Predictors of Antenatal Care Utilization in the East Akim Municipality of Ghana

Abstract

Background: Maternal and neonatal mortality rates continue to be high in sub-Saharan African countries, including Ghana. Timely and regular antenatal care (ANC) during pregnancy are essential for the early identification and management of potential risk factors associated with poor pregnancy outcomes. The purpose of this study was to investigate the uptake of ANC services in the East Akim Municipality of Ghana and identify factors influencing ANC utilization.

Methods: A cross-sectional study that employed stratified sampling methodology to select 310 women of reproductive age (15-49 years) in East Akim Municipality was conducted. A structured questionnaire was used to investigate the determinants of ANC utilization among respondents. Data were managed using Microsoft Excel 2016 and analysed using Stata version 14. Descriptive, bivariate and multivariable logistic regression analyses were performed. Results: ANC attendance, at least once during pregnancy, was almost universal (98.4%), with 83.5% making 4+ visits. However, only 58% of respondents made ANC visits in the first trimester and 61% attended all scheduled visits. Employment status, distance to health facility and pregnancy intention were significantly associated with regular ANC attendance. Self-employed women were 2.4 times more likely to attend ANC regularly (AOR: 2.42, 95% CI: 1.20-4.88) than unemployed women; those who lived <5 km to a health facility were 3.2 times more likely to attend ANC regularly than those who lived >10 km (AOR: 3.24, 95% CI: 1.20-8.72); and women with intended pregnancies were 2.5 times more likely to attend all ANC scheduled visits than those with unintended pregnancies (AOR: 2.46, 95% CI: 1.32-4.57).

Conclusion: Although ANC utilization in East Akim is high, socioeconomically disadvantaged women with unintended pregnancies, who were unemployed and who lived >10 km from a health facility did not attend ANC regularly. Interventions to ensure equitable access to ANC services at the community level for women are needed to improve timely and regular ANC attendance. Strengthening of community-based health centers to provide ANC through outreach services to women in remote locations, coverage of family planning services within national health insurance scheme and improvements in socioeconomic conditions in which people live are warranted.