Abstract
Introductionearly commencement of antenatal care by pregnant women as well as regular visits has the potential to affect maternal and fetal outcomes positively. Even with antenatal care, the intervention requires fewer resources; however, most pregnant women in sub-Saharan Africa have begun late for antenatal care services. This study aimed to assess the magnitude and contributors of late antenatal care initiation among pregnant women at selected public health institutions of the Bench-Sheko Zone in southwest Ethiopia.Methodsa cross-sectional study was conducted among 509 pregnant women attending the Antenatal Care (ANC) service at selected public health institutions. The data were collected using a structured and pre-tested questionnaire. The data were entered using Epi-data version 3.1 and analyzed using SPSS version 22. A binary logistic regression analysis was computed to determine the association using crude and adjusted odds ratios at 95% confidence intervals. Independent variables with a p-value of less than 0.05 in the multivariable logistic regression model were considered significant.Resultsof the 509 respondents interviewed, 337 (66%) reported late antenatal care initiation. The factors associated with late antenatal care initiation were mothers aged 25 years and above (AOR = 1.59, 95% CI [1.02, 2.48]), attended below secondary school (AOR =2.33, 95% CI [1.05, 5.19]), unplanned pregnancy (AOR=2.25, 95%CI [1.34, 3.77]), pregnancy recognition by missing period (AOR=0.61, 95%CI [0.39, 0.93]), perceived right time of ANC after 4 months (AOR=2.29, 95% CI [1.36, 3.85]), and did not get advice to have ANC (AOR=1.64, 95% CI [1.10, 2.45]).Conclusionthe majority of pregnant women initiate their first antenatal care lately. We can conclude that late antenatal care initiation is a major problem in the study area. Therefore, providing continuous health education on the importance of initiating antenatal care visits early to prevent unwanted pregnancy outcomes is an important segment of intervention that can be done through health extension workers.
Highlights
Maternal mortality is the leading cause of death among women aged 15-49 years old, with an estimated 303,000 maternal deaths occurring in 2015 alone
Almost all (99%) of maternal deaths occur in developing countries and sub-Saharan Africa accounted for 66% of maternal deaths [1]
All pregnant women who will come to their first Antenatal Care (ANC) visit and whose gestational age is identified either by last menstrual period or ultrasound in the selected health facility during the data collection time were included in the study
Summary
Maternal mortality is the leading cause of death among women aged 15-49 years old, with an estimated 303,000 maternal deaths occurring in 2015 alone. Women die as a result of complications during and following pregnancy and childbirth. Most of these complications develop during pregnancy and most are preventable or treatable. Other complications may exist before pregnancy but are worsened during pregnancy, especially if not managed as part of the womans care [3]. ANC is a complex of interventions that a pregnant woman receives from organized health care services intended to assure every pregnancy culminates in the delivery of a healthy child without impairing the health of the mother [5]
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