Food Insecurity Associated with Attendance to Antenatal Care Among Pregnant Women: Findings from a Community-Based Cross-Sectional Study in Southern Ethiopia

Purpose: Enrollment to antenatal care (ANC) is still not universal in Ethiopia. This study examines whether household food insecurity affects antenatal care attendance or not, as well as other factors associated with antenatal care. As optimal antenatal care is vital for the improvement of maternal and child health, the study will contribute to the efforts in improving maternal and child health. Patients and Methods: A community-based cross-sectional study was conducted among 707 pregnant women at or above 3 months of self-reported pregnancy in Southern Ethiopia. Multi-stage sampling was employed to obtain the study units. Data were collected using an interviewer-administered structured questionnaire. Logistic regression analysis was conducted to identify the independent factors associated with study outcome. Results: Out of a total of 707 study subjects, the majority (71%) of the study women visited a health facility for ANC service. The odds of ANC use was lower for women who were not in marital union (adjusted odds ratio (AOR)=0.39, 95% confidence interval (CI)=0.16-0.97), and those from food insecure households (AOR=0.50, 95% CI=0.32-0.79). ANC attendance was higher for women from high socio-economic status (AOR=2.62, 95% CI=1.29-5.29), with planned pregnancy (AOR=1.82, 95% CI=1.16-2.85) and a perceived risk from danger signs (AOR=4.32, 95% CI=1.60-11.67). Conclusion: While the overall ANC use was high, women experiencing food insecurity and those with unplanned pregnancy were having lower odds of ANC attendance among others. Interventions targeting at enhancing women's attendance to ANC service might be realized through commitment from the agriculture, economic, as well as health sectors by increasing productivity and providing special attention to women in the pre-pregnancy and pregnancy period. Moreover, educating women so that they can recognize that every pregnancy is risky and promotion of family planning to reduce unplanned pregnancy could improve attendance to the ANC service.