Timing of first antenatal care attendance and associated factors among pregnant women in public health institutions of Axum town, Tigray, Ethiopia, 2017: a mixed design study

Background: Timely initiation of antenatal care can avoid pregnancy related problems and save lives of mothers and babies. In developing nations, however, only half of the pregnant mothers receive the recommended number of antenatal care visits, and start late in their pregnancy. Thus, the study was conducted to assess the magnitude of timely initiation of antenatal care and factors associated with the timing of antenatal care attendance in Axum in which studies regarding this issue are lacking. Methods: An institution based cross-sectional study mixed with qualitative approach was conducted. A total of 386 pregnant women were selected using systematic sampling technique for the quantitative study. In addition, 18 participants were selected purposively for the qualitative part. The quantitative data were collected using structured interviewer administered questionnaire while the qualitative data were collected using an open-ended interview guide. Quantitative data were analyzed using SPSS version 22 and the qualitative data were analyzed using Atlas software. Multi-variable logistic regression was used to control the effect of confounders. Results: The magnitude of timely attendance of antenatal care was 27.5% (95% CI: 23-32%). Unintended pregnancy (AOR = 2.87; CI 95%: 1.23-6.70), maternal knowledge (AOR = 2.75; CI 95%: 1.07-7.03), educational status of the women (AOR = 2.62; CI 95%: 1.21-5.64), perceived timing of antenatal care (AOR = 3.45; CI 95%: 1.61-7.36), problem in current pregnancy (AOR = 3.56; CI 95%: 1.52-8.48) and advice from significant others (AOR = 2.33; CI 95%: 1.10-4.94) were found significantly associated with timely booking of antenatal care. Conclusion: The magnitude of timely attendance of antenatal care is low. Educational status, maternal knowledge, unintended pregnancy, problem in current pregnancy, perceived timing of antenatal care, and advise from significant others were the significant factors for timing of antenatal care. Therefore more effort should be done to increase the knowledge of mothers about importance of antenatal care and timely ante natal care booking.