{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T14:28:55Z","timestamp":1779114535843,"version":"3.51.4"},"reference-count":44,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Womens Health (Lond Engl)"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Although perceived distance is a key factor in deciding and reaching healthcare, its impact on antenatal care (ANC) utilisation remains underexplored.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aims to examine the effect of perceived distance on ANC uptake, stratified by key maternal characteristics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Cross-sectional analysis based on demographic and health survey data (DHS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study analysed the demographic and health survey data of 26 sub-Saharan African countries, comprising 186,873 women who had given birth within the five years preceding the surveys. The exposure variable was perceived distance to a healthcare facility, categorised as \u201ca big problem\u201d or \u201cnot a big problem.\u201d Whereas the outcome variable was the number of ANC contacts, classified as no, one to three, four to seven and eight or more contacts. A Generalised Structural Equation Model (GSEM) with a multinomial logit link was employed to examine the association. Analyses were further stratified by socio-demographic characteristics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The analysis revealed that women who perceived the distance as a major problem had 15% higher odds of receiving only 1\u20133 contacts (aOR = 1.15, 95% CI: 1.05, 1.25, p = 0.002), and 51% higher odds of receiving no ANC (aOR = 1.51, 95% CI: 1.35, 1.66, p &lt; 0.001), compared to those receiving eight or more contacts. These associations were particularly pronounced among women with lower educational status (aOR=1.48, 95%CI: 1.29, 1.64), rural residents (aOR=1.55, 95%CI: 1.37, 1.74), low household income (aOR=1.47, 95%CI: 1.27,1.68), and younger age (aOR=1.55, 95%CI: 1.31, 1.80).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Perceived distance remains a significant barrier to the utilisation of antenatal care services in resource-limited settings. Strengthening health system responsiveness and addressing structural barriers, such as transportation infrastructures, through innovations like mobile antenatal care is vital to improving maternal health outcomes and advancing global health equity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17455057261446938","type":"journal-article","created":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T13:41:16Z","timestamp":1778679676000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Effect of perceived distance to health facility on antenatal care service use in Sub-Saharan Africa: Do socio-demographic characteristics modify these associations?"],"prefix":"10.1177","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1272-7824","authenticated-orcid":false,"given":"Yibeltal","family":"Bekele","sequence":"first","affiliation":[{"name":"La Trobe University"},{"name":"Bahir Dar University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruth L","family":"Ngoma","sequence":"additional","affiliation":[{"name":"La Trobe University, Shepparton Campus"},{"name":"University of Newcastle"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9912-8332","authenticated-orcid":false,"given":"Gedefaw","family":"Abeje","sequence":"additional","affiliation":[{"name":"Bahir Dar University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9597-418X","authenticated-orcid":false,"given":"Bircan","family":"Erbas","sequence":"additional","affiliation":[{"name":"La Trobe University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2273-4948","authenticated-orcid":false,"given":"Mehak","family":"Batra","sequence":"additional","affiliation":[{"name":"La Trobe University"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,5,13]]},"reference":[{"key":"e_1_3_6_2_2","volume-title":"WHO recommendations on antenatal care for a positive pregnancy experience: summary: highlights and key messages from the World Health Organization's 2016 global recommendations for routine antenatal care","author":"World Health Organization (WHO)","year":"2018","unstructured":"World Health Organization (WHO). 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