Determinants of Early Booking Among Pregnant Women at Kade Government Hospital Kwaebibirem Municipality, Eastern Region, Ghana

Abstract

Introduction Early initiation of antenatal care (ANC) is essential for improving maternal and neonatal health outcomes through the timely detection and management of pregnancy-related complications. Despite its importance, many pregnant women delay their first ANC visit. This study assessed the challenges associated with early ANC booking among pregnant women attending Kade Government Hospital. Methods A descriptive cross-sectional study was conducted among 270 pregnant women attending the antenatal clinic at Kade Government Hospital. Participants were selected using stratified random sampling. Data were collected using a structured questionnaire and analyzed using descriptive statistics, Chi-square tests, and binary logistic regression at a 95% confidence level, with statistical significance set at p < 0.05. Results The study found that 46.3% (95% CI: 40.3%–52.3%) of respondents-initiated ANC within the recommended period, while 53.7% booked late. Although the majority of respondents (92.5%) had received ANC education, their overall knowledge regarding early ANC booking was moderate. Factors significantly associated with early ANC initiation included maternal age, employment status, marital status, parity, previous pregnancy experience, waiting time before receiving care, and the duration of ANC consultations. Women aged 35 years and above, single women, those with two to three children, and first-time pregnant women were significantly less likely to initiate ANC early. Conversely, employed women, those who were attended to promptly, and those who spent adequate time with healthcare providers during ANC visits were significantly more likely to book early. Conclusion: Early ANC booking among pregnant women attending Kade Government Hospital remains below the recommended level. Both socio-demographic characteristics and health system factors significantly influence the timely initiation of ANC. Strengthening maternal health education, improving the quality and efficiency of ANC service delivery, and implementing targeted interventions for vulnerable groups are recommended to promote early ANC uptake and improve maternal and neonatal health outcomes.