Magnitude and factors associated with late antenatal care booking on first visit among pregnant women in public health centers in central zone of Tigray Region, Ethiopia: A cross sectional study

Abstract

BackgroundAntenatal care (ANC) is a care given for pregnant women and is a good opportunity to deliver maternal health interventions. Even though pregnant women should start their first antenatal care within 12 weeks of gestational age, many pregnant women start their first ANC late. So, the aim of this study is to determine magnitude of late ANC booking at first visit and factors associated with it.MethodsInstitutional based cross sectional study design was conducted in central zone of Tigray Region, Ethiopia from November 1/2017 to January 30/2018 among total of 632 pregnant women. Stratified multi stage cluster sampling method was used to select health centers and systematic random sampling technique was used during the selection of study units. Data were collected using interview administer questionnaire by face to face. The collected data were entered into EPI info-7. Later on, it was exported to STATA-14 for further analysis. Proportion was used to estimate the magnitude of late ANC booking. Bivariable and multivariable analysis were done to see factors associated with the magnitude of late ANC booking.ResultsThe magnitude of late ANC booking at first visit were 85.67% (95%, CI: 82.89, 88.45). Factors that were independently associated with the late ANC booking at first visit in multivariable analysis were; having home delivery in previous delivery (AOR = 2.2, 95%, CI: 1.1, 4.49), women who had no previous ANC follow up (AOR = 3.43, 95%, CI: 1.32, 8.92) and women with poor knowledge about the advantage and service availability of ANC (AOR = 3.9, 95%, CI: 1.83, 8.29).ConclusionIn summary, most of pregnant women were not started their first ANC at the recommended time. Home delivery and history of ANC in previous pregnancy as well as women with poor knowledge about ANC were associated with late ANC booking at first visit. Health workers should work on avoiding home delivery and increasing the knowledge of pregnant women on ANC may help on reducing late ANC booking at first visit.

Prevalence and associated factors of delayed first antenatal care booking among reproductive age women in Ethiopia; a multilevel analysis of EDHS 2016 data

“…This finding is consistent with studies done in the Kembata Tembaro zone, Hadiya zone and a study done using EDHS 2011 [ 31 , 38 , 39 ]. This proportion of pregnant women who booked late was found lower compared to different studies conducted in Africa and Ethiopia [ 10 , 23 – 27 , 29 , 34 , 35 ] and higher than different studies conducted in different countries [ 28 , 30 , 32 , 33 , 36 , 37 ]. The discrepancy might be due to most of the indicated studies are institution-based with small sample size.…”

“…Specifically, in Africa, late ANC booking is still a devastating issue which ranges from 44% in Cameroon and 86.6% in Zambia [10,[23][24][25][26][27][28]. Ethiopia is also one of the developing African countries with a high prevalence of late ANC initiation which ranges from 42% in Addis Ababa to 81.8% in western Wolega [29][30][31][32][33][34][35][36][37][38][39].…”

“…Different studies across the world revealed factors like maternal education [ 23 , 27 , 40 , 41 ], maternal age [ 23 , 27 , 32 , 34 , 37 ], pregnancy intention [ 23 , 29 , 36 , 40 , 42 ], wealth status/income [ 28 , 34 ], parity [ 10 , 25 , 29 , 40 , 42 ], having history of abortion or still birth [ 10 ], marital status [ 24 , 25 , 42 ], exposure to mass media [ 41 , 43 ], distance from the health facility [ 42 , 43 ], residence [ 40 , 41 ], health insurance [ 42 , 43 ] and region [ 41 , 44 ] are associated with delayed first ANC booking.…”

Coverage of completion of four ANC visits based on recommended time schedule in Northern Ethiopia: A community-based cross-sectional study design

“…This estimate reflects under-utilization of ANC and this could possibly contribute to high maternal mortality. This prevalence of late booking is lower than study conducted in Central Tigrai (85.6%) [21]. The difference was due to study area and the definition given for late booking.…”

Socio-Demographics and Late Antenatal Care Seeking Behavior: A Cross Sectional Study among Pregnant Women at Kyenjojo General Hospital, Western Uganda

“…During antenatal care booking, assessments and tests are conducted on pregnant women, which include measuring of blood pressure to exclude pregnancy induced hypertension, urine testing to exclude proteinuria and weight monitoring to establish intrauterine growth restriction department of health [4]. Immunization against various infectious diseases such as tetanus, Human Immune virus (HIV) testing and counseling of pregnant women and if she tests positive, she will be initiated on antiretroviral therapy (ART) for elimination of mother-to-child transmission of HIV [5]. Despite all the recommendations, maternal mortality still remains a public health concern globally especially in developing countries (WHO, 2016).…”