Evaluating the implementation outcome “acceptability” of the Eight (8) Antenatal Care contacts, and modelling the predictors that determine compliance by women attending Antenatal care clinics in Wakiso district
Authors: Ssemanda Innocent , Brenda Kalembe , Vonje Riri Johnson , Mwengwe Karen , Tukei Okwadi , Ogunbayo Oluseye A 
Published: January 2023

Background

The World Health Organization increased the number of antenatal care (ANC) visits from Four (4) to Eight (8) visits or more, to reduce the exponentiated incidences of preventable deaths of newborns, maternal mortality, perinatal, and stillbirths. Unfortunately, previous studies have indicated that pregnant women are noncompliant and nonadherence to the number of antenatal visits recommended by WHO. Therefore, the study measured the level of acceptability of the Eight (8) antenatal care contacts and determined the predictors’ variable that influenced compliance to 8-ANC visit in women attending ANC in the Wakiso district.

Methodology

This was a hospital-based medical records observational-cross-section study design, that used a multi-stage-stratified sampling technique to collect data from eligible women, Antenatal Progressive examination cards, and ANC registers, after obtaining ethical approval. A questionnaire survey and checklist were used to collect the data on the acceptability of the 8-ANC from January to April 2022. 401 eligible full-term pregnant and postnatal women were invited to participate in the study, and Informed consent was obtained The data collected was cleaned, coded in Microsoft Excel software, and imported into STATA version 15 for analysis. Q-Q-plot and histogram were used to check the normality assumption of the data. Descriptive statistics were reported using a t-test. Aiken Information Criterion (AIC) and Bayesian Information Criterion (BIC) measures were used to select the best fit model, then the inferential statistics were reported after using a generalized leaner for the poison model. The level of significance was set at P < 0.05.

Results

401 eligible full-term pregnant and postnatal women participated in the study, out of which 101(25.2%) were postnatal women 300(74.8%) were full-term pregnant women and they had a mean age of 24.8 years, with an SD of 6.31 years. 193(48.13%) were married while 208(51.87) were not married. The average number of ANC visits a pregnant could accept to complete was 4 contacts. The level of acceptability to complete the 8-ANC visits was 27(6.73%) among the primigravida group at estimate of (-.222, at 95% CI [-.328 -.116], P=0.001), and 19(4.74%) among the multigravida group at estimate of 2.04 %, 95% CI [3.811, 4.184],P-value = 0.001. The predictor variables of the acceptability of 8-ANC visits were health system delay at ANC was .0384%, 95% CI; (-.073, -0343),P-value= 0.003), gestation age at which ANC started.153%, 95%; (-.252 -.054),P-value=0.002). The level of income a woman has2.025%, 95% CI; (3.001 1.047),P-value=0.001), and the level of awareness about the completion of the the8-ANC visit 1.413, 95%, CI; (1.998 3.828),P-value=0.001).

Conclusion

The level of acceptability to complete the 8-ANC visits or more was Low at Kasangati health centre IV, and this was influenced by; health system delay at ANC, high gestation age’(delay to start ANC service), level of income, and lack of awareness about the completion of the 8-ANC visits. These factors should be addressed in the social community to scale-up acceptability to complete the 8-ANC contacts or more. Among full-term pregnant and postnatal women in Wakiso District