u003c/p\u003e \u003cp\u003eHusbands, on average, had nearly twice as many years of formal education as their pregnant wives. Fathers of pregnant women had similar average years of schooling compared to the pregnant women, but exhibited a greater standard deviation. This means that, on the one hand, fathers were nearly four times more likely to have completed four or more years of formal education than their daughters, while also one and a half times more likely to have had no schooling at all compared to their daughters. Lastly, mothers of pregnant women attained the lowest level of formal education. Only 11% received any schooling, and on average, they received only a third of the years of schooling their daughters received.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eSample Descriptives and Demographics\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003eOverall (N\u0026thinsp;=\u0026thinsp;2045)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"4\" nameend=\"c7\" namest=\"c4\"\u003e \u003cp\u003eOverall (N\u0026thinsp;=\u0026thinsp;2045)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMaternal Age\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003eSelf-Reported Literacy\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c7\" namest=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eunder 15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e61 (3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNo Reading\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e68.61 (1403)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c7\" namest=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e15 to 19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e945 (46.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eOnly Burmese\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e23.08 (472)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c7\" namest=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e20 to 24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e569 (27.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eOnly Foreign\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e8.31 (170)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c7\" namest=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e25 to 29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e296 (14.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c7\" namest=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e30 to 34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e137 (6.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003eAgency and Mobility\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c7\" namest=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eover 34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e37 (1.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAlmost Never\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1511 (73.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c7\" namest=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMean (SD)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21.1 (5.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eLess than Half of the Time\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e191 (9.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c7\" namest=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eNumber of Previous Children\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMore than Half of the Time\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e91 (4.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c7\" namest=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eZero\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e641 (31.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAlmost Always\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e252 (12.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c7\" namest=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOne to Three\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1160 (56.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c7\" namest=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMore than Three\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e244 (11.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003eHealth Rating\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c7\" namest=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eVery Bad\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e74 (3.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c7\" namest=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePrevious Adverse Pregnancy Outcomes\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eBad\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e435 (21.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c7\" namest=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1559 (76.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eRegular\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e419 (20.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c7\" namest=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e485 (23.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eGood\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e996 (48.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c7\" namest=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMissing\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 (\u0026lt;\u0026thinsp;1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eVery Good\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e120 (5.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c7\" namest=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMissing\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1 (\u0026lt;\u0026thinsp;1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c7\" namest=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePregnant Woman School Type\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c7\" namest=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo School\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e124 (6.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c7\" namest=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNGO School\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e220 (10.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003eCamp\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c7\" namest=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOnly Religious Studies (Madrasa)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e909 (44.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eCamp 01E\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e263 (12.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c7\" namest=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGovernment Institution\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e788 (38.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eCamp 02W\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e231 (11.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c7\" namest=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMissing\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4 (\u0026lt;\u0026thinsp;1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eCamp 03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e392 (19.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c7\" namest=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eCamp 04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e219 (10.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c7\" namest=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePregnant Woman Years of Schooling\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eCamp 04 Ext\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e59 (2.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c7\" namest=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMean (SD)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.51 (1.90)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eCamp 07\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e423 (20.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c7\" namest=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMissing\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25 (1.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eCamp 08W\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e251 (12.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c7\" namest=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eCamp 17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e204 (10%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c7\" namest=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHusband\u0026rsquo;s Years of Schooling\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMissing\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3 (\u0026lt;\u0026thinsp;1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c7\" namest=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMean (SD)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.83 (3.40)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c7\" namest=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMissing\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e29 (1.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003eFather's Years of Schooling\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c7\" namest=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.45 (1.48)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMean (SD)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.52 (2.95)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c7\" namest=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMother's Years of Schooling\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMissing\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e43 (2.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c7\" namest=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMean (SD)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c7\" namest=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMissing\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.45 (1.48)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c7\" namest=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14 (\u0026lt;\u0026thinsp;1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c7\" namest=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e depicts ANC-related details. Remarkably, only two participants did not receive any ANC care (\u0026lt;\u0026thinsp;1%) and only 4% of the sample were lagging behind the adequacy mark of four visits, while more than a third received at least eight visits. Moreover, four out of five women attended their first ANC visit within the initial three months of pregnancy. By the beginning of the third trimester, more than 99% had at least one ANC visit.\u003c/p\u003e \u003cp\u003eCommunication about pregnancy was common; nearly all pregnant women talked with someone (94%), most often husbands, mothers, or mothers- and sisters-in-law. Communication with male family members (brothers, fathers, father-in-law) was notably rare. Only a small percentage received pregnancy information via their phone or online. Most women received information about their pregnancy from pamphlets.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eANC Characteristics\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"8\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003eOverall (N\u0026thinsp;=\u0026thinsp;2045)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"5\" nameend=\"c8\" namest=\"c4\"\u003e \u003cp\u003eOverall (N\u0026thinsp;=\u0026thinsp;2045)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eNumber of ANC Visits\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003eTime of ANC Initiation\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c8\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMean (SD)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.93 (2.60)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eWithin 3 Months of Pregnancy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e1646 (80.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c8\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRange\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u0026ndash;16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAfter 3 Months of Pregnancy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e393 (19.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c8\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMissing\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4 (\u0026lt;\u0026thinsp;1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMissing\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e6 (\u0026lt;\u0026thinsp;1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c8\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eLength of Pregnancy in Weeks\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003eReceived Information about ANC via\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c8\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMean (SD)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e39.13 (1.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e111 (5.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c8\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRange\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21\u0026ndash;42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eRadio\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e604 (29.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c8\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMissing\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e12 (\u0026lt;\u0026thinsp;1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eLeaflet/Pamphlet/Written Info\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e1456 (71)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c8\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePhone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e116 (5.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c8\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTalked about the pregnancy with\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eOnline\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e143 (7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c8\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo One\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e125 (6.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eTV\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e776 (38.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c8\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHusband\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1215 (59.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eSpeaker Announcements of Cars\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e533 (26.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c8\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMother-in-Law\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1037 (50.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c8\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFather-in-Law\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e123 (6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c8\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFather\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e215 (10.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c8\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMother\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1300 (63.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c8\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSister\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e691 (33.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c8\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBrother\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e47 (2.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c8\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFriend\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e240 (11.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c8\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSister-in-Law\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e759 (38.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c8\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec18\" class=\"Section2\"\u003e \u003ch2\u003eAntenatal care utilization \u0026ndash; Regression results\u003c/h2\u003e \u003cp\u003eWe find no hint of overdispersion for the Poisson regression model; the variance did not deviate greatly from the mean in the \u003cem\u003eNumber of ANC Visits\u003c/em\u003e. A comparison of the Poisson to a linear regression model provided highly similar AIC and BIC.\u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e presents the results from two regression models. Regarding \u003cem\u003ePredisposing Factors\u003c/em\u003e, only the pregnant woman\u0026rsquo;s education was associated with earlier not, however, with more ANC visits. For each additional year in a formal school the odds of delaying ANC until after the first trimester decreased by 12%. The education of the participants\u0026rsquo; husbands, mothers, or fathers did not predict the pregnant women\u0026rsquo;s ANC utilization behaviour, nor did the type of schooling of the pregnant women. None of the predictors derived from factor analysis and associated with SES was associated with ANC utilization behaviour.\u003c/p\u003e \u003cp\u003eRegarding predictors that enable pregnant women to receive care (\u003cem\u003eEnabling Factors\u003c/em\u003e), having a unit increase on the \u003cem\u003eAgency and Mobility\u003c/em\u003e scale was linked to 16% lower odds of delaying ANC initiation until after the first trimester. However, the predictor had no association with the number of ANC visits.\u003c/p\u003e \u003cp\u003eAssessing the perceived need to access ANC (\u003cem\u003eNeed Factors\u003c/em\u003e), compared to participants with zero children, those with one to three children reported 6% and those with more than three children reported 10% fewer ANC visits. No association between parity and the timing of ANC was found. For each unit increase of the pregnant women\u0026rsquo;s report on Health Rating, the odds of delaying ANC until after the first trimester increased by 21%. Similarly, Health Rating was approaching significance for the number of ANC visits. However, every unit increase was only associated with 1% fewer visits.\u003c/p\u003e \u003cp\u003eSurprisingly the ANC-specific predictors (\u003cem\u003eAdditional Factors\u003c/em\u003e), such as to whom they talked about their pregnancy and where they received their information, were unrelated to the number or timing of ANC visits. Only speaking to their father-in-law about their pregnancy approached significance with women displaying 8% more ANC visits. Interestingly, having received information about the pregnancy on the radio was associated with 52% higher odds of attending ANC only after the first trimester.\u003c/p\u003e \u003cp\u003eOverall, only a small proportion of the expected predictors of ANC utilization yielded a statistically significant relationship to the outcome, and with relatively small effect sizes, demonstrating modest individual effects of the found predictors. The comparable OLS regression model for the number of visits provided R\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;.062, suggesting a highly limited amount of variance explained by the chosen predictors. Additionally, a sensitivity check omitting the variable \u003cem\u003eCamp\u003c/em\u003e entirely from the model showed that the variance accounted for by \u003cem\u003eCamp\u003c/em\u003e was only 2%.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eRegression Results\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"13\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c12\" colnum=\"12\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c13\" colnum=\"13\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eNumber of ANC visits\u003c/p\u003e \u003cp\u003e(Poisson)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e \u003cp\u003eANC Initiated within the first trimester (logistic)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"6\" nameend=\"c13\" namest=\"c8\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e\u003cem\u003eN\u0026thinsp;=\u0026thinsp;1921\u003c/em\u003e\u003csup\u003e1\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e \u003cp\u003e\u003cem\u003eN\u0026thinsp;=\u0026thinsp;1920\u003c/em\u003e\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c13\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003eIRR\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003eP value\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eOR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e\u003cem\u003eP value\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c13\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge of Pregnant Woman\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c13\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eunder 15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c13\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e15\u0026ndash;19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.968\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.561\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.538\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e0.305\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c13\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e20\u0026ndash;24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.961\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.497\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.746\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e0.215\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c13\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e25\u0026ndash;29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.034\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.604\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.275\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e0.615\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c13\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e30\u0026ndash;34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.019\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.797\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.427\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e0.092\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c13\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eover 34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.086\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.388\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.210\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e0.778\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c13\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePregnant Woman Education Type\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c13\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo School\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c13\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNGO\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.966\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.460\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.611\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e0.199\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c13\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOnly Religious Studies\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.985\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.680\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.461\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e0.189\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c13\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGovernment Institutions\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.977\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.469\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e0.250\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c13\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePregnant woman Years of Education\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.015\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.124\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.879\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e\u003cb\u003e0.048\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c13\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHusband Years of Education\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.925\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.012\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e0.547\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c13\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eFather Years of Education\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.766\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.035\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e0.132\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c13\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMother Years of Education\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.995\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.930\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e0.164\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c13\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eLiteracy\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c13\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo Reading\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c13\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBurmese\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.971\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.316\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.379\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e0.098\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c13\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther Language\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.009\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.783\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.733\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e0.243\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c13\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eBasic Needs Factor\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.955\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.129\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e0.998\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c13\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSupport and Acceptance Factor\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.983\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.482\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.796\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e0.193\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c13\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSafety Factor\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.023\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.121\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.946\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e0.615\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c13\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAsset Quintiles\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c13\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePoorest\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c13\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePoorer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.041\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.142\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.800\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e0.264\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c13\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMiddle\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.005\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.857\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.139\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e0.501\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c13\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRicher\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.980\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.462\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.973\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e0.894\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c13\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRichest\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.979\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.493\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.084\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e0.707\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c13\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCamp\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c13\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCamp 01E\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c13\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCamp 02W\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.940\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.068\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.809\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e0.378\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c13\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCamp 03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.923\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e0.008\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.536\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e\u003cb\u003e0.004\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c13\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCamp 04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.022\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.507\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.959\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e0.863\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c13\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCamp 04 Ext\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.029\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.481\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.173\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e\u003cb\u003e0.006\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c13\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCamp 07\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.871\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e0.000\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.408\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e0.077\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c13\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCamp 08W\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.873\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e0.000\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.392\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e\u003cb\u003e0.000\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c13\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCamp 17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.974\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.444\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.544\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e\u003cb\u003e0.023\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c13\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAgency and Mobility\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.999\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.904\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.843\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e\u003cb\u003e0.010\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c13\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSelf Reported Health Rating\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.985\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.074\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.205\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e\u003cb\u003e0.004\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c13\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eNumber of Previous Children\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c13\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eZero\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c13\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOne to Three\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.935\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e0.004\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.919\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e0.619\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c13\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMore than Three\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.903\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e0.015\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.101\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e0.745\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c13\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePrevious miscarriages/ stillbirths/ abortions\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.014\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.483\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.338\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e\u003cb\u003e0.039\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c13\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTalked about the pregnancy with\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c13\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo One\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.002\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.970\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.243\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e0.576\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c13\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHusband\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.009\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.685\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.754\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e0.099\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c13\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMother-in-law\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.978\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.341\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.043\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e0.819\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c13\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFather-in-law\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.082\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.075\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.542\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e0.104\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c13\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFather\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.983\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.627\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.937\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e0.822\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c13\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMother\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.005\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.799\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.955\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e0.782\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c13\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSister\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.997\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.876\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.923\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e0.621\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c13\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBrother\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.987\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.801\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.114\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e0.794\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c13\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFriend\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.973\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.328\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.989\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e0.959\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c13\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSister-in-law\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.013\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.501\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.838\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e0.175\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c13\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eReceived Information about ANC via\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c13\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNone Received\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.961\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.499\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.798\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e0.595\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c13\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRadio\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.016\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.553\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.520\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e\u003cb\u003e0.038\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c13\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLeaflet/Pamphlet/Written Info\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.986\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.635\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.901\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e0.639\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c13\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePhone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.977\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.593\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.235\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e0.558\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c13\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOnline\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.046\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.305\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.132\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e0.717\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c13\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTV\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.963\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.225\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e0.239\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c13\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSpeaker Announcements\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.018\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.442\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.146\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e0.431\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c13\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGestational Length\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.026\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e0.000\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c13\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e_cons\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.026\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.107\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c13\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"7\" nameend=\"c7\" namest=\"c1\"\u003e \u003cp\u003eNotes: The lower number of participants in the regression models compared to the descriptives is due to listwise deletion. \u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003e Two participants with 0 ANC visits were excluded from this model, one of whom was already excluded in the first model due to missing data in another variable.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c13\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study examined predictors of the number and timing of ANC visits among forcibly displaced Rohingya refugees living in camps in Cox\u0026rsquo;s Bazar, Bangladesh. The average of 7 ANC visits was unexpected, as was the high rate of ANC initiation in the first trimester, practically meeting WHO\u0026rsquo;s global recommendation for ANC. Many of the factors identified in similar studies did not predict ANC utilization in this context. The significant predictors that were identified provided very small effect sizes. A sensitivity check revealed that only 6% of the variance of the number of ANC visits could be explained by this study\u0026rsquo;s predictors.\u003c/p\u003e \u003cp\u003eHowever, some interesting factors associated with ANC utilization were identified. Higher self-reported health ratings significantly increased the odds of ANC initiation after the first trimester, leading potentially to women missing the critical early window for ANC. This better rated health was also trending an association with fewer ANC visits. Together these findings may reflect unmet pregnancy care needs among healthier-feeling women and could indicate the need for better sexual and reproductive health education. Based on evidence from Bangladesh more generally, it is not uncommon for women not to reveal their pregnancy to their family until after the first trimester, let alone going to a health service provider. Given some similarity in culture and norms between Rohingya and host communities, this could be a factor for later initiation if they deem their physical health to be good.\u003c/p\u003e \u003cp\u003eThe freedom to move alone was also significantly associated with ANC timing. Women who could not move freely without accompaniment had a lower likelihood of initiating ANC within the first trimester. However, this restriction did not significantly affect the total number of ANC visits. This suggests that while restricted mobility does not reduce the overall frequency of ANC visits, it may delay the critical initiation phase, possibly compromising the adequacy of care. In contrast, in the host community restricted movement play a significant role in seeking ANC. This could well be due to distances from clinics being larger for many host community members.\u003c/p\u003e \u003cp\u003eWomen for whom this was going to be the first child reported having more frequent ANC check-ups. This aligns with previous research in Bangladesh\u003csup\u003e\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e,\u003cspan citationid=\"CR57\" class=\"CitationRef\"\u003e57\u003c/span\u003e\u003c/sup\u003e. Duodu and colleagues\u003csup\u003e\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u003c/sup\u003e have argued that such an effect may reflect the confidence of women being able to handle another pregnancy on their own, especially if previous pregnancies and births occurred without complications. Primigravid women are at a higher risk of obstetric complications\u003csup\u003e\u003cspan citationid=\"CR58\" class=\"CitationRef\"\u003e58\u003c/span\u003e\u003c/sup\u003e. However, evidence also points to increased risks for women in their fourth pregnancy or higher\u003csup\u003e\u003cspan citationid=\"CR59\" class=\"CitationRef\"\u003e59\u003c/span\u003e,\u003cspan citationid=\"CR60\" class=\"CitationRef\"\u003e60\u003c/span\u003e\u003c/sup\u003e. Furthermore, maternal age is a critical factor in pregnancy outcomes, with adolescents and women aged 30 and above, facing higher risks of complications compared to those in their twenties\u003csup\u003e\u003cspan citationid=\"CR61\" class=\"CitationRef\"\u003e61\u003c/span\u003e,\u003cspan citationid=\"CR62\" class=\"CitationRef\"\u003e62\u003c/span\u003e\u003c/sup\u003e. Despite these risks, age did not demonstrate a significant association with ANC utilization behavior. However, first-time pregnancy is highly correlated with being under the age of 18 as age of marriage in this population is very young. While the slightly higher ANC utilization among primiparous women is encouraging, there remains a need to raise awareness about pregnancy complications associated with high parity and maternal age below 20 or above 30 years within the community.\u003c/p\u003e \u003cp\u003eInterestingly, while only trending, the only person pregnant women discussed their pregnancy with that was associated with number of ANC visits was their fathers-in-law. This is surprising given the rather conservative beliefs around reproductive health in the Rohingya community, where husbands\u0026rsquo; and mothers-in-law\u0026rsquo;s knowledge and opinions often shape reproductive decisions\u003csup\u003e\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e,\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e\u003c/sup\u003e. The association may reflect specific family structures or the women\u0026rsquo;s own beliefs and attitudes, leading to discussing these topics with their fathers-in-law. Links between knowledge, attitudes, and ANC utilization have been observed in other low-income countries\u003csup\u003e\u003cspan additionalcitationids=\"CR64\" citationid=\"CR63\" class=\"CitationRef\"\u003e63\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR65\" class=\"CitationRef\"\u003e65\u003c/span\u003e\u003c/sup\u003e. These insights highlight the importance of further exploring Rohingya women\u0026rsquo;s knowledge, attitudes, and beliefs regarding ANC and how these are shaped.\u003c/p\u003e \u003cp\u003eNo reasonable explanation has been found as to why pregnant women who received information about ANC on the radio had 52% higher odds of initiating ANC only after the first trimester. This seems contradictory to a recent study that found that listening to the radio contributed to good STI and HIV knowledge in women in the Cox\u0026rsquo;s Bazar Refugee Camps\u003csup\u003e\u003cspan citationid=\"CR66\" class=\"CitationRef\"\u003e66\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eVariance in both dependent variables was exhibited between different camps. However, no camp was associated with more than a 13% increase in ANC visits. Additionally, a sensitivity check omitting \u003cem\u003eCamp\u003c/em\u003e entirely from the model showed that the variance accounted for by the location in the number of ANC visits was only 2%.\u003c/p\u003e \u003cp\u003eThe most widely cited predictors of ANC utilization in previous studies are education and SES\u003csup\u003e\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e,\u003cspan citationid=\"CR63\" class=\"CitationRef\"\u003e63\u003c/span\u003e\u003c/sup\u003e. Their lack of predictive power in the current study is noteworthy. Only a link between years of education and time of ANC initiation was found, suggesting a decrease of initiating ANC after the first three months by 12.1% for each additional year of schooling. On the other hand, no association was found with the number of ANC visits. These findings stand in contrast with comparable studies\u003csup\u003e\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e,\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e,\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e,\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e,\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e,\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e\u003c/sup\u003e, including a Bangladesh-wide study reporting that primary and secondary education was associated with 27% and 57% more ANC visits, respectively, compared to those without schooling\u003csup\u003e\u003cspan citationid=\"CR67\" class=\"CitationRef\"\u003e67\u003c/span\u003e\u003c/sup\u003e. Moreover, assets and basic living conditions predicted ANC utilization reliably in previous studies in African and South Asian countries\u003csup\u003e\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e,\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e,\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e,\u003cspan additionalcitationids=\"CR45 CR46 CR47\" citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e\u003c/sup\u003e. However, the current study found no significant relationship between ANC timing or the number of ANC visits and the \u003cem\u003eAsset Index\u003c/em\u003e or \u003cem\u003eBasic Needs Index.\u003c/em\u003e\u003c/p\u003e \u003cp\u003eThe few studies on ANC utilizaiton predictors conducted in refugee camp settings have found mixed results regarding education and SES. In an Iraqi refugee camp, researchers found that among forcefully displaced Syrians, maternal education is not associated with ANC utilization, while maternal employment status is\u003csup\u003e\u003cspan citationid=\"CR68\" class=\"CitationRef\"\u003e68\u003c/span\u003e\u003c/sup\u003e. A study in camps for internally displaced people in Sudan reported that employment status is not related to ANC utilization but identified education as a predictor\u003csup\u003e\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eSeveral studies have shown a higher rate of ANC utilization for refugees than before their forced displacement and compared the refugee to the host population. For instance, 99% of Syrian refugees in Iraqi camps attended ANC at least once, and 65% reported at least four visits\u003csup\u003e\u003cspan citationid=\"CR68\" class=\"CitationRef\"\u003e68\u003c/span\u003e\u003c/sup\u003e. Additionally, 70% of Palestinian refugees in Jordanian camps attended ANC at least four times\u003csup\u003e\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e\u003c/sup\u003e. This is similar to the current study, which observed high ANC attendance rates among Rohingya compared to Bangladesh more generally\u003csup\u003e\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e,\u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e52\u003c/span\u003e\u003c/sup\u003e and other South Asian countries where most women receive no more than three ANC visits\u003csup\u003e\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e,\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e,\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e\u003c/sup\u003e. Fareed and Ismail\u003csup\u003e\u003cspan citationid=\"CR68\" class=\"CitationRef\"\u003e68\u003c/span\u003e\u003c/sup\u003e suggest that special proximity, free services, and incentives from NGOs to attend ANC impact the higher rates in refugee camps. The current study adds to this scarce body of research in refugee camp settings, suggesting that other (context-specific) factors in the camps alter the roles of SES and educational status as a predictor of ANC.\u003c/p\u003e \u003cp\u003eConducting research in the Rohingya context is incredibly difficult. The power differentials between data collectors from the local Bangladeshi community and the Rohingya community, the linguistic barriers, among other factors, can contribute to misunderstandings and biased responses. In addition, the humanitarian aid sector can distort and render meaningless factors that are well established in the literature. For instance, household assets may not be a meaningful indicator in predicting ANC usage where assets and services are provided fairly equitably and free of charge and are thus possibly not reflective of SES.\u003c/p\u003e \u003cp\u003eKhan and colleagues\u003csup\u003e\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e\u003c/sup\u003e found that 47% of Rohingya women in Cox\u0026rsquo;s Bazar had not attended any ANC services, and were able to identify predictors in line with previous literature. This stands in stark contrast to our findings. Some of these differences could be of methodological nature including social desirability, sample, and recall biases. We know from official records and from our qualitative investigations that the ANC utilization rates in this context have changed over time. By 2019, the number of ANC visits and facility-based deliveries had already increased by 40% compared to two years earlier\u003csup\u003e\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e\u003c/sup\u003e. After assessing the quality and distribution of health services in 2019, over a third of health facilities were relocated or closed for better distribution and quality of services. This was accompanied by continued capacity building among health workers and community advocacy\u003csup\u003e\u003cspan citationid=\"CR69\" class=\"CitationRef\"\u003e69\u003c/span\u003e\u003c/sup\u003e. However, the COVID-19 pandemic led to a significant contraction of the health sector serving the camps which may be driving some of Khan and colleagues\u003csup\u003e\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e\u003c/sup\u003e findings using data collected in 2023 from women who had been pregnant in the preceding 2 years. We know that the pandemic led to a contraction in health services in the camps, likely affecting ANC services as well. The most recent official health sector bulletin reported that by February 2024, 77% of pregnant women had at least four ANC visits, and 90% of births were facility-based\u003csup\u003e\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e\u003c/sup\u003e. These numbers align with the findings in our work, establishing confidence in our data.\u003c/p\u003e \u003cp\u003eThat said, our data on assets, education, and literacy warrants further investigations. We were restricted in asking about literacy in certain languages by the RRRC, and we did not conduct any reading comprehension assessments. We know that formal schooling and literacy rates are very low in this population, but we also know that people use text messaging to communicate. Similarly, we suspect that our assets do not reflect the more nuanced socioeconomic characteristics that typically drive behaviours such as health care seeking.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eOur study suggests a fairly well-functioning antenatal care system in the Rohingya camps in Cox\u0026rsquo;s Bazar, Bangladesh, in line with the official statistics from the health sector. Particular factors contributing to relatively early and high uptake of ANC services remain somewhat unclear and should be explored more carefully in order to target specific messaging addressing some of the gaps in care. Our study does not capture any ANC quality indicators which should be a focus of future investigations. In addition, maternal (295/ 100,000 live births) and under 5 (25.31/100,000 live births) mortality rates remain rather high in the Rohingya context\u003csup\u003e\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e\u003c/sup\u003e. Future research should thus investigate the links between ANC and adverse pregnancy and birth outcomes. This study contributes to a better understanding of ANC behaviours in the Rohingya context, which constitutes an important component in ensuring maternal and offspring health in a very vulnerable population. This research provides vital information for improvements in reproductive health care in humanitarian contexts.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eAIC\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eAkaike Information Criterion\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eANC\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eAntenatal care\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eBIC\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eBayesian Information Criterion\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eCXB\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eCox\u0026rsquo;s Bazar\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eIRR\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eIncidence rate ratio\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eiRRRd\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eintergenerational risk and resilience of Rohingya in displacement\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eLMIC\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eLow- and middle-income country\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eOR\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eOdds ratio\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003ePREI\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003ePerceived refugee environment index\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eRRRC\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eRefugee Response and Repatriation Commissioner\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eSES\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eSocioeconomic status\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eWHO\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eWorld Health Organization\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study was approved by the ethical review committee of icddr,b (PR-22064) and from New York University (IRB-FY2021-4875).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eUpon request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eGenerous funding for this study was provided by the LEGO Foundation through the Play to Learn initiative.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eDS contributed to conceptualization of this paper and led in analyses and first draft of manuscript. DM supported analyses and write up of methods and results. MSR supported analyses and provided details and background on field procedures. MCH and AKR supported survey preparation, and interpretation and contextualization of results. KIS contributed to the conceptualization and design of and provided scientific oversight to iRRRd, and reviewed and provided comments on the manuscript. FT co-led the conceptualization and design of iRRRd and reviewed and provided comments on the manuscript. AJW (senior author) co-led the conceptualization and design of iRRRd, supervised and mentored the lead-author on conceptualizing and executing this paper, provided guidance on analyses and substantial feedback and edits on the manuscript throughout the process.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe thank our partners from the LEGO Foundation funded Play to Learn initiative for their ongoing support in making this study happen. We are grateful for the tireless dedication of our research teams on the ground, in particular enumerators and field managers who went to great lengths to collect high quality data under some of the most challenging conditions across a number of Rohingya camps in Bangladesh.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAdditional File\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eResults for constructs related to socioeconomic status\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eUN, Sustainable Development G. 2015. p. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.un.org/sustainabledevelopment/\u003c/span\u003e\u003cspan address=\"https://www.un.org/sustainabledevelopment/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLawn JE, Blencowe H, Oza S, et al. 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Reproductive Health. 2022;19(1):36.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBhowmik KR, Das S, Islam MA. Modelling the number of antenatal care visits in Bangladesh to determine the risk factors for reduced antenatal care attendance. PLoS ONE. 2020;15(1):e0228215.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJamil SAM, Abdullah MAA, Kek SL, Nor ME, Mohamed M, Ismail N. Detecting overdispersion in count data: a zero-inflated Poisson regression analysis. Journal of Physics: Conference Series; 2017: IOP Publishing; 2017. p. 012170.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCoxe S, West SG, Aiken LS. The analysis of count data: A gentle introduction to Poisson regression and its alternatives. J Pers Assess. 2009;91(2):121\u0026ndash;36.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCameron AC, Trivedi PK. Regression analysis of count data. 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J Adv Nurs. 2008;61(3):244\u0026ndash;60.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSingh DR, Sah RK, Simkhada B, Darwin Z. Understanding service users and other stakeholders\u0026rsquo; engagement in maternal and newborn health services research: A systematic review of evidence from low-and middle-income countries. PLoS ONE. 2024;19(11):e0309888.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFinlayson K, Downe S. Why do women not use antenatal services in low-and middle-income countries? A meta-synthesis of qualitative studies. PLoS Med. 2013;10(1):e1001373.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZakaria M, Exploring STIHIV. Knowledge and Effect of Communication Activities Among Rohingya Refugee Women: A Camp-based Cross-sectional Study in Bangladesh. J Psychosexual Health. 2024;6(1):55\u0026ndash;65.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eIslam MA, Kabir MR, Talukder A. Triggering factors associated with the utilization of antenatal care visits in Bangladesh: An application of negative binomial regression model. Clin Epidemiol Global Health. 2020;8(4):1297\u0026ndash;301.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFareed SM, Ismail KH. Utilization of antenatal care services in Syrian refugee camps in Erbil, Iraq. Zanco J Med Sci (Zanco J Med Sci). 2019;23(2):250\u0026ndash;6.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJeffries R, Abdi H, Ali M, et al. The health response to the Rohingya refugee crisis post August 2017: Reflections from two years of health sector coordination in Cox\u0026rsquo;s Bazar, Bangladesh. PLoS ONE. 2021;16(6):e0253013. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1371/journal.pone.0253013\u003c/span\u003e\u003cspan address=\"10.1371/journal.pone.0253013\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"conflict-and-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"conf","sideBox":"Learn more about [Conflict and Health](http://conflictandhealth.biomedcentral.com/)","snPcode":"13031","submissionUrl":"https://submission.nature.com/new-submission/13031/3","title":"Conflict and Health","twitterHandle":"@Conflict_Health","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"antenatal care, Rohingya, maternal health, forced displacement, humanitarian settings, Bangladesh, South Asia","lastPublishedDoi":"10.21203/rs.3.rs-6475112/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6475112/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eWhile studies in both high- and low-income settings have demonstrated the importance of early and regular antenatal care (ANC) utilization, evidence from crisis-affected populations remains limited. Rohingya refugees in Cox\u0026rsquo;s Bazar, Bangladesh, face unique barriers to healthcare; previous studies have found low rates of ANC utilization. This study examines the predictors of number of visits and timing of initiation of ANC among pregnant Rohingya women in Cox\u0026rsquo;s Bazar.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eData come from a prenatal birth cohort study of \"Intergenerational Risk and Resilience of Rohingya in Displacement\" (iRRRd). A total of 2,322 pregnant Rohingya women were recruited between February 2023 and March 2024. ANC utilization was assessed via surveys at the birth follow-up visit. Primary outcomes included the number of ANC visits and the timing of the first visit. Predictors were categorized using the Andersen-Newman model (predisposing, enabling, and need factors). We used Poisson regression for number of visits, and logistic regression to analyze timing of first visit.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eThe average number of ANC visits was 6.9 (SD\u0026thinsp;=\u0026thinsp;2.6), with 80.5% of women initiating care within the first trimester. Women with one to three children reported fewer visits (IRR\u0026thinsp;=\u0026thinsp;0.94, p\u0026thinsp;=\u0026thinsp;0.004), as did those with more than three (IRR\u0026thinsp;=\u0026thinsp;0.90, p\u0026thinsp;=\u0026thinsp;0.015). Higher self-rated health predicted delayed initiation (OR\u0026thinsp;=\u0026thinsp;1.21, p\u0026thinsp;=\u0026thinsp;0.004). More years of formal education reduced the odds of delayed initiation (OR\u0026thinsp;=\u0026thinsp;0.88, p\u0026thinsp;=\u0026thinsp;0.048) but did not affect the number of visits. Greater mobility was linked to earlier initiation (OR\u0026thinsp;=\u0026thinsp;0.84, p\u0026thinsp;=\u0026thinsp;0.010). Socioeconomic indicators and education of relatives were not associated with ANC use. Receiving information via radio was unexpectedly associated with delayed initiation (OR\u0026thinsp;=\u0026thinsp;1.52, p\u0026thinsp;=\u0026thinsp;0.038). Location of residence explained minimal variance (2%).\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eANC coverage in the Rohingya camps appears high, yet some groups remain at risk for delayed care. Feeling healthy, high parity, and restricted mobility contributed to late initiation. Conventional predictors like formal education and SES showed limited relevance in this context. Findings point to the need for tailored health communication strategies and deeper examination of the quality of ANC services and associations with maternal and neonatal outcomes.\u003c/p\u003e","manuscriptTitle":"Predictors of Antenatal Care Utilization Among the Rohingya Population in the Refugee Camps of Cox's Bazar, Bangladesh","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-05-05 03:15:59","doi":"10.21203/rs.3.rs-6475112/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-09-02T18:25:00+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-07-22T18:21:05+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"254496313600347628706018952361712660405","date":"2025-07-10T13:10:16+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"164245380585442623296475768895652025490","date":"2025-06-02T23:19:43+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-05-26T07:26:49+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"240288377781065297126650212284293243007","date":"2025-05-05T04:18:08+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"47571457401510233673250178520197871993","date":"2025-04-29T20:35:56+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-04-29T16:22:55+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-04-18T10:30:38+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-04-18T10:28:44+00:00","index":"","fulltext":""},{"type":"submitted","content":"Conflict and Health","date":"2025-04-18T01:31:41+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"conflict-and-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"conf","sideBox":"Learn more about [Conflict and Health](http://conflictandhealth.biomedcentral.com/)","snPcode":"13031","submissionUrl":"https://submission.nature.com/new-submission/13031/3","title":"Conflict and Health","twitterHandle":"@Conflict_Health","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"effa3790-a182-4fa5-8914-a6fadf64c051","owner":[],"postedDate":"May 5th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-12-08T16:08:42+00:00","versionOfRecord":{"articleIdentity":"rs-6475112","link":"https://doi.org/10.1186/s13031-025-00733-6","journal":{"identity":"conflict-and-health","isVorOnly":false,"title":"Conflict and Health"},"publishedOn":"2025-12-03 15:57:46","publishedOnDateReadable":"December 3rd, 2025"},"versionCreatedAt":"2025-05-05 03:15:59","video":"","vorDoi":"10.1186/s13031-025-00733-6","vorDoiUrl":"https://doi.org/10.1186/s13031-025-00733-6","workflowStages":[]},"version":"v1","identity":"rs-6475112","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6475112","identity":"rs-6475112","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}