Determinants of Eight Contacts Antenatal Care Uptake Among Prenatal Mothers in Changamwe Sub-County Mombasa, Kenya

Abstract

The purpose of this study was to assess the determinants influencing ANC uptake among prenatal mothers in Changamwe, Mombasa, Kenya. The study was based the following objective; to assess how quality ANC services influence ANC uptake among pregnant women in Changamwe Sub-County. The study was anchored on the Expected Utility (EU) Theory and Theory of Planned Behaviour (TPB). A mixed-method research design incorporating both qualitative and quantitative approaches was employed. The target population included postnatal mothers attending maternal child health clinics in public health facilities and maternal child healthcare clinic nurse managers as key informants. A total of 370 mothers and 4 nurse managers participated in the study, selected using stratified and simple random sampling techniques. Data collection involved structured questionnaires for mothers and key informant interviews with nurse managers. Descriptive statistics were used to summarize the findings, while correlation and multiple regression analyses assessed relationships between study variables. The results indicated that the quality of ANC services significantly influenced ANC uptake. Specifically, the quality of ANC services was another significant predictor (β = 0.42, p = .003), emphasizing the importance of service quality in encouraging ANC visits. Based on the findings, the study recommends Enhancing ANC service quality through respectful care, skilled provider training, and ensuring reliable supply chains for ANC commodities is also advised. Addressing health need-related barriers by promoting early screening for pregnancy complications and increasing maternal health literacy is crucial. Additionally, re-evaluating the role of community health care workers through targeted training, supervision, and structured home visit and referral frameworks is necessary. Implementing broad community sensitization campaigns to boost awareness and dispel myths surrounding ANC, adopting digital health tools to track ANC appointments and facilitate timely maternal care interventions, and encouraging further research on community health care workers effectiveness in ANC promotion within varied contexts are also recommended. These recommendations underscore a need for multi-level interventions— ranging from household empowerment to service delivery improvements to increase ANC uptake and ultimately reduce maternal and neonatal morbidity and mortality.