Factors associated with antenatal care dropout among pregnant women in Tororo district, Uganda

Abstract

Antenatal care is care that is given to a pregnant woman in order to attain best possible health outcome for her and her baby Antenatal health services help to detect and treat pregnancy related complications which if untreated result in maternal morbidity and mortality. GENERAL OBJECTIVE: The general objective of the study was to establish factors that are associated to ANC attendance drop-out among pregnant women in Tororo district. METHODOLOGY: The study was conducted in Tororo district located in Eastern Uganda. It was a facility based unmatched case control study employing both qualitative and quantitative methods of data collection. The facilities for the study were selected purposively. Cases (145) and controls (145) attending immunization for under five who had delivered in the last nine months and six key informants purposively selected were interviewed. The data collected was entered in Epi Info 2002 for analysis. RESULTS: A total of 145 cases and 45 controls that were comparable were interviewed. The mean age of the cases was 26 years, while that of controls was 24 years. From bivariate analysis, women with low education, below primary four (OR 4.48; 2.64- 7.61), Not living with partner( single, separated, widowed) (OR 5.0; 1.5- 16.7), Of higher parity (> 3 children) (OR 2.58; 1.51- 4.42), Of poor socio-economic status (OR 6.7; 3.7- 12.1) And poor knowledge of ANC (OR 21.9; 11.1- 44.4), And starting ANC late in the pregnancy (after 5 months) (OR 25.0; 12.5- 50.0) were more likely to drop out of ANC attendance. After logistic regression, women who had more than 3 children (OR 4.3; 1.9- 9.7), Not living with a partner (single, widowed, separated) (OR 3.9; 1.1- 14.4), who start ANC late in the pregnancy (OR 19.1; 7.4- 49.5), Of poor socio-economic status (OR 15.4; 4.3- 50.0) And poor knowledge of ANC (OR 55.6; 16.7- 100.0) were most likely to drop out of ANC attendance before completing the recommended 4 visits. CONCLUSIONS: Poor socio-economic status, having limited knowledge of the value of attending antenatal clinic, having more than 3 children and starting ANC care late in the pregnancy were associated with dropping out of antenatal care before the recommended 4 visits. RECOMMENDATIONS: The DHT should ensure that knowledge of ANC is integrated into other mother and child health services (MCH) so that mothers are informed on ANC at each contact. The district council through local structures should assist the communities in identifying and implementing community owned income generating projects which will enable them to improve on their income and overall economic status. They should also mobilize communities to encourage mothers to start ANC early in pregnancy in order to improve overall health of women and reduce maternal morbidity and mortality.