Timing of First Antenatal Care Visit and its Associated Factors among Pregnant Women Attending Public Health Facilities in Addis Ababa, Ethiopia

BACKGROUND Early initiation of antenatal care visits is an essential component of services to improving maternal and new born health. The Ethiopian Demographic and Health Survey conducted in 2011 indicated that only 11% of pregnant women start antenatal care in the first trimester. However, detailed study to identify factors associated with late initiation of care has not been conducted in Addis Ababa where access to health services is almost universal. The aim of this study was to assess the level of late first antenatal care visit and the associated factors. METHODS Facility based cross sectional study was conducted in public health centers in Addis Ababa. The health centers with experience of at least more than two years were selected randomly, one form each sub-city. The study subjects were pregnant women visiting the facilities for the first time during the index pregnancy. The study health centers were selected randomly from each sub-city, and the study women were recruited consecutively until the required sample size was achieved. Data were collected using pre-tested questionnaire. Logistic regression analysis was done to identify factors associated with late ANC initiation. RESULT A total of 979 women participated in the study; 411(42.0%; 95% CI of 38.9%, 45.1%) of them came for their first ANC visit late, after 16 weeks of gestation. Wrongly perceived ANC initiation schedule was the strongest predictor of late initiation. After controlling for basic demographic and obstetric factors, the odds of starting the first antenatal care visit late was higher for women who did not know the antennal care initiation schedule correctly compared to women who knew the schedule correctly (AOR6.6; 95% CI 3.03, 14.03). CONCLUSION Over 40% of pregnant women do not initiate ANC visit in the first trimester largely due to lack of correct knowledge of the recommended ANC schedule.