Determinants of late antenatal care attendance among high parity women in Uganda

Abstract

Timely and adequate Antenatal Care (ANC) is effective in preventing adverse pregnancy outcomes and is crucial for decreasing maternal and neonatal mortality. High parity women (5+ children) are at higher risk of maternal mortality. Limited information on the late timing of ANC among this risky group continues to hamper Uganda’s efforts to reduce maternal mortality ratios and improve infant and child survival. The aim of this study was to determine factors associated with attendance of the first ANC after 12 weeks of gestation among high parity women in Uganda. A weighted nationally representative sample of 5,266 women of high parity from the 2016 Uganda Demographic and Health Survey was analyzed at three levels. Firstly, frequency and percentage distributions were used to describe the study population by different factors. Secondly, chi-square tests were used to establish the association between late ANC and each independent variable. Lastly, a complementary log-log model was fitted to identify factors associated with late ANC attendance among high parity women in Uganda, at 5% level of significance. Results showed that majority (73%) of high parity women delayed to attend their first ANC visit. Late ANC attendance among high-parity women was associated with not finding distance to the health facility when going for their medical help to be a big problem (OR=1.113, CI: 1.004-1.234), not living with a partner (OR=1.196, 95% CI=1.045-1.370) having partners/husbands who had attained primary education (OR=1.314, 95% CI=1.075-1.607), having had last delivery in a health facility (OR=0.812, 95% CI=0.709-0.931), and desiring to have another child (OR=0.887, 95% CI=0.793-0.993). The study recommends designing and implementing strategies aimed at ensuring even women of high parity prioritize attending ANC early. There is need for integration of family planning with other services such as ANC and postnatal care education to enable women seek antenatal care within the recommended first trimester. This would not only reduce late ANC attendance but would go a long way in improving the maternal and child health outcomes. The study findings highlight the need to increase health facility-based deliveries. This study calls for increased support for programmes for education, sensitization and advocacy for health facility-based deliveries. This could be done through strengthened support for VHT activities and community engagement activities.