Utilization of WHO-recommended eight antenatal care contacts and associated factors among postnatal women in Gurage zone, centeral Ethiopia, a facility based cross-sectional study, 2024

Abstract

Antenatal care is the service provided by healthcare professionals to a woman from the start of her pregnancy through labor. In Ethiopia, the utilization of the World Health Organization’s recommended eight antenatal care contacts is suboptimal, primarily due to barriers such as limited access to services, low awareness, and socioeconomic constraints. To assess the utilization of eight ANC contacts and associated factors among postnatal women in the Gurage zone hospitals, Central Ethiopia. A facility-based cross-sectional study was conducted on 392 pregnant women at Gurage Zone Hospital from February 23 to May 22, 2024, using systematic random sampling. A pretested structured questionnaire was administered through face-to-face interviews. Data were analyzed using SPSS version 25. Logistic regression was applied to assess the association between the dependent and independent variables, with a p-value of less than 0.05 defined as statistically significant. Of the 422 participants selected, 392 women responded, resulting in a response rate of 93%. The mean age of the participants was 28 years (SD ± 5). A total of 147 women (37.5%; 95% CI: 32.5–42.5%) completed all eight antenatal care contacts. In a multivariable logistic regression analysis, several factors emerged as statistically significant predictors of completing the eight antenatal care contacts: being under 20 years of age (AOR = 3.36; 95% CI: 1.42–7.92), residing in an urban area (AOR = 2.02; 95% CI: 1.25–3.26), having a gestational age of less than 40 weeks (AOR = 3.35; 95% CI: 1.44–7.77), possessing a good level of knowledge (AOR = 1.99; 95% CI: 1.08–3.67), experiencing high perceived barriers (AOR = 1.78; 95% CI: 1.01–3.14), receiving strong cues to action (AOR = 2.37; 95% CI: 1.28–4.41), and having high satisfaction with antenatal care (AOR = 2.48; 95% CI: 1.13–5.46). The utilization of all eight ANC contacts is low in our study area, influenced by factors such as maternal age, residence, gestational age, maternal knowledge, perceived barriers, cues to action, and satisfaction with ANC services. Therefore, it is recommended that targeted interventions be implemented to increase awareness, reduce barriers, and improve satisfaction with services to enhance ANC attendance.