is it possible to guide me on fitting the model for the following goal?

Goal: "Evaluate the association between prenatal care utilization and perinatal health outcomes, and determine if the pandemic has modified these associations."

I'm not sure if prenatal care utilization latent variable. below is a definition of that:

Prenatal care utilization index (composite of initiation of care by 13 weeks; receipt of SOGC recommended # of visits; and a fetal anatomy ultrasound between 16-21 weeks). The composite variable should be grouped as no care (reference), inadequate, intermediate, adequate, adequate plus/intensive utilization

if prenatal care utilization is not a latent variable, can I run SEM model without a latent variable?