Factors associated with late antenatal care booking among pregnant women in Ndola,Zambia

Background: The World Health Organization Focused Antenatal care model states that every pregnant woman is at risk of complications and recommends early an ANC visit, of which the first should be during the first 12 weeks of pregnancy. High proportions of pregnant women book for ANC late and are at risk of poor pregnancy outcomes.
Aim: The aim of this study was to determine the factors associated with late antenatal care booking among pregnant women in Ndola District.
Methods: A quantitative paradigm using cross-sectional design was carried out. A simple random sample of 305 pregnant women attending antenatal clinic at seven (7) systematically selected clinics between May and July 2015 was selected. Pretested and structured interview schedule was used to capture information from pregnant women on demographic profile, obstetric characteristics and utilization of antenatal care services. Data from the completed questionnaires were entered into Epidata (2008) and finally analyzed with Stata 10.1. Multivariate logistic regression analysis was carried out to examine factors associated with late antenatal care booking among pregnant women in Ndola Zambia.
Results: Overall (n=305), mean (SD) age was 26.4 (CI, 25.7-27.1). Majority (86.56) of the participants booked for antenatal care after 12 weeks and 13.44% booked for antenatal care before 12 weeks gestation. Maternal age, marital status and parity were associated with late ANC booking. Pregnant women aged 25-29 were 79% (OR=0.21, p=0.039) and 40-44 were 99% (OR=0.01, p=0.010) less likely to book late compared to teenage mothers. Single mothers were 73% (OR=0.27, p=0.034), less likely to book late compared to the reference category married mothers. Pregnant women with 1-2 children, were 3.8 times (OR=3.76, p=0.023) and 3-4 children were 8.2 times (OR=8.19, p=0.48) more likely to book late for ANC compared to the reference group of pregnant mothers without children.
Conclusions: The results from this study suggest that late booking remains significantly high despite availability and free antenatal care services to all pregnant women. Therefore there is need to increase public awareness and enhance the value of early ANC booking.