Exploring factors associated with first antenatal care booking among pregnant women in Northwestern Tanzania

Objectives: Pregnant women are advised to schedule their initial antenatal care (ANC) visit during the first trimester to detect and treat any medical issues as well as screen for risk factors that may affect the course and outcome of their pregnancy. Nonetheless, delayed first ANC presentation is typical, especially in Sub-Saharan Africa. This study sought to determine the timing of the first ANC booking and identify factors that influence the first ANC booking among pregnant women. Material and Methods: This was a cross-sectional study which was carried out from June–August 2023. Data were collected using a structured questionnaire. Data analysis was done using Epi Info 7.2 and STATA version 15.0 software. Independent factors for the first ANC booking were determined by multivariate logistic regression analysis using odds ratios, 95% confidence intervals, and a P -value cut-off of ≤0.05. Results: A total of 402 pregnant women were recruited for the study. The bulk of participants, 189 (47.0%), were between 25 and 34 years. More than half 279/402(69.4%) of the pregnant women booked their first ANC appointment beyond 12 weeks of gestation. The married pregnant women had almost four-fold booking ANC earlier compared to single women (adjusted odds ratio [AOR] = 3.9, 95% confidence interval [CI] = 1.1–14.4, P = 0.036). Similarly, employed pregnant women were 2.8 times more likely to book their first ANC visits earlier as compared to self-employed women (AOR = 2.8, 95% CI = 1.3–5.8, P = 0.006). In addition, women receiving support from their family or partner were more likely to book their first ANC as recommended compared to those lacking such support (AOR = 0.5, 95% CI = 0.3–0.9, P = 0.022). Finally, those who planned pregnancy were 2 times more likely to book their first ANC visit within the recommended time, unlike those who did not (AOR = 2.3, 95% CI = 1.3–2.1, P = 0.03). Conclusion: Despite the known benefits of early antenatal appointments, many pregnant women delay their first visit, highlighting the need for targeted policies to address socioeconomic barriers and improve health-care access, thus encouraging timely ANC bookings and better maternal health outcomes.