Impact of Prenatal Care Utilization on Infant Care Practices in Nepal: a National Representative Cross-sectional Survey

This study aimed to examine the utilization of prenatal care and its association with infant care practices using a nationally representative sample of Nepalese mothers and children. The study data was based on the 2006 Nepal Demographic and Health Survey which comprised of women age 15-49 years old who had delivered within three years prior to the survey (N = 4,136). A multilevel logistic regression model was fitted to assess the influence of prenatal care utilization on several indicators of infant care. Neonatal mortality is still high in Nepal (46 per 1,000 live births). After taking into account several maternal and child characteristics, children of mothers with no prenatal care were at increased risk of neonatal death (OR = 2.03, 95 % CI = 1.28-3.23). Compared to women with no prenatal care, those with more than three visits were more likely to immunize their children (OR = 2.66, 95 % CI = 2.10-3.36) and more likely to initiate breastfeeding within 1 h after birth (OR = 1.25, 95 % CI = 1.02-1.54). Having skilled attendants at prenatal care and at birth was also associated with better infant care practices. Conclusion:Neonatal mortality is still high in Nepal. Adequate prenatal care utilization may represent a key preventative strategy, which, in the present study, was associated with improvement in neonatal mortality, higher likelihood of having immunization, and initiation of breastfeeding within 1 h after birth. Public health awareness programs and interventions are needed in Nepal to increase the utilization of prenatal care as well as delivery assisted by skilled attendants.