Timely Initiation of First Antenatal Care Visit and Associated Factors Among Pregnant Women in the Amhara Region, North-west Ethiopia: a Comparative Cross-sectional Study

Overview

Journal Pan Afr Med J

Date 2023 May 2

PMID 37128620

Authors

Workaferu Fetene

Alemtsehay Mekonnen

Zemenu Shiferaw

Almaw Genet

Semehal Haile

Affiliations

Soon will be listed here.

Abstract

Introduction: timely initiation of the first antenatal care visit is still a major public health problem in Ethiopia, especially in Amhara Region. This study assessed the prevalence of timely initiation of first ANC visit and its associated factors among pregnant women in transformed and non-transformed districts, Awi zone, Amhara Region, North-west Ethiopia.

Methods: a community-based comparative cross-sectional study was conducted from November-December 2020, among 748 women. A multistage-stratified random sampling technique was used. Data were collected by a structured questionnaire. Data analysis was done by SPSS-version 20. Binary logistics regression analysis was used to identify factors. The odds ratios were computed and a p-value < 0.05 was used to declare statistical significance.

Results: the overall prevalence of timely first ANC visits was 40% (95%CI: 36.6-43.7%). It was higher for the transformed districts 46.9% (95%CI: 42.1%-52.5%) compared to non-transformed districts 32.9% (95%CI: 28.3%-37.9%). Higher wealth (AOR=2.17, 95%CI: 1.44-3.27), previous service satisfaction (AOR=1.78, 95%CI: 1.26- 2.51), nearer to the health facility (AOR=3.09, 95%CI: 1.69-5.63), primary education and above (AOR=5.18, 95%CI: 2.99-8.96), knowledgeable mothers (AOR=2.30, 95%CI: 1.38-3.85) and waiting time (< 1-hour) (AOR=1.45, 95%CI: 1.02-2.08) were significantly associated factors.

Conclusion: the prevalence of timely initiation was higher for transformed districts but it is below the WHO target. Higher wealth, previous service satisfaction, being nearer to the health facility, maternal education, being knowledgeable, and waiting time were significantly associated with timely initiation of the first ANC visit. Hence, the district´s transformation should be enhanced. Maternal knowledge, access, and quality of maternal health services should be enhanced.

Citing Articles

Exploration of urban-rural disparities in institutional delivery in Bangladesh: Assessing the effect of antenatal care dynamics.

Fatima K, Khan M, Rahman M, Khan M, Sarker B Heliyon. 2025; 11(3):e42152.

PMID: 39968141 PMC: 11834091. DOI: 10.1016/j.heliyon.2025.e42152.

Determinants of early antenatal care booking among pregnant mothers attending antenatal care at public health facilities in the Nole Kaba district, western Ethiopia: unmatched case-control study.

Gelassa F, Tafasa S, Kumera D BMJ Open. 2023; 13(10):e073228.

PMID: 37879687 PMC: 10603512. DOI: 10.1136/bmjopen-2023-073228.

References

Asah-Opoku K, Ameme D, Yawson A, Guure C, Aduama D, Mumuni K . Adherence to the recommended timing of focused antenatal care in the Accra Metropolitan Area, Ghana. Pan Afr Med J. 2019; 33:123. PMC: 6756781. DOI: 10.11604/pamj.2019.33.123.15535. View

Gudayu T, Woldeyohannes S, Abdo A . Timing and factors associated with first antenatal care booking among pregnant mothers in Gondar Town; North West Ethiopia. BMC Pregnancy Childbirth. 2014; 14:287. PMC: 4152591. DOI: 10.1186/1471-2393-14-287. View

Gebrekidan K, Worku A . Factors associated with late ANC initiation among pregnant women in select public health centers of Addis Ababa, Ethiopia: unmatched case-control study design. Pragmat Obs Res. 2017; 8:223-230. PMC: 5667792. DOI: 10.2147/POR.S140733. View

Wolde F, Mulaw Z, Zena T, Biadgo B, Limenih M . Determinants of late initiation for antenatal care follow up: the case of northern Ethiopian pregnant women. BMC Res Notes. 2018; 11(1):837. PMC: 6260707. DOI: 10.1186/s13104-018-3938-9. View

Ndyomugyenyi R, Neema S, Magnussen P . The use of formal and informal services for antenatal care and malaria treatment in rural Uganda. Health Policy Plan. 1998; 13(1):94-102. DOI: 10.1093/heapol/13.1.94. View

Owolabi O, Wong K, Dennis M, Radovich E, Cavallaro F, Lynch C . Comparing the use and content of antenatal care in adolescent and older first-time mothers in 13 countries of west Africa: a cross-sectional analysis of Demographic and Health Surveys. Lancet Child Adolesc Health. 2018; 1(3):203-212. DOI: 10.1016/S2352-4642(17)30025-1. View

Bayou Y, Mashalla Y, Thupayagale-Tshweneagae G . The adequacy of antenatal care services among slum residents in Addis Ababa, Ethiopia. BMC Pregnancy Childbirth. 2016; 16(1):142. PMC: 4908857. DOI: 10.1186/s12884-016-0930-z. View

Muhwava L, Morojele N, London L . Psychosocial factors associated with early initiation and frequency of antenatal care (ANC) visits in a rural and urban setting in South Africa: a cross-sectional survey. BMC Pregnancy Childbirth. 2016; 16:18. PMC: 4727269. DOI: 10.1186/s12884-016-0807-1. View

Abosse Z, Woldie M, Ololo S . Factors influencing antenatal care service utilization in hadiya zone. Ethiop J Health Sci. 2012; 20(2):75-82. PMC: 3275839. DOI: 10.4314/ejhs.v20i2.69432. View

10.

Kusuma Y, Kumari R, Kaushal S . Migration and access to maternal healthcare: determinants of adequate antenatal care and institutional delivery among socio-economically disadvantaged migrants in Delhi, India. Trop Med Int Health. 2013; 18(10):1202-10. DOI: 10.1111/tmi.12166. View

11.

Sinyange N, Sitali L, Jacobs C, Musonda P, Michelo C . Factors associated with late antenatal care booking: population based observations from the 2007 Zambia demographic and health survey. Pan Afr Med J. 2017; 25:109. PMC: 5325499. DOI: 10.11604/pamj.2016.25.109.6873. View

12.

Ayalew T, Nigatu A . Focused antenatal care utilization and associated factors in Debre Tabor Town, northwest Ethiopia, 2017. BMC Res Notes. 2018; 11(1):819. PMC: 6240228. DOI: 10.1186/s13104-018-3928-y. View

13.

Villar J, Baaqeel H, Piaggio G, Lumbiganon P, Miguel Belizan J, FARNOT U . WHO antenatal care randomised trial for the evaluation of a new model of routine antenatal care. Lancet. 2001; 357(9268):1551-64. DOI: 10.1016/s0140-6736(00)04722-x. View

14.

Pell C, Menaca A, Were F, Afrah N, Chatio S, Manda-Taylor L . Factors affecting antenatal care attendance: results from qualitative studies in Ghana, Kenya and Malawi. PLoS One. 2013; 8(1):e53747. PMC: 3546008. DOI: 10.1371/journal.pone.0053747. View

15.

Bernardes A, Silva R, Coimbra L, Seabra Soares de Britto Alves M, Queiroz R, Batista R . Inadequate prenatal care utilization and associated factors in São Luís, Brazil. BMC Pregnancy Childbirth. 2014; 14:266. PMC: 4133632. DOI: 10.1186/1471-2393-14-266. View

16.

Tran T, Gottvall K, Nguyen H, Ascher H, Petzold M . Factors associated with antenatal care adequacy in rural and urban contexts-results from two health and demographic surveillance sites in Vietnam. BMC Health Serv Res. 2012; 12:40. PMC: 3305637. DOI: 10.1186/1472-6963-12-40. View

17.

Moller A, 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. Lancet Glob Health. 2017; 5(10):e977-e983. PMC: 5603717. DOI: 10.1016/S2214-109X(17)30325-X. View

18.

Alemu T, Gutema H, Legesse S, Nigussie T, Yenew Y, Gashe K . Evaluation of public health surveillance system performance in Dangila district, Northwest Ethiopia: a concurrent embedded mixed quantitative/qualitative facility-based cross-sectional study. BMC Public Health. 2019; 19(1):1343. PMC: 6805593. DOI: 10.1186/s12889-019-7724-y. View

19.

Agha S, Tappis H . The timing of antenatal care initiation and the content of care in Sindh, Pakistan. BMC Pregnancy Childbirth. 2016; 16(1):190. PMC: 4962355. DOI: 10.1186/s12884-016-0979-8. View

20.

Wereta T, Betemariam W, Karim A, Zemichael N, Dagnew S, Wanboru A . Effects of a participatory community quality improvement strategy on improving household and provider health care behaviors and practices: a propensity score analysis. BMC Pregnancy Childbirth. 2018; 18(Suppl 1):364. PMC: 6157250. DOI: 10.1186/s12884-018-1977-9. View