Socio-cultural determinants of first trimester antenatal care(anc) visits in Kalabo district,Zambia

Globally, more than 50% of pregnant women attend antenatal care in the first trimester
in most developed countries. However, in developing countries, less than 50% of
pregnant women do so. Timing of the first antenatal care visit in the first trimester is
important because it allows for sufficient time to identify and treat problems such as
anemia, malaria, HIV and STIs. The objective of the study was to establish the sociocultural
determinants of first trimester antenatal care visits in Kalabo district of
Western Province in Zambia.
We used a mixed-methods approach. The convergent parallel design was employed. A
cross sectional study was used in the quantitative approach while the qualitative one
used a case study. A sample of 454 pregnant women aged between 14 and 49 years
were selected for interviews through multi-stage cluster sampling and three focus group
discussions were held. The quantitative data was analyzed through multiple logistic
regression using STATA version 14 while thematic analysis was used in the qualitative
approach.
The first trimester antenatal care attendances are still very low at 34.6%. Socio-cultural
determinants related to awareness of the right time to attend ANC (first trimester) and
marital status were found to be highly associated with First trimester Antenatal care.
Awareness was found two times more likely being associated with antenatal attendance
in first trimester among women (AOR =2.03, CI=1.50—4.48, P-Value=0.004) and
married women were 2 times more likely to attend ANC in the first trimester
(AOR=2.59, CI=1.17-3.54, P Value=0.019). Women also described their not being sure
about the existence of the pregnancy in the earliest stages as a factor hindering them to
attend ANC early. Cultural beliefs and practices, lack of male involvement, fear of HIV
testing, age, marital status, and age of partner, distance and health status, decision
making challenges, economic problems were also described as barriers to first trimester
ANC initiation.
The proportion of first trimester antenatal care attendances is still very low being
affected by mostly the socio-cultural factors. The study has implications for
strengthening health education on the timing of antenatal care and provision of
community –based pregnancy test kits in rural communities.