Factors Influencing Completion of Antenatal Care Among Women in Kiruhura District, Western Uganda

Abstract

Antenatal care (ANC) is one of the global interventions designed to contribute to the reduction of maternal and child mortality playing an important role in ensuring a healthy mother and baby during pregnancy and after delivery. Uganda has recorded inadequate utilization of antenatal care programs with low completion of four recommended ANC visits. However, it is assumed that predisposing, enabling and need factors can improve complete Antenatal care services‟ utilization.

A cross-sectional descriptive study that employed mixed methods utilized Andersen‟s behavioural model to establish factors that influenced antenatal care (ANC) completion of four recommended visits. The same model was also used to interpret the relationship between the factors and the level of ANC completion. Data were obtained from 383 women of reproductive age in Kiruhura district using guided questionnaire, one FGD comprising of women of reproductive age selected from the general population and in depth interview with eight women that completed four ANC visits during the most recent pregnancy and had turned up for child immunization at the health facility were conducted.

It was observed that one time ANC visit was at 380 (99%), but with more women inclined to completing all the four ANC visits for their first child 260 (68%), as compared to second child 68 (37%) and third child none (0%) respectively. ANC completion was significantly influenced by level of education (P-Value < 0.002); Occupation (P-Value <0.007); number of pregnancies had (P-Value < 0.003); number of children born (P-Values<0.003); knowledge of the required number of ANC visits (P-Value < 0.000); and distance to the health facility (P-Value < 0.000).

Factors found to enable women complete ANC visits included availability of community initiative and programs (P-Value < 0.024). Women who were aware of their scheduled ANC visits were nearly twice more likely to complete all the four ANC visits as compared to those who were not (Odds Ratio= 1.909). Women‟s knowledge of the importance of going for ANC during pregnancy, and satisfaction with ANC services had a significant influence on ANC completion (P-Value < 0.010). Regression analysis clearly indicated that the time taken before going for first ANC visit had a strong positive relationship with the number of ANC

This study therefore recommends that health facilities introduce ANC appointment reminder system prior to the next scheduled ANC using short message (SMS) and or phone call using mothers‟ or immediate neighbors‟ contacts. The column of woman‟s phone contact should be created in ANC register. Community initiatives and programs that promote ANC awareness on the package, timely initiation and completion, such as VHTs, voucher system, health education and health radio talk should be reinforced and scaled up by the district health office. Further studies should be conducted in identifying how the available technology can be used effectively to promote health services‟ utilization.

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