Factors Associated with the Timing of Antenatal Care Service Initiation in Two Health Facilities in the Tamale Metropolis

ABSTRACT

Background: Starting maternal health care services within the first trimester of pregnancy is viewed as a strong determinant of the health status of both the mother and the foetus. However, many pregnant women in developing countries, especially Ghana initiate their antenatal care late (after 12 weeks) thereby missing the benefits associated with antenatal care as some may be unable to attain the minimum visits of eight before delivery.

Objective: This study sought to determine the proportion of women who initiate ANC late, determine the mean gestational age at which pregnant women initiate ANC and to identify the factors influencing the initiation of ANC services at the Tamale Teaching Hospital and the Tamale Reproductive and Child Health Clinic.

Methodology: The study used a cross-sectional design with simple random sampling technique involving 206 women who were pregnant and initiated their antenatal care service at the Tamale Reproductive and Child Health Clinic and the Tamale Teaching Hospital. The tool for collection of data was a structured questionnaire. These data were analyzed with Stata version 15. Frequencies, chi-square test and logistic regression were used for the analysis 

Results: The study found that, out of the sample of 206 women, 51% were within the ages of 2534 years, slightly above half (51.9%) were Dagombas and 70.9% of the women also practice the Islamic faith. Those who were married also constituted the majority (52.4%), those who had senior high and tertiary education were also in the majority (55.8%) whiles 5 in 10 women were employed in the informal sector. Majority (61.7%) of the women were multiparous with 9 in 10 of their children being alive. About 70% of the women viewed the cost of transportation to the nearest ANC clinic as not costly whiles 7 in every 10 (69.9%) pregnant women initiated ANC after 12 weeks with the Mean and Standard Deviation of gestational age 19± 8.2 weeks. Multiple regression analysis indicates that ethnicity and client dissatisfaction were associated with late initiation of antenatal care service. 

Conclusion: The study revealed that majority of pregnant women initiate antenatal care service late. The Mean and Standard Deviation of gestation at ANC initiation was 19 ± 8.2 weeks. Community-based   education on the importance of early antenatal care could lead to early initiation of antenatal care services.