FACTORS INFLUENCING ANTENATAL CARE ATTENDANCE DURING FIRST TRIMISTER AMONG PREGNANT WOMEN UTILISING MOTHER AND CHILD HOSPITAL, AKURE ONDO STATE

Abstract

Maternal mortality is a strong indicator of maternal health. Studies in Nigeria have attributed, high maternal mortality to late antenatal care (ANC) attendance. First trimester (FT) is a critical determinant of pregnancy outcome. However, previous studies have focused more on factor influencing the general ANC attendance without much information on the factors that influence the attendance at FT. Thus, this study was designed to determine the factors influencing ANC attendance during FT of pregnancy at Mother and Child Hospital, Akure, (MCHA), Ondo state. A cross-sectional design which utilised systematic sampling technique was used to select 420 consenting respondents that were registered at MCHA. A pre-tested, semi-structured, interviewer-administered questionnaire was used to collect information on socio-demographic characteristics. 11-point knowledge of ANC and 10-point perception of ANC scale, practice and factors influencing ANC attendance at FT. Knowledge scores of < I 0 and ≥10 were classified as poor and good, and perception scores <8 and ≥8 were classified as poor and good, respectively. Data were analysed using descriptive statistics and Chi-square test at p=0.05. Respondents' mean age was 28.6±4.8 years, while the age of those who attended ANC at FT was 28.2±4.5 years. Most of the respondents (86.0%) were Yoruba, and 96.4% were married. Only 13.3% of the respondents attended ANC at FT, 16.9% at second and 69.8% at third trimesters. More than half (51.0%) of the respondent had tertiary education. Respondents who had good knowledge of ANC at FT were 78.0%. Among FT attendees, 76.8% had good knowledge of ANC at FT as compared to 56.6% of non-FT attendees. Thirty-six percent of the respondents had poor perception. FT attendees (67.9%) had good perception compared to 63.5% of non-FT attendees. Majority (81.7%) of the FT attendees indicated that foetal growth monitoring was essential. Reported reasons for non-utilisation of ANC at FT included previous loss of pregnancy (48.3%), belief that taking herbs is enough during early stage of pregnancy (12.1%) and belief that booking early can cause evil people to notice that one is pregnant (12.1%). Other reasons identified that could influence ANC attendance during FT included high cost of services (33.6%), non-availability of means of transportation (17.2%), and bad attitude of health workers (11.7%). The factors hindering antenatal care attendance during first trimester among women attending Mother and Child Hospital Akure were cost of services, non-availability of means of transportation, bad attitude of health workers, personal and cultural beliefs. Government should intervene in these areas of service cost reduction, subsidised shuttle buses, reorientation of health care workers and public health enlightenment campaign to change negative beliefs.