What predicts delayed first antenatal care contact among primiparous women? Findings from a cross-sectional study in Nigeria

Abstract

Background Delayed first antenatal care contact refers to first antenatal care contact occurring above twelfth weeks of gestation. Studies in Nigeria and in other countries have examined the prevalence and predictors of delayed first antenatal care contact. Nevertheless, existing studies have rarely examined the predictors among primiparous women. In addition, the evidence of higher health risks associated with primigravida emphasizes the need to focus on primiparous women. This study, therefore, examined the predictors of delayed first antenatal care contact among primiparous women in Nigeria. Methods The study was a descriptive cross-sectional design that analyzed data extracted from the 2018 Nigeria Demographic and Health Survey. The study analyzed a weighted sample of 3,523 primiparous women. The outcome variable was delayed first antenatal care contact. explanatory variables were grouped into predisposing, enabling, and need factors. The predisposing factors were maternal age, education, media exposure, religion, household size, The knowledge of the fertile period, and women’s autonomy. The enabling factors were household wealth, employment status, health insurance, partner’s education, financial inclusion, and barriers to accessing healthcare. The need factors were pregnancy wantedness and spousal violence during pregnancy. Data were analyzed using Stata 14. Two multivariable logistic regression models were fitted. Statistical significance was set at p < 0.05. Results Nearly two-thirds (65.0%) of primiparous women delayed first antenatal care contact. Maternal age, maternal education, media exposure, religion, household membership, and knowledge of the fertile period were predisposing factors that significantly influenced the likelihood of delayed first antenatal care contact. Also, household wealth, employment status, health insurance, partner’s education, perception of distance to the health facility, and financial inclusion were enabling factors that had significant effects on delayed first antenatal care contact. Pregnancy wantedness was the only need factor that significantly influenced the likelihood of delayed first antenatal care contact. Conclusion The majority of primiparous women in Nigeria delayed first antenatal care contact and the delay was predicted by varied predisposing, enabling, and need factors. Therefore, a public health education program that targets women of reproductive age especially primiparous women is needed to enhance early antenatal care contact in the country.

Muslim and Christian Women’s Perceptions of the Influence of Spirituality and Religious Beliefs on Motherhood and Child-Rearing: A Phenomenological Study

“…However, Christian women are more likely to partake in these programs while Muslim women place more value on the knowledge transmitted to them by their mothers and women in their families. This result agrees with that of other studies in which Christian women were more likely to use the services of skilled midwives in Guinea [56]; this is also a proven fact in the case of Muslims in sub-Saharan Africa [57], India [58], Bangladesh [59], Ethiopia [60], and Nigeria [61], but not those in Burundi [62].…”

Exploring Perceptions about Enablers of Women’s Attendance and Adherence to the Recommended Antenatal Care Visits in Rwanda: A Qualitative Study

“…CHW can encourage women to discuss health issues and concerns with HCPs. [55] Similar to other studies in Uganda and Nigeria, [41,56] the health facility location facilitated the pregnant women's attendance. Some health facilities are located in areas where pregnant women live, making it easier to access services.…”

“…For instance, in Ghana and Nigeria, women with higher financial security were more likely to seek ANC services than those without. [40,41] Women's involvement in decision-making was also a critical factor in their ability to obtain ANC services, which was the same finding as women in Nigeria and Uganda, where a decision-making role versus no role increased attendance. [42,43] Women's exposure to adequate information, education, and advice at ANC visits was found to significantly increase attendance, [44] and improve maternal child health outcomes.…”

Compliance towards WHO recommendations on antenatal care for a positive pregnancy experience: Timeliness and adequacy of antenatal care visit in Sub-Saharan African countries: Evidence from the most recent standard Demographic Health Survey data

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