Abstract
Background
Although Ethiopia has shown remarkable achievements in reducing maternal mortality in the last 10 years, the prevalence of late antenatal care (ANC) initiation is still high in the country.
Objective
The primary purpose of this study was to identify the factors related to late ANC initiation among pregnant women in selected public health centers in Addis Ababa, Ethiopia.
Subjects and methods
A total of 402 pregnant women (cases=134, controls=268) were recruited using multistage sampling. The design selected for the study was unmatched case–control. EpiData version 3.02 and SPSS version 20.0 were used for data entry and statistical analysis, respectively. Binary logistic regression model was used to model the odds of late ANC initiation.
Results
The odds of attending ANC late were significantly higher for mothers with a monthly household income of <US$45.5 (AOR=6.67; 95% CI: 2.40, 18.60), who were educated up to eighth grade or below (AOR=2.17; 95% CI: 1.03, 4.60), who had unplanned pregnancy (AOR=2.73; 95% CI: 1.03, 7.23), who did not receive advice from health extension workers or TV/radio (AOR=5.21; 95% CI: 2.49, 10.88), who stayed for <5 years in Addis Ababa (AOR=3.93; 95% CI: 1.89, 8.12), and who was charged >$8.50 to start the ANC service (AOR=3.04; 95% CI: 1.98, 4.67).
Conclusion
Low educational level, low income of the household, unplanned pregnancy, stay for <5 years in Addis Ababa, not getting advice from health extension workers or local TV/radio and higher cost associated with initiation of the first ANC service were the main predictors of late ANC initiation. Therefore, any intervention which would need to improve early ANC initiation should focus on economic empowerment of women, and tailored health education for migrant women should be strengthened.
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Acknowledgments
The authors would like to thank to Addis Continental Institute of Public Heath for their support in carrying out the research. They also like to acknowledge the administrators of the selected subcity health office, health centers, and data collectors and the study participants for sparing their time and providing information. Moreover, they thank Addis Ababa Health Bureau, Public Health Research and Management Core Process Ethics Review Committee for their valuable comments to the research proposal.
Disclosure
The authors report no conflicts of interest in this work.
Author contributions
KG initiated the project idea, drafted data collection tool, study design and methodology, and participated in data collection analysis and manuscript write up. AW supervised the overall research and critically edited and reviewed the manuscript based on reviewers’ comments. Both authors contributed toward data analysis, drafting and critically revising the paper and agree to be accountable for all aspects of the work.