Abstract

Optimal antenatal care (ANC) plays a pivotal role in promoting maternal health and wellbeing,
a standard healthcare service provided globally to expectant mothers, offering
essential health assessments and guidance throughout pregnancy, childbirth, and early
parenthood. Timely initiation of ANC is crucial, commencing from the beginning of
pregnancy until childbirth. This study aimed to ascertain the timing of the first antenatal
visit, explore associated factors, and determine the proportion of pregnant women
adhering to the recommended schedule when attending antenatal care at Kampala
International University Teaching Hospital in Bushenyi, Western Uganda. A hospital-based
cross-sectional observational and analytical study involved 220 randomly selected
participants from the antenatal clinic. Univariate, bivariate, and multivariate logistic
regression analyses using STATA version 14.0 were conducted to identify factors
influencing the timing of the first antenatal visit. Odds ratios with 95% confidence intervals
were computed at the bivariate level, while adjusted odds ratios were calculated during
multivariate analysis to determine independently significant factors. The mean age of the
participants was 27 years, with a standard deviation of 6 years. The minimum age was 16
years, while the maximum was 41 years. The average timing of the first antenatal visit was
at 18 weeks. Only 31.36% (69/220) of participants adhered to the recommended schedule,
while 68.64% (151/220) initiated ANC later. Factors such as age, marital status, education
level, gravidity, planned pregnancy, attitude towards ANC, perception of health workers'
attitudes, and waiting time were independently associated with the timing of the first
antenatal visit. This study revealed that a significant proportion of pregnant women in the
clinic commenced ANC later than the WHO-recommended period, emphasizing the need to
raise awareness about the optimal timing for ANC initiation. Additionally, factors
contributing to delayed initiation were identified, offering valuable insights for service
providers to focus on when promoting early ANC attendance