Determinants of early antenatal care booking in Kisumu, Kenya: A hospital-based cross-sectional study applying the Andersen-Newman health service utilization model.

Abstract

Starting antenatal care early is important for healthy pregnancies. In 2016, the World Health Organization updated its antenatal care guidelines, recommending that pregnant women begin antenatal care by 12 weeks of gestation. Kenya adopted this model in 2022, yet only 29% of women initiate antenatal care early, compared with 37.5% in Sub-Saharan Africa. This study used a cross-sectional design to examine the proportion of women who booked antenatal care early and the factors associated with early booking. The study used Andersen-Newman's health services utilization model as its conceptual framework. A sample of 292 women was selected through systematic random sampling at Jaramogi Oginga Odinga Teaching and Referral Hospital in Kisumu, Kenya. Data was collected using questionnaires and the Kenya Mother and Child Health Handbooks. Analyses included descriptive statistics, the Mann-Whitney U test, the chi-square test, and multivariable logistic regression. The median time to booking antenatal care was 20.0 weeks (IQR: 16.0-24.0), and only 34.2% of women booked early. The most significant predictor of early antenatal care booking was receiving information from healthcare providers (AOR = 1.96; 95% CI: 1.06-3.71; P = 0.036). This study recommends improving healthcare providers' messaging to address social influences from family and friends and to encourage early ANC booking.