Determinants of antenatal care services uptake among women of reproductive age in Isiolo north sub-county, Isiolo county, Kenya

Abstract

Antenatal care (ANC) is a crucial component of maternal medical care that has a major influence on the outcome of pregnancy. One important tactic for lowering the dangers of pregnancy and delivery is ANC. About 287,000 women lost their lives in 2020, either during pregnancy or after giving delivery. Little is known about the variables driving the adoption of ANC services in Isiolo County, and usage of these programs is still below optimal levels. The purpose of the investigation was to identify the variables influencing the usage of prenatal care services by reproductive-age women in Kenya's Isiolo North Sub-county and Isiolo County. The study's particular goals were to evaluate the adoption of ANC services and investigate the sociodemographic, sociocultural, and health system-related aspects linked to ANC usage. The investigation used a cross-sectional design that combined qualitative and quantitative approaches. Women of reproductive age made up the subject of the investigation population. A multi-stage selection procedure was used to select the research sample, yielding 220 individuals. Purposive sampling was used to conduct focus groups and key informant interviews. Data were collected through researcher-administered questionnaires and key informant interview guides. To ensure validity and reliability, the instruments were pretested and necessary adjustments were made. Ethical guidelines were strictly followed throughout the study. Qualitative data were analyzed using NVivo version 14, while quantitative data were analyzed using SPSS version 29. Data triangulation was performed after analysis. Descriptive statistics such as frequencies and percentages were used to summarize the data. Binary and multivariate logistic regression analyses were conducted to examine the relationship between variables, with p-values less than 0.05 considered statistically significant. The results showed that 75.9% of women utilized ANC services. Most participants were married (n = 157, 71.4%). Over 25% (n = 81, 36.8%) of the participants were aged 18–23 years. Only 16.8% (n = 37) of the participants were employed. More than a quarter (n = 80, 36.4%) had a primiparous parity status. Factors that significantly increased the odds of ANC uptake included age (aOR = 2, 95% CI: 0.143–1.911, p = 0.016), parity status (aOR = 4.5, 95% CI: 0.062–0.794, p = 0.002), pregnancy disclosure (aOR = 2.9, 95% CI: 0.115–0.997, p = 0.04), distance to the health facility (aOR = 2.8, 95% CI: 0.004–0.206, p < 0.001), and patient privacy (aOR = 2.4, 95% CI: 1.086–5.129, p = 0.03). On the other hand, lower education level (aOR = 8.8, 95% CI: 0.953–12.205, p = 0.05) and stigma (aOR = 7.1, 95% CI: 2.731–4.601, p = 0.001) were associated with decreased odds of ANC uptake. The results of the investigation provide insightful suggestions to pertinent parties with the goal of removing obstacles that prevent women of reproductive age from using ANC. The burden of morbidity and death associa