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19 A key limitation in campaigns to reduce admissions has been an inadequate utilisation of existing evidence.
Furthermore, midwives should keep a close eye on the prenatal care utilisation of women with these characteristics to enable timely intervention in case of inadequate utilisation.
For this study, the modified index (see Additional file 1) was dichotomised into: Inadequate utilisation: onset at ≥ 12 weeks and/or received < 50% of expected visits Adequate utilisation: onset < 12 weeks and received ≥ 50% of expected visits.
However, non-western ethnicity does not of itself explain these women's inadequate utilisation of prenatal care; instead, via a number of underlying factors, it influences the need, propensity and ability to make use of care [ 12, 13].
(This category also includes women who made more than adequate use of prenatal care (i.e. received ≥ 110% of expected visits) Inadequate utilisation: onset at ≥ 12 weeks and/or received < 50% of expected visits Adequate utilisation: onset < 12 weeks and received ≥ 50% of expected visits.
However, these do not fully explain the patterns of utilisation: inadequate utilisation of antenatal care is also due to a lack of perceived benefit of antenatal care by pregnant women, as well as a lack of understanding regarding how it can address potential threats to the health of both the mother and the child [ 6, 7].
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We have court and tribunal buildings across the country which are no longer fit for purpose, with inadequate facilities and very poor utilisation rates".
For the second generation, sociocultural factors explained 66% of inadequate prenatal care utilisation.
Demographic and pregnancy factors also contributed substantially to the explanation of first-generation non-western women's inadequate prenatal care utilisation.
After adjusting for these three blocks of factors, 105% and 76% of first and second-generation non-western women's inadequate prenatal care utilisation respectively could be explained.
This raises the question whether these findings are limited to urban regions and to which extent the reported factors explain non-western women's inadequate prenatal care utilisation.
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