Prevalence and correlates of age at first birth and utilization of maternal health care services among pregnant women in four Asian-Pacific Island countries

BACKGROUND Maternal mortality is still high among adolescent women worldwide. This study explores the influence of socio-demographic characteristics on having four or more antenatal care (ANC4+) visits and use of Skilled Birth Attendants (SBA) among women in four island countries: Indonesia, the Philippines, Papua New Guinea, and Timor-Leste. METHODS Data from Demographic and Health Surveys of Indonesia, the Philippines, Papua New Guinea, and Timor-Leste were used. We studied the relationship of utilization of ANC4+ visits and SBA among women aged 15-49 years with socio-demographic variables including women’s age at first birth, age at first cohabitation, age at last birth, age groups, place of residence, education, wealth, birth order, number of living children, household ownership of a vehicle, and reproductive health knowledge. Descriptive, bivariate, and multivariable logistic regression analyses were performed. RESULTS Women at first birth before age 18 ranged from 18% in Indonesia to 31% in Papua New Guinea. In all countries, wealth status and having knowledge on modern contraceptives were significant predictors for having ANC4+ visits and SBA use. In Indonesia, women older than 25 were 1.38 times (95% CI=1.09-1.74) more likely to use SBA than those younger than 19. Each country demonstrated different patterns of ANC4+ visits and use of SBA that varied by education, place of residence, birth order, number of living children, and household ownership of a vehicle. CONCLUSION Having a high number of adolescent births highlighted a need for reproductive health knowledge reach to the young women, which can achieve through ANC4+ visits and use of SBA.