Delayed initiation of antenatal care and its associated factors among pregnant women visiting Hawassa City, South Ethiopia
DOI:
https://doi.org/10.20372/mhsr.v2i1.1936Keywords:
Late ANC initiation, Associated factors, Pregnant women, Hawassa, EthiopiaAbstract
Background: One of the primary measures for reducing maternal mortality in developing countries is the utilization of focused antenatal care. This study study assessed magnitude of delayed antenatal care initiation and factors associated among pregnant women visiting public health facilities in Hawassa, Southern Ethiopia.
Method: A cross‑sectional study was conducted from 15 June to 15 August 2019. Three hundred ninthy two pregnant women were selected using a systematic random sampling. Data collection employed interviewer‑administered, semi‑structured questionnaires. It was entered into EpiData v3.1, and analyzed in SPSS v24. All variables that demonstrated a p‑value below 0.25 during bivariable analysis were incorporated into the multivariable logistic regression. Statistical associations were interpreted as significant when the p‑value was under 0.05.
Results: The magnitude of delayed antenatal care initiation was 57.7% (95% CI: 52.74-62.57%). Factors independently associated with late initiation included maternal age 31-35 years (AOR = 4.93, 95% CI: 1.70-14.27), lower husband education (AOR = 2.88, 95% CI: 1.17-7.31), no previous ANC attendance (AOR = 2.03, 95% CI: 1.20-3.43), presence of obstetric complications (AOR = 4.05, 95% CI: 2.06-7.96), unplanned pregnancy (AOR = 2.40, 95% CI: 1.23-4.68), lack of partner support (AOR = 2.47, 95% CI: 1.16–5.26), and decision-making by others rather than the woman herself (AOR = 0.40, 95% CI: 0.18-0.87).
Conclusion: Late initiation of antenatal care was high in the study area. Factors significantly associated with delayed ANC included maternal age, husband’s education, lack of previous ANC experience, history of obstetric complications, unplanned pregnancy, limited maternal decision‑making autonomy, and insufficient partner support. City health offices should encourage timely ANC attendance, increase public awareness about the importance of starting ANC early, and strengthen health education on pregnancy danger signs and their potential consequences.
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References
Gabbe SG, Niebyl JR, Simpson JL, Landon MB, Galan HL, Jauniaux ER, et al. Obstetrics: normal and problem pregnancies: Elsevier Health Sciences; 2016.
WHO. antenatal care randomized trial: manual for the implementation of the new model. Geneva: World Health Organization, 2002.
Lawn J, Kerber K. Opportunities for Africas newborns: practical data policy and programmatic support for newborn care in Africa. 2006.
Stephenson P. Focused antenatal care: a better, cheaper, faster,evidence-based approach. Global Health Technical Briefs. 2005.
Moller A-B, Petzold M, Chou D, Say L. Early antenatal care visit: a systematic analysis of regional and global levels and trends of coverage from 1990 to 2013. The Lancet Global Health. 2017;5(10):e977-e83.
Committee ES. The public health importance of antenatal care. Facts, views & vision in ObGyn. 2015;7(1):5.
Belayneh T, Adefris M, Andargie G. Previous early antenatal service utilization improves timely initiation: cross-sectional study at university of Gondar hospital, northwest Ethiopia. Journal of pregnancy. 2014;2014.
Zolotor AJ, Carlough MC. Update on prenatal care. American family physician. 2014;89(3).
Reynolds HW, Wong EL, Tucker H. Adolescents' use of maternal and child health services in developing countries. International family planning perspectives. 2006:6-16.
WHO U. World Health Organization:Trends in maternal mortality: 1990-2015: estimates from WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division. 2015.
FMoH. Federal Democratic Republic of Ethiopia Ministry of Health: Health Sector Development Program IV (2010/11- 2014/15). 2010.
Geta MB, Yallew WW. Early Initiation of Antenatal Care and Factors Associated with Early Antenatal Care Initiation at Health Facilities in Southern Ethiopia. Advances in Public Health. 2017;2017.
Weldemariam S, Damte A, Endris K, Palcon MC, Tesfay K, Berhe A, et al. Late antenatal care initiation: the case of public health centers in Ethiopia. BMC research notes. 2018;11(1):562.
Wolde F, Mulaw Z, Zena T, Biadgo B, Limenih MA. Determinants of late initiation for antenatal care follow up: the case of northern Ethiopian pregnant women. BMC research notes. 2018;11(1):837.
Tesfaye Gezahegn LD, Chojenta Catherine,, Semahegn Agumasie aSR. Delayed initiation of antenatal care and associated factors in Ethiopia: a systematic review and meta-analysis. Reproductive health. 2017;14(1):150.
FMoH. Federal ministry of health Basic Emergency obstetrics and New Born Care (BEMONC) Traning Manual. 2013. 2013.
UNICEF. The State Of The World’s Children A Fair Chance For Every Childdren 2015.
Dembelu M, Samuel A, Andarge K, Tamirat S, Kolcha M. Assessment of Timely Initiation of First ANC Visit and Associated Factors among Pregnant Mothers in Wolayita Soddo Public Health Facilities, Soddo Town, Wollayita Zone, SNNPR, Ethiopia. 2016.
Aung TZ, Oo WM, Khaing W, Lwin N, Dar HT. Late initiation of antenatal care and its determinants: a hospital based cross-sectional study. International Journal Of Community Medicine And Public Health. 2017;3(4):900-5.
Tolefac PN, Halle-Ekane GE, Agbor VN, Sama CB, Ngwasiri C, Tebeu PM. Why do pregnant women present late for their first antenatal care consultation in Cameroon? Maternal health, neonatology and perinatology. 2017;3(1):29.
Jiee SF, Safii R, Hazmi H. Late Antenatal Initiation and its Predictors in Lundu District of Sarawak, Malaysia. International Journal of Public Health Research. 2018;8(2):956-64.
Grum Teklit, Brhane Ermyas. Magnitude and factors associated with late antenatal care initiation on first visit among pregnant women in public health centers in central zone of Tigray Region, Ethiopia: A cross sectional study. PloS one. 2018;13(12):e0207922.
Ejeta E, Dabsu R, Zewdie O, Merdassa E. Factors determining late antenatal care initiation and the content of care among pregnant mother attending antenatal care services in East Wollega administrative zone, West Ethiopia. Pan African Medical Journal. 2017;27(1).
Tekelab Tesfalidet BB. Factors associated with late initiation of antenatal care among pregnant women attending antenatal Clinic at Public Health Centers in Kembata Tembaro zone, Southern Ethiopia. Science, Technology and Arts Research Journal. 2014;3(1):108-15.
Gedle M, Yarinbab T. Determinants of antenatal care service utilization during the first trimester among pregnant women in Boke Woreda, Ethiopia: A facility based unmatched case control study. International Academic Journal of Health, Medicine and Nursing. 2017;1(1):66-74.
Utuk NM, Ekanem A, Abasiattai AM. Timing and reasons for antenatal care initiation among women in a tertiary health care center in Southern Nigeria. International Journal of Reproduction, Contraception, Obstetrics and Gynecology. 2017;6(9):3731-6.
Horiguchi H, Nakazawa M. The Factors Associated with the Delayed First Antenatal Care in the Philippines. 2018.
Gebresilassie B, Belete T, Tilahun W, Berhane B, Gebresilassie S. Timing of first antenatal care attendance and associated factors among pregnant women in public health institutions of Axum town, Tigray, Ethiopia, 2017: a mixed design study. BMC pregnancy and childbirth. 2019;19(1):340.
Wolde HF, Tsegaye AT, Sisay MM. Late initiation of antenatal care and associated factors among pregnant women in Addis Zemen primary hospital, South Gondar, Ethiopia. Reproductive health. 2019;16(1):73.
Soontornprakasit PM, Aroonsri CJ. Factors associated with time to start antenatal care within 12 weeks gestational age among mothers in Mahasarakham province, Thailand. 2016.
Weldearegawi GG, Teklehaimanot BF, Gebru HT, Gebrezgi ZA, Tekola KB, Baraki MF. Determinants of late antenatal care follow up among pregnant women in Easter zone Tigray, Northern Ethiopia, 2018: unmatched case–control study BMC health services research. 2019;12(1):752
Alemu Yibeltal, Amanu. A. Early initiations of first antenatal care visit and associated factor among mothers who gave birth in the last six months preceding birth in Bahir Dar Zuria Woreda North West Ethiopia. Reproductive health. 2018;15(1):203.
Manda-Taylor L, Sealy D, Roberts J. Factors associated with delayed Antenatal Care attendance in Malawi: Results from a Qualitative study. Medical Journal of Zambia. 2017;44(1):17-25.
Turyasiima M, Tugume R, Openy A, Ahairwomugisha E, Opio R, Ntunguka M, et al. Determinants of first antenatal care visit by pregnant women at Community Based Education, Research and Service Sites in Northern Uganda. East African medical journal. 2014;91(9):317-22.
AMNA A. Late Antenatal Initiation, Its Barrier and Maternal Complications. Isra medical journa. 2015;25(1):35.
Gudayu TW. Proportion and factors associated with late antenatal care initiation among pregnant mothers in Gondar town, north West Ethiopia. African journal of reproductive health. 2015;19(2):93-9.
Gidey G, Hailu B, Nigus K, Hailu T, Gerensea H. Timing of first focused antenatal care initiation and associated factors among pregnant mothers who attend antenatal care in Central Zone, Tigray, Ethiopia. BMC research notes. 2017;10(1):608.
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