Predictors for Delayed First Antenatal Care Visit in Rural Area of Rwanda: Evidence from Rwanda Demographic Health Survey 2019-2020

<i>Background: </i>Timely commencement of antenatal care (ANC) improves maternal outcomes by reducing complications that often result in death. According to the World Health Organization, 800 women died daily in 2020 from preventable complications related to pregnancy and childbirth, with almost 95% occurring in low and middle-income countries where Rwanda is located. Therefore, this study aimed to determine predictors of delayed first ANC visits in rural areas of Rwanda. <i>Methods: </i>This cross-sectional study utilized the Rwanda Demographic and Health Survey (RDHS) data, enrolling a weighted sample of 5,060 women who had been pregnant within the five years preceding the survey. Logistic regression modeling identified socio-demographic and maternal characteristics associated with delayed first ANC visits. <i>Results: </i>The prevalence of delayed first ANC visits was 40.2%. After adjustment of variables in a multivariate regression model, factors associated with the delays included low wealth index, marital status, maternal age (25-34 and 35-49), having 2-4 or more than 4 children, and occupation. Health insurance coverage was a protective factor against the delays of ANC. <i>Conclusion: </i>The findings highlight the need for interventions at multiple levels to increase timely uptake of the first antenatal care visit, as the study revealed socio-demographic and maternal factors that significantly influence delays in initiating antenatal care.