{
  "abstract": "Background\n\nAlthough 77.7% of ever-married women with a recent live birth in Afghanistan attended at least one antenatal care (ANC) contact, 74.5% of ANC-attending women delivered in a health facility. Provincial variation in this transition remains poorly characterised.Objective\n\nTo examine associations of ANC contact frequency and measured clinical content with facility-based delivery and to characterise provincial patterns of continuity.Methods\n\nWe analysed the Afghanistan Multiple Indicator Cluster Survey 2022-23. The cohort included 9,268 ANC-attending ever-married women aged 15-49 years. Survey-weighted logistic regression examined ANC contact frequency (1-3, 4-7, ≥8) and a three-item measured clinical-content score (0-3). Province-specific ANC 4+ coverage and facility-based delivery were also examined.Results\n\nFacility-based delivery was 74.5%. Compared with 1-3 contacts, adjusted odds were higher with 4-7 contacts (adjusted odds ratio 1.49; 95% confidence interval 1.25-1.77) and ≥8 contacts (adjusted odds ratio 1.93; 95% confidence interval 1.45-2.57), corresponding to adjusted probability differences of 6.5 and 10.3% points. For measured clinical content, a score of 3 versus 0 was associated with a 4.6-point higher adjusted probability, while intermediate scores showed no clear gradient. Provincial facility-based delivery ranged from 16.8% to 93.3%, with substantial heterogeneity in joint ANC and delivery patterns.Conclusions\n\nAmong women who had initiated ANC, approximately one quarter delivered outside a health facility. Greater ANC contact frequency was consistently associated with facility-based delivery, while marked provincial variation highlights the importance of continuity between antenatal and childbirth care.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Management Science, University of Strathclyde, Glasgow, UK.",
    "Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 4,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Rajeev Ranjan",
      "orcid": "0009-0005-1242-7671"
    },
    {
      "affs": [
        1
      ],
      "name": "Palwasha Anwari",
      "orcid": "0000-0001-6989-0791"
    },
    {
      "affs": [
        0
      ],
      "name": "Abigail Colson",
      "orcid": "0000-0002-3241-5855"
    },
    {
      "affs": [
        0
      ],
      "name": "Robert van der Meer",
      "orcid": "0000-0002-9442-1628"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/2gatcte4wybgs.bib",
  "cited_by": 0,
  "doi": "10.1080/16549716.2026.2750043",
  "fulltext_url": "https://europepmc.org/articles/PMC13686201",
  "id": "2gatcte4wybgs",
  "issns": [
    "1654-9716",
    "1654-9880"
  ],
  "landing_url": "https://europepmc.org/article/MED/42897985",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2735|Global Maternal and Child Health"
    ]
  ],
  "openalex": "W7223017335",
  "pdf_url": "https://europepmc.org/articles/PMC13686201?pdf=render",
  "pmcid": "PMC13686201",
  "pmid": "42897985",
  "published": "2026-10-20",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/2gatcte4wybgs.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:32Z",
      "native_id": "MED:42897985",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42897985"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2735|Global Maternal and Child Health",
      "subfield": "reproductive-child"
    }
  ],
  "title": "From antenatal contact to facility-based delivery: a provincial analysis of dropout along the maternal continuum of care in Afghanistan using the 2022-23 MICS.",
  "title_text": "From antenatal contact to facility-based delivery: a provincial analysis of dropout along the maternal continuum of care in Afghanistan using the 2022-23 MICS.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:19:32Z",
  "url": "https://research.draconitic.com/paper/2gatcte4wybgs",
  "venue": "Global health action",
  "versions": []
}