Abstract
BackgroundDelay on timely initiation of antenatal care has a great impact on adverse pregnancy out comes. However, evidences in Ethiopia revealed that majority of pregnant mothers did not start their first visit as recommrnded by WHO. The aim of this study was to assess delay and associated factors of first antenatal care visit among pregnant mothers at public health facilities of Debremarkos town, North West Ethiopia.MethodsAn institutional based crosss-sectional study was conducted from February to March, 2014 in public health facilities of Debremarkos town North west Ethiopia. A total of 320 pregnant mothers who were sure of their last menstrual periods were interviewed with a structured questionnaire. Data entry was done using Epi data 3.1 and analysis was done using SPSS version 20. Descriptive statistics, binary and multivariable logistic regression analyses were employed to identify the magnitude and factors associated with delay on timely initiation of the first antenatal care visit.ResultsThe proportion of respondents who made their first antenatal care visit after 16 weeks of gestation was found to be 33.4%. Mothers residing in rural settings (AOR = 2.8 [95% CI:1.54–5.44]), not attained formal education(AOR = 2.2 [95% CI:1.10–4.68]),with unintended pregnancy (AOR = 3.6 [95% CI:2.00–6.80]) and who perceived that the right initiation time of the first antenatal care visit is beyond 16 weeks of gestation (AOR = 3.9 [95% CI:1.61–9.76]) were more likely delayed on their first antenatal care visit .ConclusionResidence, educational status, intention of pregnancy and perception on the right time of first antenatal care visit initiation were found to be predictors of delay on timely initiatin of first antenatal care visit. Therefore, the Zonal health department should strengthen awareness creation about timely initiation of first antenatal care visit and family planning to prevent unintended pregnancy in the community especially in the rural settings.
Highlights
Delay on timely initiation of antenatal care has a great impact on adverse pregnancy out comes
The bivariate analysis showed that pregnant mothers who were residing in rural areas[Crude Odds Ratio (COR) = 3.4, 95% Confidence Interval (CI): 2.01–6.07], not attained formal education[COR = 4.5,95% CI: 2.33–8.67], farmers [COR = 7. 8, 95% CI: 3.37–18.05], having less than 1000 ETB average monthly income[COR = 2.7, 95% CI: 1.45–5.37],experience
Mothers who were residing in rural areas, not attainding formal education, having unplanned pregnancy and perciving the right time of antenatal care (ANC) initiation as greater than 16 weeks of gestation were more likely delayed on first ANC visit (Adjusted Odds Ratio (AOR) =2.8 [95% CI:1.54–5. 44]), (AOR = 2.2 [95%CI:1.10–4.68]),(AOR = 3.6 [95% CI: 2.00–6.80]) and (AOR = 3.9[95%CI:1.61–9.76]) respectivelly (Table 4)
Summary
Delay on timely initiation of antenatal care has a great impact on adverse pregnancy out comes. The aim of this study was to assess delay and associated factors of first antenatal care visit among pregnant mothers at public health facilities of Debremarkos town, North West Ethiopia. The traditional approach of the ANC is a high risk approach which intended to classify pregnant women at low risk or high risk based on predetermined criteria and involved many ANC visits. This approach was hard to implement effectively since many women had at least one risk factor, and not all developed complications; at the same time, some low risk women did develop complications. The first visit is in the first trimester but not after 16 weeks of gestation [2, 3]
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