Factors Associated with discontinuing Four Antenatal Care Standard Visits in Musanze

Abstract

Nizeyimana Fidele, Jean Marie Vianney Nkurikiyintwali, Singirankabo Vital, Mutabazi Placide, Muhammad Akram, WalaaFikry Elbossaty, Nderelimana Olivier

Background: Antenatal Care (ANC) service for pregnant women by trained health professional improve maternal and new born health outcome. It is one of the most significant means taken by the state to reduce deaths in mother and fetus.Rwanda has followed the 2001 WHO model of 4 focused ANC visits for pregnant women without past and current complications. A total of 98% women attend at least one ANC visit. However, only 47 % complete 4 ANC standard visits and 56% of women go for their 1st visit before the 4th month of pregnancy.

Objective: To determine factors contributing to low level of attending the fourth Antenatal Carestandard visits.

Materials and methods: The cross-sectional and quantitative study was conducted in Musanze health center and its catchment area. The study enrolled 8 health providers and 67 pregnant women who completed 4 ANC standard visits or who failed to attend the 4th ANC visit in the study period. Study participants were recruited using a purposive sampling technique.The multivariable logistic regression model was applied by the backward elimination stepwise method to evaluate the association between dependent and independent variables.

Findings:The study showed seven factors associated with discontinuing four standard ANCvisits. The respondents who had not been visited by a CHW were 2.6 times more likely not to complete four standard ANC visits as compare to their counterparts. The variable of not being visited by CHW was statistically significantly associated with discontinuing 4 standard ANC visits.The variable outlining the reasons of not completing 4 ANC standard visits reported two factors which are strongly associated with discontinuing 4 ANC standard visits. These include the respondents who reported lack of knowledge on the role of attending ANC service and the respondents who thought that doing one or two visits was enough.

Conclusion: Modifiablefactors like pregnant mothers who were not visited by CHW, pregnant women who were not reminded the day of ANC appointment, lack of knowledge on the role of doing ANC, thinking that one or 3 visits was enough and mothers who delivered before the last ANC appointment were factors significantly associated with not achieving 4 standard ANC visits.

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