Abstract:
Introduction: The time of antenatal care initiation determines the women’s and children’s
health later in life. Early antenatal care visit is important for ensuring optimal care and health
outcomes for women and children. In the study area, there is lack of information about the
time to initiation of antenatal care and its predictors among reproductive age women.
Objective: To assess the time to initiation of antenatal care visit and its predictors among
pregnant women who delivered in Arba Minch town public health facilities.
Methods: An institution-based retrospective follow-up study was done. A systematic random
sampling technique was employed to select the study participants. The data were collected
using Kobo collect and downloaded into an excel sheet and transferred to Stata 14 for data
cleaning and statistical analysis. The Kaplan-Meier survival curve was used to estimate the
survival time and Log-rank tests was used to compare the survival probabilities. Bivariable
and multivariable Cox proportional hazard regression models were fitted to identify
predictors of the time to initiation of antenatal care. Adjusted Hazard Ratio with 95%
confidence intervals was used to assess the strength of association and statistical significance.
Result: The median survival time to antenatal care initiation was 18 weeks; with 95% CI =
(18, 19) among woman who delivered in Arba Minch town public health facilities. Urban
residence (AHR = 2.67; 95% CI = 1.52, 4.71), Tertiary and above level of education of the
women (AHR = 1.90; 95% CI = 1.28, 2.81), having pregnancy-related complications in
previous pregnancy (AHR = 1.53; 95% CI = 1.08, 2.16), not having antenatal care for
previous pregnancy (AHR = 0.39; 95% CI = 0.21, 0.71) and unplanned pregnancy (AHR =
0.66; 95% CI = 0.48, 0.91) were statistically significant predictors.
Conclusion: About half of the women start their first antenatal care visit after 4.2 months
which is not in line with the recommendation of the World Health Organization, which is
before three months. Urban residence, tertiary and above level of education of the women,
having pregnancy-related complications in previous pregnancy, not having previous antenatal
care visit and unplanned pregnancy were predictors of the time to initiation of antenatal care.
Intervention is needed on women who are less educated and live in rural area and health
education on family planning is necessary to prevent unplanned pregnancy.
