Factors influencing uptake of antenatal care in Taita Taveta County, Kenya

Abstract

49% of pregnant women are able to make four or more ANC visits in Sub Saharan part of Africa. General objective of the study was to find out factors influencing uptake of ANC in public health facilities in Taita Taveta County. The specific objectives were; to assess influence of early initiation of ANC on uptake of ANC in, determine influence of skilled health providers’ attitude on uptake of ANC, establish influence of availability of community health volunteers on uptake of ANC and determine effects of skilled health providers’ availability on uptake of ANC. A total of three hundred and eighty four mothers and eighteen health facility in-charges participated in the study. The study adopted survey research design and data collected using structured questionnaires for the sampled mothers and key informant interview for the in-charges. The researcher analysed data using Statistical Package for the Social Sciences (SPSS) version 23. Descriptive analysis (percentages and frequencies) and inferential analysis (Chi-square and Spearman’s correlation tests, and regression analysis at significance level of alpha=0.05) were performed. Results indicated 43.6% of the mothers managed 2 ANC visits, 41.7% 3 visits and14.7% just 1 ANC visit. The findings also indicated that timing of ANC initiation had significant association (X2 (6) = 102.854, p < 0.001) and weak negative relationship (Spearman’s R = -0.201, p < 0.001) with uptake of ANC. An R2 of 0.071 (7%) showed early ANC initiation had low degree of influence on ANC uptake. Reception during ANC visits had significant association (X2 (8) = 564.235, p < 0.001) and strong positive relationship (Spearman’s R = 0.905, p < 0.001) with ANC uptake; and adequacy of privacy had significant association (X2 (8) = 459.447, p < 0.001) and moderate positive relationship (Spearman’s R = 0.763, p < 0.001) with ANC uptake. An R2 of 0.819 (81.9%) showed skilled health providers’ attitude had high degree of influence on ANC uptake. Moreover, number of CHVs visits had significant association (X2 (8) = 317.099, p < 0.001) and high positive relationship (Spearman’s R = 0.870, p < 0.001) with ANC uptake; and CHVs perceived importance had significant association (X2 (8) = 321.872, p < 0.001) and strong positive relationship (Spearman’s R = 0.863, p < 0.001) with ANC uptake. An R2 of 0.784 (78.4%) showed that availability of CHVs had high degree of influence on ANC uptake. Lastly, the results indicated that waiting time had significant association (X2 (6) = 354.829, p < 0.001) and moderate negative relationship (Spearman’s R = -0.745, p < 0.001) with ANC uptake; presence of skilled health providers had significant association (X2 (4) = 668.9, p < 0.001) and strong positive relationship (Spearman’s R = 0.947, p < 0.001) with ANC uptake; and adequacy of sessions had significant association (X2 (8) = 321.872, p < 0.001) and strong positive relationship (Spearman’s R = 0.899, p < 0.001) with ANC uptake. An R2 of 0.920 (92%) showed that availability of skilled health providers had high degree of influence on ANC uptake. The researcher concludes that; pregnant women in the county are knowledgeable about ANC, however initiation is poor; Staff attitude contributes significantly towards improved ANC uptake; Pregnant mothers who have been visited by CHVs initiate ANC in time; Availability of healthcare providers in the right number and mix contribute to improved ANC uptake. The researcher, therefore recommends that County should recruit additional healthcare providers to render better quality ANC services.