Factors associated with timely initiation of antenatal care among reproductive age women in The Gambia: a multilevel fixed effects analysis

Silas Selorm Daniels-Donkor; Agani Afaya; Dennis Bomansang Daliri; Timothy Tienbia Laari; Solomon Mohammed Salia; Mabel Apaanye Avane; Richard Adongo Afaya; Vida Nyagre Yakong; Martin Amogre Ayanore; Robert Kaba Alhassan

doi:10.1186/s13690-024-01247-y

Factors associated with timely initiation of antenatal care among reproductive age women in The Gambia: a multilevel fixed effects analysis

Arch Public Health. 2024 May 17;82(1):73. doi: 10.1186/s13690-024-01247-y.

Affiliations

¹ School of Health Sciences, University of Dundee, Dundee, Scotland, UK.
² Department of Nursing, School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana. aagani@uhas.edu.gh.
³ Department of Global Health, School of Public Health, University for Development Studies, Tamale, Ghana.
⁴ Presbyterian Primary Health Care (PPHC), Bolgatanga, Ghana.
⁵ Department of Nursing, School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana.
⁶ Department of Preventive Health Nursing, School of Nursing and Midwifery, University for Development Studies, Tamale, Ghana.
⁷ Department of Midwifery and Women's Health, School of Nursing and Midwifery, University for Development Studies, Tamale, Ghana.
⁸ Department of Health Policy Planning and Management, Fred N. Binka School of Public Health, University of Health and Allied Sciences, Ho, Ghana.
⁹ Centre for Health Policy and Implementation Research, Institute of Health Research, University of Health and Allied Sciences, Ho, Ghana.
¹⁰ University of Dundee, Scotland United Kingdom, Dundee, Scotland, UK.

Abstract

Background: A significant factor impacting the incidence of maternal and neonatal fatalities is the timely initiation of antenatal care (ANC) services in healthcare facilities. Despite the recommendations by the World Health Organization and the numerous benefits of timely initiation of ANC, studies have revealed that the overall prevalence of timely ANC initiation in 36 sub-Saharan African countries remains low and women in The Gambia also initiate ANC late. However, no known study in The Gambia has focused on assessing the factors associated with timely initiation of ANC at the time of writing this paper. Thus, this study aimed to assess the prevalence and factors associated with the timely initiation of ANC among reproductive-age women in The Gambia.

Methods: A cross-sectional survey design was used in this study and conducted among 5,734 reproductive-age women using data from the 2019-2020 Gambia Demographic and Health Survey (GDHS). Using STATA version 14.0, we conducted the analysis using descriptive and inferential statistics. Multilevel logistic regression models were fitted to determine the factors associated with timely ANC utilization and adjusted odds ratios were used to present the results with statistical significance set at p < 0.05.

Results: The overall prevalence of timely initiation of ANC services among reproductive-age women in The Gambia was 43.0%. We found that women aged 30-34 [aOR = 1.79, 95% CI = 1.30-2.47], those who were married [aOR = 2.69, 95% CI = 1.85-3.90] as well as women from the richest households [aOR = 1.63, 95% CI = 1.20, 2.20] had higher odds of seeking timely ANC services as compared to their counterparts. Also, those who had given birth to two children [aOR = 0.74, 95% CI = 0.6 -0.91] had lower odds of initiating timely ANC as compared to those who had given birth only once. Women who reside in rural areas [aOR = 1.72, 95%CI = 1.34, 2.20] also had higher odds of seeking timely ANC services than those residing in urban areas.

Conclusion: Individual-level factors such as maternal age, marital status, parity, wealth status, place of residence, and religion were associated with the timely initiation of ANC services among reproductive-age women. These factors ought to be considered in efforts to increase the timely initiation of ANC among reproductive-age women in The Gambia.

Keywords: Antenatal care; GDHS; Reproductive-age women; The Gambia.