Patterns and factors affecting antenatal care utilization in Damietta Governorate, Egypt: a retrospective cross-sectional study

Background. Timely antenatal care (ANC) has been proven to save lives and maximizes health and potential. The study aimed to assess ANC utilization rates in Damietta district, Egypt and to identify the components of ANC provided and factors affecting utilization rates. Methods. A cross-sectional study was conducted in four Family Health Centers (FHC) in Damietta district. The study included any mother, who gave birth within the last 6 months, after giving written consent to participate. Women were interviewed about their experience with ANC during the last pregnancy using a pre-designed questionnaire. Results. The study found that similar to 85% of the mothers have ever attended ANC during the last pregnancy, two-thirds were regular attendants. Urban residence, being not working, having high education and high family income were positively associated with utilization of ANC (P < 0.001). Only 30% of the mothers received ANC in FHCs, while the majority received ANC at private clinics. Rates of receiving ANC components were variable with significantly higher rates in private clinics than governmental FHCs (P < 0.001 for most components). Health education was the least ANC component to be received by mothers at governmental and private sites. Conclusion. More work is needed to improve the utilization of ANC in FHCs. Providers of ANC should be trained and supervised to provide full package of ANC especially health education message, being the most neglected component of ANC.