Late initiation of antenatal care, associated factors, and drivers among pregnant women attending Buwambo Health Centre IV, Wakiso District

Abstract

Background: Late initiation of ANC services is not only associated with negative health outcomes such as premature births, still births, low birth weight and increased complications during pregnancy and childbirth, but it also leads to the poor use of other services such as delivering in health facilities and using skilled attendants during delivery. In Uganda, a big number of pregnant women still initiate their ANC visits at a late stage, leading to increased rates of maternal mortality and morbidity, stillbirths, miscarriages, and neonatal deaths. Therefore, this study sought to determine late initiation of antenatal care, associated factors, and drivers among pregnant women attending Buwambo Health Centre IV. Methods: This was a health facility-based cross-sectional study that used mixed methods. Data was collected using quantitative methods to assess the prevalence and factors together with qualitative methods to assess the drivers. Quantitative data was analyzed using EPI Info version 7.0 for statistical analysis where bivariate and multivariable logistic regressions were carried out to determine the independent factors effect of the predictor variables on the dependent variable by adjusting the effect of potential confounding variables at 95% Confidence Interval and statistical significance declared at a p≤0.05. Qualitative data was analyzed thematically. Results: The prevalence of late initiation of ANC attendance among pregnant women attending Buwambo Health Centre IV was 59.4% (82/138). Late ANC initiation was affected by residing at a distance of over 5 Km from the health facility [AOR=3.8, CI= (1.57-9.09)] and being escorted by the partner to the health facility to initiate ANC [AOR= 0.4, CI= (0.15-0.94)]. The drivers of late initiation of ANC attendance included; self-examination and medication among mothers, limited knowledge about ANC attendance and its benefits, health facility challenges, poor attitude towards ANC, and reliance on partner support. Conclusion: A prevalence of 59.4% of late initiation of ANC attendance among pregnant women attending Buwambo Health Centre IV was affected by longer distance of over 5km to the health facility and being escorted to the health facility by the partner. Late ANC initiation drivers included; individual drivers, interpersonal drivers and health facility drivers.