Abstract
BACKGROUND: Adolescent pregnancy is associated with several challenges, and partner support is crucial. However, the causal effect of partner support on the use of maternal health services among pregnant adolescents has not been rigorously examined. We assessed the causal effect of partner support on the frequency of antenatal care (ANC) visits among married adolescents in rural Uganda. METHODS: We conducted a quasi-experimental study using observational data from a cross-sectional study that involved married adolescents aged 10-19 years in rural northwestern Uganda. The primary exposure was partner support, measured as a binary variable. Adolescents were considered to have received support if their spouse encouraged ANC attendance, accompanied them to visits, or provided financial or emotional support during ANC; otherwise, they were classified as having not received support. The primary outcome was the number of ANC visits, while the secondary outcome was attending four or more ANC visits. Propensity score weighting was used to ensure covariate comparability between the partner support groups (yes vs. no). Poisson regression was used to estimate the causal effect of partner support on the number of antenatal care (ANC) visits (primary outcome), while the modified Poisson regression was used to estimate the causal effect on attending four or more visits (secondary outcome). RESULTS: Of 281 participants, 205 (72.9%) received partner support. Among participants with partner support compared to those without partner support, the frequency of ANC visits (Risk Ratio 1.15, 95% CI: 1.00-1.32) and four or more ANC visits (Risk Ratio 1.25, 95% CI: 1.01-1.52) improved. CONCLUSION: The study showed that partner support was associated with improvements in ANC visit frequency and attendance of four or more ANC visits, among married adolescents in northwestern Uganda. Interventions aimed at improving ANC utilization should consider engaging and educating partners, as their support positively influences ANC utilization.