“No visible signs of pregnancy, no sickness, no antenatal care”: Initiation of antenatal care in a rural district in Northern Ghana

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dc.contributor.authorKotoh, A.M.
dc.contributor.authorBoah, M.
dc.date.accessioned2019-09-30T08:47:32Z
dc.date.available2019-09-30T08:47:32Z
dc.date.issued2019-07-30
dc.description.abstractBackground Attending antenatal care (ANC) early contribute to better birth outcomes. Studies have shown that many pregnant women in Sub-Saharan Africa do not initiate ANC early (i.e. in the first trimester). This study determined the gestational age of pregnancy at first ANC attendance. It also explored factors that influence initiation of ANC. Methods This cross-sectional study, conducted in Ghana, used mixed methods to collect data from women aged 15–45 years who delivered 6 months prior to the study. Crosstabs, chi-square test and logistic regression were used to analyse quantitative data. Also, 33 participants were engaged in focus group discussions (FGDs). Thematic content analysis was used to develop themes from the data. Results Of the 431 participants, 8.9, 8, 25.4, 45.3 and 10.7% started ANC in the first, second, third, fourth and fifth months of pregnancy respectively. Formal education, employment and number of living children were predictors of initiating ANC early; by 12 weeks of gestation. Women who attained primary, junior high, secondary education and above had 5.6, 57.5 and 163.2 higher odds respectively of initiating ANC in the first trimester compared to women with no education (p ≤ 0.05). Women with two, three and four to nine living children were 4.1, 3 and 3.5 times respectively more likely to access ANC early compared to primigravidae women. However, women with five or more children and primigravidae women are more likely to initiate ANC late; after 12 weeks gestation. The FGD data also show that most of the participants initiated ANC late. Two themes: visible signs of pregnancy and or sickness influence ANC attendance in the first trimester. The themes that explain late initiation of ANC are: healthy, do not value the benefits of early ANC attendance, desire to avoid embarrassment associated with the pregnancy, unplanned pregnancy, indirect cost of accessing ANC and traditional rites and practices.en_US
dc.description.sponsorshipResearch Articleen_US
dc.identifier.otherhttps://doi.org/10.1186/s12889-019-7400-2
dc.identifier.urihttp://ugspace.ug.edu.gh/handle/123456789/32340
dc.language.isoenen_US
dc.publisherBMC Public Healthen_US
dc.relation.ispartofseries19;1
dc.subjectPregnancyen_US
dc.subjectAntenatal careen_US
dc.subjectFirst trimesteren_US
dc.subjectSecond trimesteren_US
dc.subjectTraditional ritesen_US
dc.subjectGhanaen_US
dc.title“No visible signs of pregnancy, no sickness, no antenatal care”: Initiation of antenatal care in a rural district in Northern Ghanaen_US
dc.typeArticleen_US

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