Determinants of focused antenatal care service uptake among women of reproductive age in Sirisia sub county ,Bungoma county, Kenya

Abstract

Women's health is a good predictor of a country's overall economic health and well-being. Maternal health is strongly linked to neonatal survival. For every woman who dies, almost thirty others sustain lasting damage. Focused prenatal care is one of the therapies used to reduce maternal morbidity and death. The study's overall purpose was to investigate the factors that influence the uptake of specialized prenatal care services among pregnant women in Sirisia Sub- County, Bungoma County, Kenya. The study used a cross-sectional descriptive design to investigate the uptake of FANC among pregnant women in Bungoma County. The target group for this study was women who had given birth in the last two years in Sirisia Sub-County. The sample size was 323 participants who delivered within the last two years. Data was analyzed using SPSS version 26, and the chi-square test was used to assess the association between variables and content analysis for qualitative data. A piloted questionnaire was used to collect quantitative data, while a Focused Group Discussion (FGD) guide was utilized to obtain qualitative data. The findings showed that 103 (31.9%) were between 21-30 years, 276 (85.4%) were in marital union, 185 (57.3%) had secondary level of education, 112 (34.7%) were self-employed, and 98 (30.3%) had between 1-2 births. More than half 183 (56.7%) had initial prenatal care attendance between 4-6 months, 202 (62.5%) had four or more ANC visits with 5 (1.5%) and 85 (26.3%) had one and three visits respectively. The utilization of WHO recommended four FANC services reduced with increase in respondents age from 39(65.0%) to 38(60.3%) among respondents 20 years and below and above 40 years respectively. Uptake of FANC services was higher among married 125(67.6%), respondents affiliated to Christianity faith 47(70.1%), formally employed 176(63.8%), and with between 1-2 births 66(67.3%). The uptake of recommended FANC services was higher 146(62.7%) among respondents who agreed that there was a sense of well-being experienced when attending FANC, further analysis showed that likelihood was 5.8 times likely to utilize recommended FANC services, and women who agreed to attend recommended FANC services to identify pregnancy issues early on were 72(62.6%). Marital status (ꭓ2=4.674, df=1, p=0.031), level of education (ꭓ2=19.096, df=3, p=0.0001), agreeing there is a sense of well-being experienced when attending FANC (OR=5.810; 95% CI=1.921-36.674; p= 0.017), FANC visits alleviates worries about pregnancy and its outcome (OR=2.425; 95% CI=1.165-9.623; p= 0.041), completing FANC visits reduces risk of pregnancy-related complications (OR=5.011; 95% CI=2.001-10.210; p= 0.003), the considerable distance to the health facility during pregnancy hinders my access to FANC services (ꭓ2=56.109, df=2, p=0.0001), and the poor terrain makes traveling to the FANC clinic uncomfortable (ꭓ2=77.610, df=2, p=0.0001) were significantly associated with uptake of FANC services. The county health team and hospital administrators should organize quarterly ANC outreaches to improve mothers' skills and knowledge, establish delivery champions, increase awareness, adopt group ANC, and integrate CHW and HCW services into a single package.