Factors contributing to utilization of antenatal care services among mothers delivering at Kawempe National Referral Hospital

Abstract

Background: Antenatal Care is a key element in realizing a reduction in maternal and perinatal deaths. The benefits of Antenatal Care include risk identification; early detection of diseases; prevention of adverse health conditions, health education, and treatment of complications aimed at optimizing pregnancy outcomes. In 2016, the World Health Organization recommended a shift from Focused Antenatal Care every to 8 contacts which Uganda adopted and rolled out in 2018. However, the uptake of the 8 contacts and factors contributing to utilization has not been appropriately documented. The study objective was to establish the factors associated with the utilization of ANC among mothers delivering at Kawempe National Referral Hospital. The method: A cross-sectional study was conducted at Kawempe National Referral Hospital in May and July 2021 among women admitted to the postnatal ward after delivery. Interviewer-administered questionnaires were used to collect data on the number of visits, the timing of the first visit, and factors associated with its uptake. Data were analyzed using STATA software and Akaike's Information criteria used for the best model in multivariate analysis. Results: Data was collected from 381 respondents using interviewer-administered questionnaires. Participants aged 16-24 years constituted the highest proportion at 185 (48.7%). 57 (15%) had attained college/University education. 26.8% of the respondents had ≥ 8 contacts and 32.5% initiated ANC within the first trimester. Respondents who were more likely to have ≥ 8 contacts included: married (O.R 1.6), those seen by a specialist (OR 1.6), and those who had laboratory investigations. However, College/University education (p<0.001), level of health facility attended (p=0.025), waiting time of 2-3 hours (0.017) were associated with uptake of the 8 contacts model of ANC at multivariate analysis. Conclusion and Recommendations: Five years after of adoption of the 8 contact ANC model, there is low uptake. Inter-ministerial collaboration to promote girl-child education child and addressing the causes of long waiting time will go a long way to improve ANC contacts and early initiation.