Healthcare Service Delivery Factors Influencing Uptake of Four Plus ANC Visits Among Mothers Attending MCH/FP Clinic at Rachuonyo South Sub County Hospital, Homabay County, Kenya

Background: Antenatal care (ANC) is crucial for ensuring maternal and child health, yet many women in Kenya do not attend the recommended four or more ANC visits. Socio-demographic factors, such as age, marital status, education, and employment, alongside healthcare service delivery, influence ANC utilization. This study investigates these factors and explores their impact on ANC attendance in a selected community. Methods: An analytical cross-sectional design was used, combining quantitative and qualitative methods to gather data from 319 mothers who attended ANC clinics at a public hospital between March and May 2024. Systematic random sampling was employed. The quantitative data were analysed using SPSS v29, while qualitative data were analysed thematically. Ethical approval was obtained, and statistical significance was set at p<0.05. Results: The study revealed that 53.9% of the respondents achieved four or more ANC visits. Regarding healthcare service delivery, service providers’ attitude (p=0.05) was significantly associated with the uptake of four plus ANC visits, while factors such as the place of ANC service (p=0.87), transport means (p=0.10), and payment for services (p=0.06) were not significantly linked. Conclusions: This study highlights that socio-demographic factors like age, marital status, education, and employment significantly influence ANC attendance. Additionally, healthcare service delivery, especially provider attitudes, plays a critical role. To improve maternal health outcomes, interventions should focus on addressing socio-demographic barriers and enhancing service delivery, including improving provider attitudes and ensuring better access to quality ANC services for all mothers.