Timing of first antenatal care attendance and associated factors among pregnant women in an obstetric health facility in eThekwini district, KwaZulu-Natal Province, South Africa

Abstract

The purpose of the study was to determine timing of first antenatal care attendance and associated factors among pregnant women in an obstetric health facility in eThekwini district, KwaZulu-Natal Province, South Africa. A Midwives’ Obstetric Unit forms a section of the Cato Manor Primary Health Care clinic that is responsible for providing maternal and childcare services, which include antenatal, intrapartum and postnatal care to women from socioeconomically disadvantaged community living in informal settlements. In South Africa, despite the widespread availability of free antenatal care (ANC) services, most women in underprivilleged settings present late for their first antenatal care and fail to return for ANC follow-up, potentially leading to perinatal and maternal complications. Using a crosssectional survey design, data was collected from 329 pregnant women attending ANC in a Midwives’ obstetric unit at Cato Manor Primary Health Care Clinic in eThekwini District, KwaZulu-Natal. Late booking was a challenge in the primary health care clinic. There was no evidence of association between late ANC booking and most demographic variables except one (planning of pregnancy). This highlights the importance of assisting all women to have their pregnancies planned. The number of pregnant women that initiate ANC before 12 weeks (40-50%) and the few women that still initiate ANC after 24 weeks (less than 10%) suggest an improvement in the trends of timing of ANC bookings for the rural women. There is a need to intensify community awareness programmes and social mobilisation in order to educate pregnant women about the importance of early booking at the ANC (10-12 visits) as stipulated in the guidelines of the Basic Antenatal Care approach (BANC).

Keywords: Antenatal care, timing of first attendence, accessibility, primary health care