Antenatal care in Meghalaya – An Uphill Battle: A Community-based Study of Drivers and Barriers of Antenatal Care Utilization

Abstract Background: Antenatal care (ANC) is essential to providing holistic care for health promotion, preventive health services, and the overall wellbeing of pregnant women. Material and Methods: To assess the ANC utilization and identify influencing factors among mothers in Meghalaya. A cross-sectional quantitative study was conducted in an aspirational district of Meghalaya. 360 mothers over 18 years old who gave birth in the past 12 months, selected through a multistage sampling technique. This study was conducted from August 2023 to July 2024. Statistical Analysis Used: Data were analyzed using SPSS version 27.0. Bivariate logistic regression was applied at P < 0.05. Results: In this study, 87.2% of mothers attended ANC clinics during their last pregnancy, with 29.4% having four or more checkups and 65.3% registering in the first trimester. Significant factors influencing ANC attendance included women’s occupation, family income, travel costs, distance to the nearest health facility, and satisfaction with ANC services. Women with a monthly income of Rs. 5001–10,000 were more likely to attend ANC visits (adjusted odds ratio [AOR] =34.86). Satisfaction with ANC services also positively influenced attendance, with satisfied women more likely to attend ANC visits (AOR = 7.73). Employed women, particularly farmers, were more likely to attend ANC visits (AOR = 2. 53); high travel expenses (AOR = 0.11) and proximity of nearest health facilities (AOR=0.56) were associated with lower ANC visits attendance. Conclusions: The study highlights that, despite many women registering for ANC, attendance rates remain insufficient. These insights underscore the need to address economic and structural barriers to improve ANC attendance among pregnant women.