Predictors of Delayed Antenatal Care Initiation in a Rural District of Ghana: Insights from a Cross-Sectional Study

Aim: Pregnancy complications significantly affect health, making timely antenatal care (ANC) essential for early detection and skilled delivery. Despite WHO guidelines, some pregnant women in Ghana's Offinso North District delay their first ANC visit. This study explored intrapersonal and interpersonal factors contributing to this delay. Methods: Conducted from October 2021 to March 2022, this institutional cross-sectional study collected data from 397 pregnant women through a structured questionnaire. Descriptive and inferential statistical analyses were conducted with SPSS version 20. Results: Approximately 47% of pregnant women booked their antenatal care late. Key personal reasons hindering early ANC initiation included financial constraints, busy schedules, and insufficient knowledge about early ANC. Interpersonal barriers included pregnant women’s difficulty in initiating antenatal care (ANC) on their own, inadequate support from partners and family, and a lack of information about the importance of ANC in the media. Lower educational attainment (AOR = 1.86, 95% CI [1.13, 3.08], p = 0.016), lower income levels (AOR = 2.42, 95% CI [1.00, 5.85], p = 0.049), lack of knowledge about early ANC (AOR = 0.59, 95% CI [0.36, 0.99], p = 0.045) and busy schedules (AOR = 0.09, 95% CI [0.05, 0.17], p < 0.001) were significant predictors of late ANC initiation. Conclusion: The study identifies a high prevalence of delayed antenatal care (ANC), primarily linked to educational and income levels, with financial constraints, demanding schedules, and insufficient knowledge as major contributing factors. Recommendations: To improve early antenatal care (ANC) uptake and health outcomes, targeted interventions such as financial support and ongoing health education through outreach are crucial. Future research should evaluate the long-term effects of these interventions and explore additional support mechanisms.