FACTORS ASSOCIATED WITH LATE REPORTING FOR ANTENATAL CARE AMONG WOMEN OF CHILDBEARING AGE IN UDI LOCAL GOVERNMENT AREA, ENUGU STATE, NIGERIA

Abstract

Maternal mortality due to pregnancy and childbirth poses a major public health challenge in Nigeria and late reporting for Antenatal Care (ANC) is known to be a contributory factor. However, the reasons for poor utilization of antenatal services are yet to be adequately documented. This study therefore assessed factors associated with late reporting for ANC among women of child-bearing age in Udi Local Government Area (LGA), Nigeria. A two-stage random sampling technique was used to select 450 respondents from three (Ngwo, Udi and Umuabi) out of twelve communities in Udi LGA. The inclusion criteria included registration for ANC and delivery of a life baby in two years preceding the survey. A validated semi-structured questionnaire was used to collect quantitative data. Six Focus Groups Discussion (FGDs) and nine Key Informant Interviews (KIIs) were conducted among respondents. Quantitative data were analyzed using descriptive and Chi-square statistics. The thematic approach was used for analyzing the qualitative data The mean age was 27.7 ± 5.2 years. Most (96.4%) were married and 67.1% were employed. Majority (63.1%) had secondary education. The mean number of antenatal visits was 8.1 ± 4.6. Facilities (4.2%). Forty-one percent booked early while 59.0% registered late. Of the 266 who reported late? 87.2% and 12.8% booked during the second and third trimesters respectively. The major reasons for reporting early included: inexperience (72.3%) and ill health (52.6%). Major reasons for reporting late included: prior experience (95.1%). Perceived sound health (75.8%) and nonchalant attitude (72.8%). The pattern of late reporting by level of education was primary (20.5%), secondary (65.5%) and tertiary (14.0%) (p<0.05). More respondents carrying first pregnancies (54.3%) booked early compared with those with two or more previous pregnancies (p<0.05). the reason for non-compliance with the following visits among 17.1% of the respondents were ‘’feeling wellness’’ (37.3%) and enough experiences from previous pregnancies (62.3%). Respondents’ attitude to early booking was positive as 94.4% agreed that the best time to report for ANC was in the first trimester. The perceived consequences of late booking included: complications (84.4%), poor health outcomes for the baby (58.2%), inadequate planning for delivery (51.6%), and missed opportunity for health education (49.6%). The view of most key informants was that women booked late for ANC due primary to lack of knowledge of the association benefits. Most FGD discussants associated late reporting for ANC with wrong perception of pregnancy and believed that public enlightenment could help in addressing the situation. The high prevalence of reporting late for Antenatal care was due mainly to misconceptions. Health education should focus on promoting early booking for Antenatal care as an indispensible health seeking behavior.