Antenatal care among ethnic populations in Louang Namtha Province, Lao PDR.

One in 33 women in Lao PDR dies due to pregnancy-related causes, which is the highest in Southeast Asia. This study assessed ANC utilization rates and the determinants for these rates; it also explored rural maternal decision-making regarding the place of delivery and immunizations for their children under age five years. A cross-sectional study was carried out in Viengphukha District, Louang Namtha Province, Lao PDR in January 2008. Of 1,005 household representatives, 620 who had children age under five years were interviewed using a semi-structured questionnaire. Nearly one-quarter of mothers (23.4%) had at least one ANC visit during their most recent pregnancy, of which 4.5% had > or = 4 ANC visits. ANC visit rates among lowland and midland mothers were 3.6 and 7.6 times higher than highland mothers, respectively (p < 0.005 and p < 0.001). Mothers with no ANC were more likely to deliver at home (adjusted OR = 18.0; p < 0.0001). Home deliveries were more common among highland than lowland mothers (adjusted OR = 10.5; p < 0.05). Children born to mothers who had no ANC visit were more likely to not complete routine immunization than those who were born to mothers who had ANC visits (adjusted OR = 1.9; p < 0.01). Low ANC utilization rates in Lao PDR were observed among ethnic minority mothers who were less educated. ANC visits enhanced hospital deliveries and child immunizations. The promotion of ANC among women in remote rural communities is needed.