Does antenatal care matter in the use of skilled birth attendance in rural Africa: AÂ multi-country analysis

► The effect of antenatal care on skilled birth attendance is biased downward in all four countries if endogeneity is not taken into account. ► This effect is mediated by the quality of antenatal care service in Kenya and Uganda but not in Ghana and Tanzania. ► Women's level of education influence both the quality of antenatal care received and the delivery with professional. ► Distance to health facility has negative effect on skilled birth attendance in all countries.