Factors associated with obstetric ultrasound screening behavior during antenatal care at public health centers in Palu City

Antenatal screening by general practitioners in primary care using basic obstetric ultrasound aims to identify suspected pathological cases early. Early detection allows for timely intervention, potentially preventing complications. This study analyzed factors related to the knowledge, attitudes, and practices of pregnant women utilizing ultrasound for antenatal care in Palu City. A mixed-methods study with a quantitative approach was conducted on 380 pregnant women from 14 public health centers in Palu City using proportional random sampling with pregnant women and Maternal and Child Health (MCH) program officers at the Palu Health Office. Quantitative data were collected using a structured questionnaire that was adapted and modified from existing literature. Researchers visited mothers’ homes to obtain information on socio-demographic factors, obstetric history, and knowledge and attitudes towards obstetric ultrasound scans. For the qualitative study, researchers conducted observations and in-depth interviews to explore sources of information about ultrasound, as well as knowledge, attitudes, practices, and barriers related to obstetric ultrasound during antenatal care. Bivariate and multivariate logistic regression were used to identify associated factors. The study found that 70.8% of pregnant women had good knowledge about obstetric ultrasound, and 77% had positive attitudes. Ultrasound was accessed by 55.4% of women on their first visit (K1) and 57.0% on their fifth visit (K5). Significant factors associated with knowledge included having a bachelor’s degree or higher (AOR 2.70; 95% CI 0.21-35.23), being a government employee (AOR 3.901; 95% CI 1.92-7.90), and previous exposure to ultrasound (AOR 1.966; 95% CI 1.24-3.12). Factors significantly associated with the practice of ultrasound screening were higher education (AOR 3.17; 95% CI 0.54-21.20), government employment (AOR 4.53; 95% CI 1.17-15.18), good knowledge (AOR 3.71; 95% CI 1.71-11.23), and positive attitudes (AOR 11.07; 95% CI 2.09- 17.20). Educational level, occupation, and previous exposure to ultrasound significantly influenced knowledge about obstetric ultrasound. The practice of ultrasound screening was significantly associated with education level, occupation, knowledge, and attitudes.