Determinants of antenatal care service utilization among pastoralist women in Kiteto District, Tanzania.

Abstract

Utilization of antenatal care services is associated with improved maternal and neonatal health outcomes among pregnant women in Kiteto District. A cross-sectional design   was used to examine the association between the independent variables and the outcome variable among targeted population at a single point in time. The Andersen’s Behavioral Model of health services utilization was adopted because it explains why individuals use healthcare services through predisposing, enabling and need based factors. Stratified and simple random sampling was used sample 427 women aged between 15-49 years for the study based on inclusion and exclusion criteria. A structured questionnaire which constituted socio-demographic characteristics, number and timing of antenatal care visits, place of delivery and assistance during child birth was used in this study. The data was analyzed using logistic regression to predict key determinants influencing outcome variable.  The finding shows that 73.3% of the respondents received antenatal care services; among them only 30% made at least four visits during their last pregnancy. This suggests that while initial ANC access is relatively high, structural barriers like distance, cost, or competing demands likely to hinder consistent care utilization throughout pregnancy. The results further indicate that a small proportion (19.2%) had first antenatal care (ANC) visit during the first trimester of pregnancy. The multivariate regression analysis show that being a small business woman (AOR=1.31, 95% CI=0.738-2.334) and urban residency (AOR=2.19, 95% CI=1.219-3.947) encouraged  the antenatal care  utilization while higher parity of ≥4 (AOR=0.523, 95% CI=0.264-1.035) was inversely associated with ANC utilization as compared to women who had  1-3 parity. Similarly, women with primary or above education level were more likely to visit ANC services (AOR=5.591, 95% CI=3.050-9.181) as compared to women who had no formal education. The study recommends that mothers should be educated and made to access skilled health providers for antenatal, delivery and postnatal care to enable early detection of pregnancy complications and allow prompt treatment for a mother and the newborn. Similarly, the study recommends a comprehensive policy interventions including mobile clinics and outreach program to improve antenatal care (ANC) utilization among pastoralist communities.