Timely initiation of antenatal care and associated factors among pregnant women attending antenatal care in Southwest Ethiopia

Abstract

Background The timing of initiation of first antenatal care visit is paramount for ensuring optimal care and health outcomes for women and children. However, the existing evidence from developing countries, including Ethiopia, indicates that most pregnant women are attending antenatal care in late pregnancy. Thus, this study was aimed to assess timely initiation of antenatal care and associated factors among pregnant women attending antenatal care services in Southwest Ethiopia. Methods Institutional based cross-sectional study was conducted among 375 pregnant women from April 15 to June 15, 2019 in Southwest Ethiopia. A structured and pre-tested face-to-face interviewer-administered questionnaire technique was used to collect data. Systematic random sampling technique was employed to recruit pregnant women. The data were entered into Epi data version 4.4.2 and analyzed using SPSS version 25. Frequency tables, charts and measures of central tendency were used to describe the data. The effect of each variable on timely initiation of antenatal care was assessed using bi-variable logistic regression. A multivariable logistic regression model was used to identify factors associated with timely initiation of antenatal care. The adjusted odds ratio with 95% confidence interval and p<0.05 was used to identify factors associated with timely initiation of antenatal care. Results The study revealed that 41.9% of pregnant women started antenatal care timely. Pregnant women who had good knowledge of timely initiation of antenatal care (AOR = 3.8, 95% CI: 2.2–6.5), planned to be pregnant (AOR = 5.1, 95% CI: 2.9–8.9), being primigravida (AOR = 2.6, 95% CI: 1.4–4.7) and confirmed their pregnancy by urine test (AOR = 4.1, 95% CI: 2.4–6.9) were found to be significant predictors for timely initiation of antenatal care. Conclusions Despite the efforts made to make ANC visit services freely available, timely initiation of antenatal care among pregnant women in the study area was low. Pregnant women who had good knowledge of timely initiation of antenatal care, planned to be pregnant, being primigravida and confirmed pregnancy by urine test were found to be significant predictors for timely initiation of antenatal care. Therefore, efforts that strengthen awareness on antenatal care and its right time of commencement, increase pregnant women’s knowledge of timing of antenatal care services and reducing unplanned pregnancies should be organized.

Timely Initiation of Antenatal Care and Associated Factors among Pregnant Women Attending at Wachemo University Nigist Eleni Mohammed Memorial Comprehensive Specialized Hospital, Hossana, Ethiopia: A Cross-Sectional Study

“…Women with zero parity were likelier to start receiving ANC services on time than women with high parity (one or more). This conclusion aligns with research from Ethiopia [ 18 , 31 , 38 ], Saudi Arabia [ 21 ], Ghana [ 24 ], and Myanmar [ 26 ]. This conclusion may be explained by the fact that women who have never been pregnant or birth before are likelier to be anxious about finding out whether they are pregnant and to think that starting ANC as soon as possible is crucial.…”

“…Regarding the timely initiation of ANC service, knowledgeable women were likelier to initiate ANC service in a timely manner compared with nonknowledgeable women. This finding is again supported by studies conducted in Ethiopia [ 14 , 19 , 27 , 35 , 38 ]. A possible justification might be that women who have good knowledge of maternal healthcare are directly linked to higher maternal healthcare utilisation because knowledgeable women might have a better understanding of their health, which contributes to their acceptance and utilisation of healthcare services.…”

“…Compared to women who had an unplanned pregnancy, those who had a planned pregnancy started their ANC services earlier, as shown in studies conducted in Ethiopia [ 14 , 27 , 31 , 35 , 38 ], Nepal [ 23 ], Uganda [ 25 ], Myanmar [ 26 ], and Cameroon [ 30 ]. This conclusion may be explained by the fact that pregnant women may prioritise maternal health care because they desire a healthy pregnancy and child.…”

“…Women who had a high level of knowledge about pregnancy danger signs were more likely to start ANC timely compared with less knowledgeable women. This might be due to the fact that the more mothers know about the danger signs, the more they use them [ 38 – 40 ]. In addition, women who are knowledgeable about danger signs are likelier to work on preventing dangerous situations before they occur.…”

Sociodemographic Predictors of Initiating Antenatal Care Visits by Pregnant Women During First Trimester of Pregnancy: Findings from the Afghanistan Health Survey 2018

“…Previous studies from LMICs reported significant associations between timely initiation of ANC attendance by pregnant women and women’s age, 17 , 18 , 20 , 22–25 , 30–32 , 37 wealth status, 18 , 24 , 25 , 31 , 33 , 37 education, 18 , 21–25 , 29 , 31 parity, 18 , 20 , 23–27 , 29 , 32 access to media, 23 , 24 , 28 , 31 , 38 pregnancy intention, 16 , 19 , 21 , 23 , 24 , 26 , 27 , 29–31 , 39 residential area, 24 , 29 , 36 family size, 17 , 29 and husband’s education. 19 , 36 Except for the statistically insignificant correlation of husband’s education with pregnant women’s timely ANC attendance, our findings on the higher odds of pregnant woman’s timely ANC attendance by age, education, wealth status, parity, pregnancy intention, residential area, and access to media were fairly consistent with previous studies.…”