Level of optimal antenatal care utilization and its associated factors among pregnant women in Arba Minch town, southern Ethiopia: new WHO-recommended ANC 8+ model.

Abstract

To fully realize the life-saving and health-promoting benefits of antenatal care (ANC), the latest World Health Organization (WHO) recommendations call for pregnant women to have at least eight contacts with skilled healthcare providers. This increased number of recommended ANC visits represents a shift toward a more comprehensive, individualized approach to prenatal care. The focus is on health promotion, disease prevention, and the early detection and management of complications during pregnancy. However, in sub-Saharan African countries, including Ethiopia, the coverage rate for this level of recommended antenatal care is only 58%. Given this relatively low utilization, identifying the key risk factors that prevent adequate antenatal care would have significant implications for increasing overall ANC uptake in these regions. The aim of the present study was to assess the level of optimal antenatal care utilization and its associated factors among pregnant women in Arba Minch town, southern Ethiopia in 2023 using the new WHO-recommended ANC 8+ model. An institution-based cross-sectional study was conducted among 416 mothers who were enrolled between 1 December 2022 and 30 January 2023. The total sample size was allocated proportionately to the number of women who delivered at each public health facility. Thus, systematic sampling was applied. Kobo Toolbox was used for data collection and cleaning, which was then analyzed using SPSS Version 26. Statistical significance was determined at a p-value <0.05. In this study, the level of optimal antenatal care was 41% [95% confidence interval (CI): 37-45.3]. The associated factors with optimal antenatal care were the presence of pregnancy danger signs [adjusted odds ratios (AOR) = 4.1, 95% CI: 1.87-8.82], having bad obstetric history (AOR = 3.90, 95% CI: 1.94-7.83), antenatal contact at hospital (AOR = 5.11, 95% CI: 2.28-11.21), having good knowledge about antenatal care (AOR = 2.26, 95% CI: 1.15-4.44), women's high decision-making power (AOR = 3.9, 95% CI: 1.2-7.63), and male partner involvement (AOR = 2.0, 95% CI: 1.04-3.78) were positively associated with optimal antenatal care utilization. The level of optimal antenatal follow-up is still low. Therefore, it is crucial to provide more information during the antenatal contacts to lower the rate of women discontinued from antenatal care.