Peer-reviewed article

Do sociodemographic factors modify the association between antenatal care utilisation and acute respiratory infection among infants in Ethiopia?

Asresie M, Fekadu G, Erbas B, Batra M · 14 May 2026

Abstract

Antenatal care (ANC) is vital for optimum maternal care and could provide an opportunity to prevent acute respiratory infection (ARI) in early childhood, particularly in low-resource settings; however, its impact on ARI remains underexplored. This study examined the association between ANC utilisation and ARI in Ethiopian infants, including stratified analyses by key socio-demographic factors. A total of 4,154 mother-infant pairs were analysed, using data from the Performance Monitoring for Action Ethiopia panel surveys conducted from 2019 to 2021 and from 2021 to 2023. At least one ANC visit, adequate ANC visits, and timely initiation of ANC were the exposures, and ARI among infants was the outcome. Generalised linear mixed models (GLMMs) were fitted using STATA 17 to estimate odds ratios (ORs) with 95% confidence intervals (CIs). Stratified analysis was conducted by maternal education, family wealth status, and administrative regions. Adequate ANC visits (≥4 ANC visits) were associated with significantly lower odds of ARI (aOR = 0.47; 95% CI: 0.24, 0.90). The protective effect was more pronounced among infants of mothers with higher education (aOR = 0.15; 95% CI: 0.04, 0.56), from wealthier households (aOR = 0.31; 95% CI: 0.14, 0.67), and those residing in agrarian regions (aOR = 0.44; 95% CI: 0.22, 0.88). At least one ANC visit showed a reduction in odds, but only among infants of educated mothers (aOR = 0.20; 95% CI: 0.05, 0.79). Adequate ANC visits significantly reduced the odds of ARI, especially among infants of educated mothers, wealthier families, and in agrarian regions. In contrast, just one visit or early initiation alone showed no benefit. Ensuring quality ANC access and targeting women in poverty with limited transport, income, and health literacy needs to be the focus of maternal and child health programs if we are to improve child health outcomes in low-resource settings like Ethiopia.