Determinants of Late Initiation for Antenatal Care Follow up Among Pregnant Mothers Attending Public Health Centers at Jimma Town, South West Ethiopia, 2021: Unmatched Case Control Study.

BackgroundWorld Health Organization recommends that, a woman without complications should have at least four antenatal care visits, the first of which should take place during the first trimester (not > 16 weeks). But, high proportion of pregnant women in most of developing countries attended first ANC at a late time. In Ethiopia, magnitude of late ANC follow up initiation is 64% and in study area 68.7% however determinants of the problem were not identified particularly in the study area. ObjectiveTo identify determinants of late antenatal care initiation among pregnant women attending antenatal care in public health centers of Jimma town, south west Ethiopia 2021. MethodsFacility based unmatched case control study was conducted from May 1-30. The cases (n=177) were mothers who attended their first antenatal care visit at >= 16 weeks of gestational age and the controls (n=177) were mothers who attended their first antenatal care visit at <16 weeks of gestational age during the data collection period. Data was collected through face to face interview using pre tested structured questionnaire. Descriptive and summary statistics was done. Bivariable and multivariable logistic regression analysis was done using SPSS version 21.0 to identify candidate variables at P-value <0.25 and determinants of late ANC initiation at P-value <0.05 respectively. ResultsThe current study identified that, being age > 25 years (AOR= 2.623, 95% CI 1.059 - 6.496), poor knowledge about ANC (AOR= 3.856, 95% CI 1.266-11.750), lack of history of abortion (AOR= 3.326, 95% CI 1.082-10.224), place of previous delivery (AOR=3.926, 95%CI 1.023-15.063), recognizing pregnancy through missed period(AOR= 3.631, 95% CI 1.520-8.674), pregnancy related pain(AOR= 3.499, 95% CI 1.423 - 8.603) and lack of family support (AOR=2.647, 95% CI 1.092-6.415) were determinants of late ANC initiation. ConclusionBeing age > 25 years, poor knowledge about ANC, lack of history of abortion, place of previous delivery, recognizing pregnancy through missed period, pregnancy related pain, and lack of family support during ANC booking were determinants of late ANC initiation.Health facilities and respective health care providers should provide health education at facility level regularly with due attention to late ANC initiation.