Menu
Menu
Menu
Menu
Background: Late antenatal care initiation is linked to a higher risk of maternal death. Women who do not start ANC at an early stage may experience the effects of pregnancy-related health difficulties, as well as long-term health issues and pregnancy complications. Therefore, our study aimed to determine the prevalence of late initiation of antenatal care and associated factors among pregnant women in Jimma Zone public Hospitals. Methods: A facility-based cross-sectional study design was employed in Jimma zone public hospitals from February 1 up to 30 March 2020 and 409 pregnant women were participated in the study by using a systematic random sampling method. Structured questionnaire was used to collect data that contain socio demographic variables, socio cultural variables, pregnancy related factors and predisposing factor related variables. The data was entered into EPI data version 3.1 and exported to SPSS version 20 for statistical analysis. Binary and multivariable logistic regression analysis were performed by using 95%CI and significance was declared at P < 0.05. Result: Forty-eight percent of pregnant women were initiated their first ANC late. Primary education (AOR = 0.242; 95% CI, 0.071–0.828) and college diploma and above was (AOR = 0.142; 95% CI, 0.040- 0.511), mothers with an unplanned pregnancy (AOR = 11.290; 95%CI, 4.109–31.023), time taken to arrive the health facility greater than sixty (60) minutes (AOR = 8.285; 95% CI, 2.794–24.564) and inadequate knowledge about ANC service (AOR = 4.181; 95%CI, 1.693–10.348) were associated with late first Antenatal care initiating. Conclusion: The prevalence of late initiation of ANC still remains a major public health concern in the study area. Level of education, unplanned pregnancy, distance from house to health facility, and lack of understanding about ANC services were all found to be significant variables in late ANC starting. As a result, healthcare workers can provide ongoing health education on the need of starting antenatal care visits early to avoid unfavorable pregnancy outcomes by considering all identified factors.
A facility-based cross-sectional study design was carried out from February 1 to 30, 2020 in Jimma zone public hospitals. The zone has eight public hospitals, two private hospitals, and 120 health centers. Of the eight governmental hospitals, one is a referral hospital, three are general hospitals, and four are primary hospitals. The source and study population were all pregnant women who attended selected public hospitals of the ANC clinic and participant who were selected for the study during the data collection period from the sampled hospitals respectively. All pregnant women who were initiated into ANC were included, and who were severely ill and who attended their first ANC visits in other health facilities were excluded. A single population proportion formula was used assuming a 95% confidence interval and a 59% prevalence (P) of receiving ANC [15] and a precision of 5% between the sample and the 10% non- response rate, thus a total of 409 pregnant women were required for the study. Simple random sampling techniques were used to select the hospitals. Of the total of eight hospitals found in the Jimma zone, four (Jimma University medical center, Agaro general hospital, Seka primary hospital, and Shenen Gibe general hospital) were selected for the study. Finally, proportional allocation to sample size of each hospital was done, all eligible study participants were selected from each hospital till the allocated sample size was reached by systematic random sampling with kth interval values. (Fig. 1). Schematic presentation of sampling procedure An interviewer-administered structured questionnaire was adapted through reviewing existing literature which encompasses information related to socio-demographic characteristics, pregnancy-related variables, socio-cultural variables, and predisposing factors [16, 17]. Data were collected by trained data collectors using pretested and structured questioners. The questionnaires were prepared in English, then translated into the languages of both Afaan Oromo (the language spoken by the local residents) and Amharic versions (the official language of Ethiopians), and retranslated back to English by experts to ensure consistency. Face-to-face interviews were used to collect data; gestational age was estimated by asking about the last normal menstrual period, and if respondents were unable to recall their gestation age, further informed consent was obtained to access medical records. Two days of training were given by the principal investigator, which focused on the objective of the study to create a common understanding of the questionnaires. A pretest was conducted among 20 pregnant women in the Limu Genet Primary hospital. After the pretest, the necessary correction was made. Dependent Variable was late initiation of ANC and the independent variables were Socio-demographic variables such as (age, educational status, marital status, and occupation of respondents’, house Income and residence), Socio-cultural variables (religion, family support, advice from significant others, Decision-making and Husbands Educational status), Pregnancy related variables (number of delivery, gravidity, abortion history), Types of pregnancy and means of recognizing pregnancy and Predisposing factors (Knowledge of pregnant women related to ANC visits, and pregnancy related health problem). Antenatal care:-is the care given to pregnant women so that they have safe pregnancy and healthy baby. Pregnant women were considered late ANC initiated at first visit, when they came to health facility after 16 weeks of gestational age. Respondents were categorized as inadequate knowledge about ANC service, if they scored below to the mean knowledge score questions of about ANC service (34), otherwise adequate knowledge. A pregnancy which is consciously desired and planned by a couple The completed questionnaire was coded and entered into a data entry template in EPI-DATA version 3.1, then exported to SPSS version 20 for analysis. Descriptive statistics like frequencies, cross-tabulation, graphs, and percentages were employed. The goodness of fit was checked with the Hosmer–Lemeshow test (p = 0.35). Multicollinearity was checked by examining the variance inflation factor. In the bi-variable logistic regression analysis, p-values of less than 0.25 were used to select the candidate variables for multivariable logistic regression analysis. An adjusted odds ratio (AOR) with a 95% CI was used to determine the predictor of the outcome variable independently and to show the strength of an association. A p-value of less than 0.5 were considered as statistically significant.
N/A
