Factor Contributing to Late Uptake of First Focused Antenatal Services to Prevent Control Obstetrics Complications among Pregnant Female of Reproductive Age Visiting Murunda Hospital

Abstract

UWUMUREMYI Viateur, ERIC NSENGIMAN and Maurice B Silali

Late utilization of the first Focused Antenatal Care (FANC) services remains a major public health concern globally and in sub-Saharan Africa, contributing to preventable maternal and neonatal morbidity and mortality. In Rwanda, despite improvements in maternal health indicators, limited evidence exists regarding factors contributing to delayed initiation of antenatal carein Rutsiro District, particularly at Murunda District Hospita information remain undocumented. Thus timely need to study factors contributing to late utilization of first antenatal care services among pregnant women of reproductive age attending murunda district hospital. Specifically determine accessibility to the health facility, community participation, socio-economic factors, and lastly evaluate maternal health education contribution to timely antenatal services utilization. A descriptive cross-sectional design using a mixed-methods approach was employed. A total sample size of 152 respondents and 167 with 10% non responses were selected using purposive and census sampling techniques. Data were collected using semi-structured questionnaires, focus group discussions, and key informant interviews. Quantitative data were analyzed using SPSS version 22 through descriptive statistics, cross-tabulations, and inferential analysis, while qualitative data were analyzed thematically.The results on age distribution show that the majority of respondents were aged 20–24 years 52, (31.1%), while the smallest proportion, 28 (16.8%) and was in 3 and significant contribution of chi square 8.21.marital status, the study revealed that 74 (44.3% )of respondents were smarried, only were divorced or separated 15 (9.0%), and 10 (6.0%) were widowed.Results on accessibility majority of the respodents, 58 (34.7%) reported that it was easy, while the least repodents 24 (14.4%) reported having very difficulties to access the facility with significat contribution of P value 0.03 and chisqure of 11.47, Community participartion, the majority of respondents, 68 (40.7%), agreed and 42 (25.1%) strongly agreed, giving a total of 110 respondents (65.8%) who perceived positive community encouragement. Result on Social economic showed majority had registerd to community based insurance to enable free anatenatal services. The study concludes that late utilization of first antenatal care is influenced by a combination of socio-economic, accessibility, knowledge-related, and behavioral factors as explained by the theoretical frameworks. Strengthening maternal health education, improving accessibility, expanding health insurance coverage, and enhancing community-based interventions are recommended to promote timely antenatal care utilization and improve maternal and neonatal health outcomes in Murunda District Hospital.

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