BACKGROUND: Although there is a general agreement on the importance of antenatal care to improve
the maternal and perinatal health, little is known about its importance to improve health facility delivery
in developing countries. The objective of this study was to assess the association of antenatal care with
birth in health facility.
METHODS: A systematic review with meta-analysis of Mantel–Haenszel odds ratios was conducted by
including seventeen small scale studies that compared antenatal care and health facility delivery between
2003 and 2013. Additionally, national survey data of African countries which included antenatal care,
health facility delivery and maternal mortality in their report were included. Data were accessed via a
computer based search from MEDLINE, African Journals Online, HINARI and Google Scholar
databases.
RESULTS: The regression analysis of antenatal care with health facility delivery revealed a positive
correlation. The pooled analysis also demonstrated that woman attending antenatal care had more than
7 times increased chance of delivering in a health facility. The comparative descriptive analysis, however,
demonstrated a big gap between the proportion of antenatal care and health facility delivery by the same
individuals (27%-95% vs 4%-45%). Antenatal care and health facility delivery had negative correlation
with maternal mortality.
CONCLUSION: The present regression and meta-analysis has identified the relative advantage of
having antenatal care to give birth in health facilities. However, the majority of women who had
antenatal care did not show up to a health facility for delivery. Therefore, future research needs to give
emphasis to identifying barriers to health facility delivery despite having antenatal care follow up