Журнал беременности и здоровья детей

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Patient and Obstetric Factors Influencing First Antenatal Care Visit among Pregnant Women in Embakasi North Sub-County Health Centres, Kenya

Moses Wamwea Muraguri, Esther Ndonga, Joseph Nyamai Juma and Oliver Waithaka Mbuthia

Background: Globally, maternal mortality ratio has reduced by 45% but the mortality rate in Sub-Saharan Africa remains elusive. Antenatal care (ANC) is one of the most effective interventions in reducing maternal mortalities. In Nairobi County, ANC coverage stands at 33% with low ANC visits contrary to the WHO recommendation of four ANC visits. The study aimed to determine factors influencing first ANC visit among pregnant women. Specifically, patient-related factors and obstetric related factors on access to first ANC visit among pregnant women in Embakasi North Sub-County were evaluated.

Methods: In the year 2018, 368 pregnant women attending ANC in Kariobangi North health centre, Dandora 1 and Dandora 2 health centres were randomly selected. Factors influencing first ANC visit among pregnant women were determined. The study used a cross-sectional study design. A standardized questionnaire was used to collect information from the study participants and Focus Group Discussion (FGDs) formed. Statistical analyses were performed using SPSS and NVIVO software.

Result: The 368 participants responded 100% to the structured questionnaires. Majority of the study participants were aged between 35-39 years, followed by 34-34 years, then 25-25 years while the least was aged 40-44 years. Patient and obstetric factors were statistically significant in explaining the change in the first ANC visit (p ˂ 0.05). A significant positive influence on the first ANC visit was found on patient (ß1) and obstetric (ß3) related factors with regression coefficient values of, ß0=3.312, ß1=0.752, ß2=0.545 and ß3=0.487. Among patient-related factors, Social Media Avenue contributed the most in providing ANC information (68%) while print media was the least at 42%. When asked reasons why pregnant women fail to seek ANC, financial constraints (78%), fear of disclosing pregnancy (56%), culture (40%), religion (38%), unplanned pregnancy (36%), fear of testing for HIV status (34%), limited Knowledge about ANC (33%), poor family and social support (44%), peer Influence (40%) and low decision-making authority (36%) were all statistically significant in accessing ANC services (p<0.05). Slightly over half of the mothers (52%) interviewed indicated that they had never had complications with their previous pregnancy and equally 52% had given birth 2-4 times, 34% had been pregnant once while 19% had been pregnant for >5 times.

Conclusion: Patient and obstetric related factors influenced first ANC seeking behaviour among pregnant women in Embakasi North health centres. Patient-related attributes contributed more than the obstetric factors in access to the first ANC visit.

Conclusion and recommendation: This study showed that less than half of the participants had achieved continuum of care and education level, both respondents and husband occupation, parity, autonomy to health care decision, exposure to the mass media and wontedness of pregnancy were associated with completion of maternity continuum of care, therefore working on enhancing of the capacity of women autonomy in health care decision making and preventing unintended pregnancy helps to improve completion of maternity continuum of care.