determinants of early antenatal care attendance among mothers attending antenatal care in kawempe division health facilities kampala, uganda

Description

Background: Early initiation of antenatal care is an essential component of services to improve pregnancy outcomes. The World Health Organization recommends that all pregnant women should have eight contacts with a health provider throughout pregnancy. This should be initiated with a first contact at less than 12 weeks of pregnancy. Objective: This study identified the determinants of early antenatal attendance among mothers attending antenatal care in Kawempe division health facilities. Methods: It was a cross sectional study conducted within a period of 2 months in lower health facilities in Kawempe division. The study subjects were pregnant women visiting the facilities for first and subsequent visits. Univariate analysis was used to determine the prevalence of early ANC and multivariate logistic regression analysis was done to identify factors associated with early antenatal care attendance with the level of significance set at 0.05. Qualitative data was analysed thematically. Results: A total of 418 pregnant mothers were included in the study. Of these, 53 (12.7%) came early for antenatal care. The most common reasons for coming early for first ANC were having present and past obstetric complaints. The factors associated with early ANC after multivariate logistic regression were: Maternal age 20-29 years (AOR 3.90, P value 0.01) and 30-44 years (AOR 4.09, P value 0.02), maternal formal employment (AOR 0.16 95% CI (0.03 – 0.80) and paternal occupation: business and formal employment, AOR 3.84 95% CI (1.45 – 10.16) p value 0.01 and AOR 3.38 95% CI (1.05 – 10.93) P value 0.041respectively. Among the community and health system factors, attitude and perception of the mothers and cost of antenatal care respectively were found to influence early antenatal care attendance. Conclusion: Few mothers started antenatal care attendance early. This was influenced by maternal age, maternal and paternal occupation, and attitude of mothers and cost of antenatal care attendance. Recommendation: There is need for community sensitization on early ANC attendance, provision maternity or ANC insurance covers .to reduce cost of early ANC attendance in Kawempe division.