Late antenatal care booking and associated factors among pregnant women in Ethiopia: evidence from 2019 performance monitoring for action data analysis

Pregnancy is a crucial period for a woman, her family, and society. Early initiation of antenatal care (ANC) follow-up helps to identify pre-existing health conditions and complications arising during pregnancy. It also allows the mother to receive health promotion and disease prevention services. On the other hand, late initiation or missing of ANC follow-up may lead to transmission of the infections to their fetus, stillbirth, anemia, congenital malformation, and congenital syphilis. This study aims to determine the magnitude and determinant factors of late ANC booking in Ethiopia.

The 2019 Ethiopia Performance Monitoring for Action (PMA) cross-sectional survey data was used for this study. It is a multistage cluster, nationally representative household survey. A total of 709 pregnant women were eligible for our study. The results of this study were presented as narrations, frequency tables, and graphs. Variables with p-value < 0.2 in univariable logistic regression were taken to a multi-variable logistic regression analysis and in the final model variables with Adjusted Odds Ratio (AOR) at 95% confidence interval and p-value of ≤ 0.05 were identified as predictor variables of late antenatal care booking.

The overall prevalence of late ANC booking was 54.28% (95% CI: 48.85, 59.49). Women who never attend formal education (AOR = 0.16 95% CI: 0.13, 0 0.67), women whose parity was 1 or 2 (AOR = 2.30, 95% CI: 1.05, 4.53) and women with wanted pregnancies (AOR = 1.80, 95% CI: 1.73, 4.32) were significant variables associated with late antenatal care booking.

In Ethiopia, over half of the pregnant mothers initiated their ANC follow-up late and it is high as compared to the WHO recommendation. Unwanted pregnancy, being uneducated, and parity I or II were the factors for late ANC booking. Hence, it is important to provide health education on the timing of ANC among women within reproductive ages. Priority should be given to women with low levels of education, women who have one or more parity, and women with unplanned pregnancies. Family planning or birth spacing programs should be enhanced to prevent unwanted pregnancies.