Factors associated with late antenatal care booking in Zambia

Introduction
In spite of the extreme importance of an early antenatal care visit, more than 50 per cent of Zambian pregnant women book for antenatal care late (ANC booking after 14 gestational weeks). Mothers who attend antenatal care late miss the opportunity to have early detection and prevention of both infectious and non-infectious diseases in pregnancy. The aim of the study was to determine factors associated with late antenatal care booking in Zambia using secondary survey data.
Methods
Firstly, proportions of ANC booking at 0-3 months, 4-5 month and 6-9 months were explored. Secondly, the social-demographic, social-economic, and biological factors associated with late ANC booking were investigated. Lastly the associations between barriers faced by women in accessing medical care and late antenatal care booking were investigated. The outcome variable was late ANC booking and this was compared with predictor variables. A weighted analysis using STATA version 12.0 was used. This involved descriptive statistics which included cross tabulations. Analytical statistics were done using bivariate logistic regression. To control for possible confounders, a multiple logistic regression was applied.
Results
A data set with a total of 3979 women aged 15 to 49 years was analysed. The proportion of ANC booking at 0 to 3 months, 4 to 5 months and 6 to 9 months were 19%, 56% and 25% respectively. Women who wanted their last child later (AOR: 1.35(1.10-1.66)) were more likely to book late than those with wanted pregnancies then. Women with higher education (AOR: 0.45 (CI-0.27-0.74)) were 55% less likely to book for ANC late compared to women with no education. Women aged 20-34 years (AOR: 0.70 (0.50-0.97)) were 30% more likely to book earlier than women younger than 20 years.
Conclusion
The results from the study suggest that women younger than 20 years of age, women with unwanted pregnancies and women with no education were more likely to book for antenatal care late. It is therefore recommended that more women should be educated beyond secondary education; should have access to family planning methods and be able use them