Inequality in Afghanistan in the use of prenatal healthcare services according to the sex of newborns.

Abstract

Objective: The association between the sex of newborns and the utilization of prenatal healthcare services during pregnancy and childbirth has not been thoroughly studied. This study investigated the association between the sex of newborns and the extent to which women used prenatal healthcare services in Afghanistan.

Materials and methods: This study used data obtained from a nationally representative demographic and health survey. The participants in this analysis were women who had given birth in the last five years (n=19,126). Four indicators related to prenatal healthcare utilization were used: (1) number of antenatal care (ANC) visits, (2) number of ANC services provided by skilled professionals, (3) quality of ANC services, and (4) institutional delivery. Multivariate linear and logistic regression models were employed to examine the association between the sex of newborns and the use of prenatal healthcare services after adjusting for sociodemographic and decision-making autonomy variables.

Results: There was a significant association between the sex of newborns and use of prenatal healthcare services. Women with female newborns used ANC services fewer times (β =-0.10, 95% CI: -0.17, -0.03), used ANC services provided by skilled professionals fewer times (β=-0.11, 95% CI: -0.18, -0.04), were less likely to receive high-quality ANC (adjusted odds ratio (AOR)=0.78, 95% confidence interval (CI): 0.67, 0.90), and were less likely to deliver their babies at health institutions (AOR=0.83, 95% CI: 0.77, 0.91) than those with male newborns, after adjusting for other variables.

Conclusion: The findings revealed a negative association between female newborns and the utilization of prenatal healthcare services among women of reproductive age in Afghanistan. It is important to pay attention to this issue and ensure that all women have equal access to healthcare services regardless of their newborn's sex.