Full Antenatal Care Service Utilization Among Tribal Mothers in India: A Multilevel Analysis

Scheduled Tribes (ST) are one of the most disadvantaged socioeconomic groups in India, with a significant maternal mortality and morbidity burden. The coverage of full antenatal care (ANC) is low among ST mothers, leading to poor maternal and child health outcomes. We analyzed the data from the fourth round of the National Family Health Surveys (NFHS-4), conducted in 2015–2016. A multilevel binary logistic regression model was used to examine the factors associated with full ANC among ST mothers in India. Only one in every six tribal mothers in India received full ANC. Although 46% of ST mothers had four or more ANC visits and about 88% received one or more tetanus toxoid (TT) injections, only 27% consumed 100 or more iron–folic acid (IFA) tablets/equivalent amount of IFA in syrup during their pregnancy. Household wealth, maternal education, pregnancy registration, and spouse’s presence at the last ANC visit were associated with higher odds of receiving full ANC. High parity and undergoing the first ANC visit in the second or third trimester were associated with lower odds of receiving full ANC. India’s northern and central regions reveal a deplorable condition compared to southern and western regions in terms of the utilization of full ANC. To improve the coverage of full ANC, the government should prioritize reaching out to poor, illiterate, and high-parity ST women and encourage early registration of preganacy and a timely first ANC visit.