Individual, Household, and Contextual Factors Influencing the Timing of the First Antenatal Care Attendance in Northwest Ethiopia: A Two-Level Binary Logistic Regression Analysis

Figures & data

Table 1 Percentage Distribution of Women Who Made Their First Antenatal Care Visits within the First 4 Months and at or After 4 Months of Pregnancy, According to Selected Individual- and Community-Level Characteristics, in West Gojjam Zone, Northwest Ethiopia, 2018 (N = 898)

Variables	Time at First ANC Visit		Total
Level-1 Variables	Booked Early (n=194)	Booked Late (n=704)	Number (%)
Age (years)
15–24  25–34  ≥35	53(30.5) 115(22.5) 26(12.2)	121(69.5) 396(77.5) 187(87.8)	174(19.4) 511(56.9) 213(23.7)
Maternal education
No formal education  Primary education  Secondary education and above	54(11.1) 56(21.0) 84(58.3)	433(88.9) 211(79.0) 60(41.7)	487(54.2) 267(29.7) 144(16.0)
Paternal education
No formal education  Primary education  Secondary education and above	57(14.0) 50(17.2) 84(49.7)	350(86.0) 240(82.8) 85(50.3)	407(45.3) 290(32.3) 169(18.8)
Religion
Orthodox Christian  Others	178(20.7) 16(41.0)	681(79.3) 23(59.0)	859(95.7) 39(4.3)
Household wealth status
Poor  Middle  Rich	92(47.4) 43(22.2) 59(30.4)	322(45.7) 142(20.2) 240(34.1)	414(46.1) 185(20.6) 299(33.3)
Birth order of the last child
1  2–4  5+	79(33.0) 98(20.4) 17(9.5)	160(67.0) 382(79.6) 162(90.5)	239(26.6) 480(53.5) 179(19.9)
Intendedness of the last pregnancy
Yes  No	187(23.5) 7(6.9)	610(76.5) 94(93.1)	797(88.8) 101(11.2)
Level of knowledge about the timing of the first ANC visit
Knowledgeable  Not knowledgeable	173(26.7) 21(8.4)	475(73.3) 229(91.6)	648(72.2) 250(27.8)
Level of knowledge about the danger signs of pregnancy
Yes  No	152(41.0) 42(8.0)	219(59.0) 485(92.0)	371(41.3) 527(58.3)
Encountered any danger sign of pregnancy
Yes  No	52(40.3) 142(18.5)	77(59.7) 627(81.5)	129(14.4) 769(85.6)
Level-2 Variables
Residence
Urban  Rural	106(40.3) 88(13.9)	157(59.7) 547(86.1)	263(29.3) 635(70.7)
Facilities’ level of readiness to ANC (measured at the district level)
Low  Moderate  High	39(21.4) 63(32.5) 92(28.2)	43(78.6) 327(83.9) 234(71.8)	182(20.3) 390(43.4) 326(36.3)
Walking distance to the nearest health facility
Less than 2 hours  At least 2 hours	194(23.3) 0 (–)	640(76.7) 64(100)	834(92.9) 64(7.1)
Population density to the nearest health facility (health center or hospital) at the district level
≥25,000 people  <25,000 people	156(80.4) 36(21.0)	561(79.7) 143(79.0)	717(78.2) 181(20.2)

Table 2 Results of the Random Intercept Model (Measures of Variation) for Late ANC Initiation at Cluster Level by the Two-Level Logistic Regression Analysis, Northwest Ethiopia, June 2018

Random Effect Variances	Model 1 (Null Model)	Model 2 (Full Model)
Variance at the cluster level	1.316*	1.185
ICC	0.286	0.265
MOR	3.68	3.44

Notes: *p<0.05; Model 1 is the null model, without any explanatory variable. Model 2 is the full model adjusted for both individual- and community-level factors.

Abbreviations: ICC (p), intra-class correlation coefficient; MOR, median odds ratio.

Table 3 Multilevel Logistic Regression of the Timing of First ANC Visit Among Pregnant Women in West Gojjam Zone, Northwest Ethiopia, 2018 (n=898)

Predictors	N	Crude Odds Ratio (95% CI)	Adjusted Odds Ratio (95% CI)
Level-1 Variables
Maternal age
15–24 years  25–34 years  ≥35 years	174 511 213	0.36(0.21, 0.63) 0.50(0.31, 0.81) 1.00	0.82(0.35, 1.92) 0.96(0.49, 1.90) 1.00
Education status of women
No formal education  Primary education  Secondary and above	487 267 144	11.95(7.18, 19.88) 4.08(2.50, 6.65) 1.00	4.08(2.20,7.55)* 2.49(1.44, 4.31)* 1.00
Intendedness of the last pregnancy
Yes  No	797 101	0.21 (0.09, 0.47) 1.00	0.31(0.12, 0.79)* 1.00
Knowledge on the first antenatal care visit
Knowledgeable  Not knowledgeable	648 25	0.21 (0.13, 0.35) 1.00	0.43(0.25, 0.75)* 1.00
Birth order of the last baby
5+  2–4  1	179 480 239	4.30(2.35, 7.89) 1.78(1.25, 2.59) 1.00	1.05(0.43,2.58) 0.76(0.44, 1.29) 1.00
Knowledge about danger signs of pregnancy (mentioned at least)
Yes  No	371 527	0.10 (0.07, 0.15) 1.00	0.16(0.10, 0.26)* 1.00
Household wealth status
Rich  Middle  Poor	299 185 414	1.16(0.77, 1.74) 1.02(0.65, 1.60) 1.00	1.48(0.92,2.38) 1.19(0.70,2.03) 1.00
Level-2 Variables
Average distance to the nearest health facility	-	1.05 (1.02, 1.08)	1.04(1.01, 1.08)*
Population to health facility ratio(at district level)
≥25,000 people  <25,000 people	717 181	0.94 (0.17, 5.17) 1.00	0.59(0.11,3.26) 1.00

Note: *Shows statistically significant at 0.05.