Socioeconomic and regional predictors of antenatal care contact frequency among ever-married somali women with recent pregnancies

Antenatal care (ANC) is critical for preventing complications and reducing maternal and child mortality. Apart from essential services, such as hypertension treatment and HIV testing, ANC provides women with preventive healthcare, including tetanus vaccinations, advice on healthy pregnancy practices, warning signs, and social and emotional support. This study evaluated the factors associated with the number of ANC contacts among ever-married women with recent pregnancies in Somalia. This cross-sectional study used data from the 2020 Somalia Health and Demographic Survey. This study included 8,909 women aged 15–49 years who met the inclusion criteria. Count regression models were used to examine factors associated with the number of ANC contacts among ever-married women with recent pregnancies in Somalia, and Incidence Rate Ratio (IRR) with 95% CI were reported. In this study, 67.96% of women had no contact with ANC during their last pregnancy. Zero-inflated Poisson (ZIP) regression model was obtained to be the best fit. According to this model, women with secondary education (IRR = 1.21, 95% CI 1.03–1.42) and higher education (IRR = 1.27, 95% CI 1.08–1.48) had more ANC contacts than women with no formal education. Being in the highest wealth quintile (IRR = 1.27, 95% CI 1.09–1.49) was also associated with increased ANC contacts. Living in certain regions was associated with the number of ANC contacts. In the zero-inflated section, maternal age, education, region, media exposure, and wealth index emerged as key predictors of ANC utilization in Somalia. Many ever-married women with recent pregnancies did not receive any ANC, and socio-demographic factors such as educational level, maternal age, wealth index, place of residence, media exposure, and region were significantly associated with the number of ANC contacts in Somalia. Implementing initiatives based on these findings and developing public health strategies on promoting a culture of increased ANC utilization could improve maternal and child health outcomes.