Timely First Antenatal Care Visit and associated factors among Adolescent Girls in Fishing Communities of Namayingo District, East Central Uganda

Abstract

Background: In Uganda, the average timing of 1st ANC is at 19 weeks of pregnancy, this is late based on the WHO recommendation of attending early 1 st ANC at ≤ 12 weeks of pregnancy. Timely 1 stANC is critical as it permits enough time for the provision of essential interventions, early identification of underlying conditions, and prevention of complications in pregnancy to ensure positive pregnancy outcomes. Adolescent girls are more vulnerable to adverse birth outcomes. Those who reside in underserved areas like fishing communities on the Islands and lakeshores are exposed to poor socio-cultural outcomes like the high prevalence of HIV, early and unwanted pregnancies further negatively affecting their health. Their health can be promoted if pregnant adolescents start attending ANC early in pregnancy to receive a comprehensive goaloriented ANC package. However, the timing of the 1st ANC visit and associated factors among this special group is unknown. The study aims to estimate the proportion of pregnant adolescent girls who attend timely 1st ANC and determine the associated factors in fishing communities of Namayingo district in East Central Uganda Methods: The study was a cross-sectional design involving a total of 406 pregnant adolescent girls aged 12 to 19 years attending ANC at health facilities that serve fishing communities on the Islands and lakeshores of Namayingo district. Data regarding their 1st ANC visit was collected using an exit interview administered structured questionnaire. Weeks of pregnancy 1 st ANC visit was determined using a pregnancy wheel after obtaining the participant’s 1 st day of the Last Normal Menstrual Period. Participant ANC records were also reviewed for missing data and to minimize recall bias. Results: The proportion of pregnant adolescent girls who attend timely 1 st ANC visits in the fishing Communities of Namayingo District, East Central Uganda is 18%. The factors associated with timely attendance of 1st ANC are age, being in union, and awareness of health benefits of timely 1st ANC. Respondents in the 18-19 years age group were more likely to have a timely 1st attendance of ANC than those of the 12-17 years age group (OR 1.06,1.01-1.11). Respondents who were not in union (not staying with their partners) were more likely to have a timely 1 st ANC attendance than those in union (OR 1.10, 1.04-1.15). Lastly, respondents who were not aware of the health benefits of timely 1 st ANC were less likely to have a timely 1 st ANC visit than those who were aware (OR 0.95, 0.91-0.99). Conclusion: The results indicate that timely 1stANC attendance is low among adolescent girls in fishing communities and worse among the younger adolescent of ≤18 years and those in a union. This calls for more emphasis on knowledge and awareness creation on health benefits of timely 1st ANC attendance.