Assessing The Prevalence and Major Drivers of Late Antenatal Care Registration at The Nanumba South District in The Northern Region of Ghana

Abstract

Introduction: Late antenatal care registration can be defined as a pregnant woman visiting a healthcare facility for assessment and booking after twelve weeks gestation. ANC provides both psychological and medical needs of pregnant women within the context of the health care delivery system. Late antenatal care registration mars the baseline health data of the pregnant woman and thereby affects the early detection of complications. This study assessed the prevalence and major drivers of late antenatal care registration in a rural district in Ghana. Methods: A facility-based cross-sectional study was conducted among pregnant women attending antenatal care services in the Nanumba South District of Ghana. A structured questionnaire was administered to a random sample of 194 pregnant women. Data analysis was performed using Stata version 18. Descriptive statistics, including frequencies and confidence intervals, were used to summarize the data. In this study, participants' knowledge of ANC services was measured by asking ten (10) questions about ANC services. Each correct response was scored Yes (1) with an incorrect response scoring No (0). The overall score was computed for each participant and expressed as a percentage of the total possible score of 10. The participants' knowledge of ANC services was rated as adequate knowledge of ANC services (≥70% scores) and inadequate knowledge of ANC services. Inferential statistics, including chi-square and logistic regression, was used to identify associations and predictors of late antenatal care service utilization, with a significance level set at p < 0.05. Results: One hundred and ninety-four pregnant women participated in the study. The majority of the women were young, with 42.3% aged 15-24 years and 44.3% aged 25-34 years. The study revealed both encouraging trends and areas of concern in antenatal booking practices. While 62.9% of women booked early for ANC within the first trimester, a significant 37.1% delayed booking vii until later in pregnancy. Age emerged as a crucial predictor, with women aged 35-44 being significantly less likely to book early for ANC compared to those aged 15-24 [aOR = 0.28 (CI: 0.11-0.74), p=0.010]. Religion also played a significant role, with Christian women less likely to book early compared to those with no religious affiliation [aOR = 0.10 (CI: 0.01-0.80), p=0.031]. Conclusion: Overall, the study found that women in the Nanumba South District registered late (37.1%) for antenatal care services, even though they demonstrated a good level of knowledge (56.7%) on antenatal care services. Factors such as age and employment status were significant, with older women (34-44) and those unemployed showing differing patterns in antenatal care registration and knowledge.