Barriers to the utilization of antenatal care services among women attending public health facilities in Elgeyo Marakwet County, Kenya

Abstract

Introduction: Antenatal Care services provide a crucial opportunity for health care practitioners to collect a proper history, perform a physical examination, and create an antenatal profile, which aids in the detection, treatment, early birth preparation, and prevention of impending difficulties. However, impediments to Antenatal Care Service Utilization in Elgeyo Marakwet County are not extensively documented. Objectives: The study's objectives were to investigate the impact of socio-demographic variables, assess the role of expectant women's level of knowledge about ANC services, and assess the influence of women's perceptions on the importance of completing the ANC service in accordance with WHO criteria. Methods: Three health institutions were surveyed using a descriptive cross-sectional quantitative survey design. A total of 358 women who had given birth in the previous year were interviewed using a semi-structured questionnaire with closed and open ended questions. A bivariate analysis was performed to identify the barriers associated with women failing to complete the four ANC visits. The significance of the statistical tests was interpreted using a P value of 0.01. Results: Of the 353 respondents, 174 (48%) had at least four ANC visits, while 10 (3%) had none. The vast majority (170) were between the ages of 20 and 29, however only 84 had four ANC visits. The vast majority (71.7%) were married, and 35% had four ANC. Only 24% had four ANC visits, although the majority (48%) had a secondary education. The majority (203) were working women, however only (100) completed all four ANC visits. The majority (171) were Protestants (84) who completed the four ANC visits, whereas the non-religious were the fewest (5) but still (2). Only (104) attended the public health institution for the first time between 4 and 6 months, while the majority (165) did not. The majority (169) visited ANC 1-3 times, 165 attended 4–6 times, and only 9 attended 7–9 times, with 118 indicating that the facilities were too far away. The majority (86%) were aware of HIV tests, yet 42% had four ANC visits. Concerning predicted difficulties, 91% said yes, and 45% had four ANC visits. Although 62% were aware that heavy bleeding was a warning sign, only 31% had four ANC visits. The majority (91%) were aware of acute danger signals, despite the fact that only 62% had four ANC visits. 82% believed ANC services were necessary, and 40% had four ANC visits. The majority (97%) believed HIV testing was essential, and 48% completed the four ANC visits. The majority (39%) made their first visit between the fourth and sixth months, making completing the four ANC visits impossible, and 53% chose to attend at that time. The majority (42%) stated that pregnant women should attend the ANC clinic three times or less before delivery, therefore 20% had four ANC visits. Because more than half (49%) paid for ANC services, just 24% had four ANC visits. Conclusion: Socio-demographic, women’s level of knowledge was found to have an influence in the utilization of ANC services. Women’s perception though high did not increase the uptake of ANC services. Recommendations: Financial challenges should be addressed by the government in order to increase the ANC uptake. Health education should be conducted in the county to increase awareness and the importance of these services in all health facilities.