Inadequate Receipt of ANC Components and Associated Factors Among Pregnant Women in Northwest Ethiopia, 2020-2021: a Community-based Cross-sectional Study

Background: Women's health and pregnancy outcomes are directly depends on the extent of ANC components received during their ANC visits. There are limited information about the components of ANC and associated factors. Therefore, the aim of this study was to assess the magnitude of inadequate recipient of ANC components and associated factors in northwest Ethiopia.

Methods: This is a community based cross sectional survey conducted in Dabat Demographic and health survey from December 10/2020 to January 10/2021 among women who gave birth within two years before the survey. This study applied a census method to identify and select eligible pregnant women. A structured and pretested questionnaire was used to collect the data. The data was entered into Epi-data version 3.1 and exported to STATA version 14 for analysis purpose. Adjusted Odds Ratio at 95% confidence interval was used to show the association between dependent and independent variables. Statistical significance was declared at a P value less than 0.05.

Results: A total of 871 pregnant women were identified from the survey and included in this study. Overall, 96.67% (95% CI: 95.24, 97.67) had not get adequate (all components) ANC. The components of ANC services were increased from 3.35 to 32.34%, 2.52 to 46.33% 1.96 to 55.8%, 2.31 to 46.53%, 3.54 to 55.75%, 2.46 to 44.62%, 1.18 to 45.96%, and 2.45 to 54.6% for tetanus toxoid Vaccine, HIV/AIDS testing and counseling, danger sign, place of delivery, deworming, iron folic acid, family planning, and breast feeding counseling, from first ANC visit to fourth ANC visit, respectively. Rural residence (AOR = 4.89, 95% CI: 1.21, 19.86), and less than four number of ANC visit (AOR = 5.15, 95% CI: 2.06, 12.86) were significantly associated with inadequate uptake of ANC components.

Conclusion: Only three in hundred pregnant women were received adequate ANC components in the study area. Rural residence and less than four number of ANC visit were factors significantly associated with inadequate ANC uptake. Therefore, the district health department managers and program implementers need to train the health care providers about the components of ANC. As well, increasing community and facility awareness of WHO recommendations on ANC visits focusing on rural women is needed.