Predictors and Timing of Initiation of Ante Natal Care

Abstract

Background: Maternal mortality is a major problem in developing countries. Sub saharan countries host more than 90% of maternal deaths in the world. In Kenya the maternal mortality ratio is quite high at 362 maternal deaths per 100 000 live births.  Ante natal care is one of the key entries for strategic interventions to reduce maternal mortality. These include health promotion, birth preparedness and sensitization on skilled birth attendance. Early initiation of ante natal care is necessary to achieve the targeted outcomes. The main aim of this study was to assess the predictors and outcomes of timing of initiation of ante natal care. Methods: This was a cross sectional study among women who had delivered within six months prior to the study. Interviewer administered questionnaires were used to collect data in a sample size of 327 respondents. Chi square and Fishers’ exact were used to test associations while binary logistic regression was used to determine the predictors. Results: The mean gestational age of initiation of ante natal care was 5.3 months while the proportion of early initiation of ante natal care was 26%. The predictors of  early initiation of ante natal care were attaining secondary education, formal employment, increased family income, having a partner during pregancy and short duration to the health facility. Early initiation of ante natal care increased the likelihood the key outcomes; birth preparedness, focused ante natal care and skilled birth attendance. Conclusion: Most women start their ante natal care late. Timing of initiation of ante natal care determines other outcomes of perinatal care. This can be improved by increasing the number of women with secondary education, social support, economic empowerment and increasing accessibility to health facilities.