Adherence to the recommended timing of focused antenatal care in the Accra Metropolitan Area, Ghana

Abstract

Introduction: the proportion of antenatal attendants in Ghana who had at least four antenatal visits increased from 78% in 2008 to 87% in 2014.
However, it is not known whether these visits followed the recommended timing of focused antenatal clinic attendance in Ghana. We sought to
assess the adherence to the clinic schedule and its determinants in the Accra Metropolis. Methods: a cross-sectional study was conducted.
Face-to-face interviews were conducted with postpartum women. Multiple logistic regression was used in the analysis of determinants of adherence
to the recommended timing of clinic attendance. A p-value of <0.05 was considered statistically significant. Results: among 446 focused antenatal
care clinic attendants, 378 (84.8%) had four or more visits. Among these, 101 (26.7%) adhered to the recommended clinic schedule. Women who
adhered were more likely to have had education up to Junior High School [AOR=3.31, 95%CI (1.03-10.61)] or Senior High School [AOR=4.47,
95%CI (1.14-17.51)], or have history of abortion [(AOR=3.36, 95%CI (1.69-7.96)]. For every week increase in gestational age at booking at the
antenatal clinic, respondents were 34% less likely to complete all four antenatal visits at the recommended times.
[(AOR=0.66, 95% (0.60-0.73)]. Conclusion: majority of women receiving focused antenatal care in the Accra Metropolis have four or more visits
but only about a quarter of them adhered to the recommended clinic schedule. Having high school education, history of abortion and early initiation
of antenatal care were predictors of adherence to clinic schedule. Women should be educated on early initiation of antenatal care to enhance
adherence.