Factors Influencing Late Initiation of First Antenatal Care Services Among Pregnant Women in Kicukiro District, Rwanda 2025

Abstract: Background: Timely initiation of antenatal care (ANC) is essential for preventing maternal and neonatal complications. Despite Rwanda’s progress in maternal health, many women still delay their first ANC visit beyond the recommended 12 weeks of gestation. This study assessed factors influencing the late initiation of the first ANC visit among pregnant women in Kicukiro District, Rwanda, aiming to guide evidence-based interventions for improved maternal and fetal outcomes. Methods: A descriptive cross-sectional study was conducted among 383 pregnant women attending ANC services in Kicukiro District. The sample size was determined using Fisher’s formula. Data were collected through a validated KOBOCOLLECT questionnaire and analyzed using SPSS version 25. Descriptive statistics summarized demographic characteristics, while inferential statistics identified associations between independent variables and ANC initiation timing. Results: The findings revealed that 53.26% of respondents-initiated ANC after 12 weeks of gestation, with 52.48% reporting unplanned pregnancies. Maternal age, partner’s education level, and pregnancy planning status were significantly associated with ANC initiation timing. Women aged 30–34 years were less likely to delay ANC (AOR=0.377, p=0.021), whereas those whose partners had tertiary education were more likely to delay (AOR=3.470, p=0.027). Surprisingly, planned pregnancies were strongly associated with late ANC initiation (AOR=8.451, p<0.001). Other socio-economic factors showed no significant relationship. Conclusion: Late initiation of ANC remains prevalent in Kicukiro District and is influenced by demographic, educational, and pregnancy-related factors. The study recommends intensifying community awareness, strengthening reproductive health education, involving male partners, empowering community health workers in early pregnancy detection, and improving access and quality of ANC services through mobile clinics and financial support programs. These interventions could promote timely ANC initiation and enhance maternal and neonatal health outcomes in Rwanda. Keywords: antenatal care (ANC), ANC services, maternal and neonatal health, health education. Title: Factors Influencing Late Initiation of First Antenatal Care Services Among Pregnant Women in Kicukiro District, Rwanda 2025 Author: Kubwayo Jean Irene, Dr. Rosemary Okova International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Vol. 13, Issue 2, October 2025 - March 2026 Page No: 317-329 Research Publish Journals Website: www.researchpublish.com Published Date: 20-November-2025 DOI: https://doi.org/10.5281/zenodo.17661656 Paper Download Link (Source) https://www.researchpublish.com/papers/factors-influencing-late-initiation-of-first-antenatal-care-services-among-pregnant-women-in-kicukiro-district-rwanda-2025