Late initiation of antenatal care and associated factors among women attending Itojo hospital, southwestern Uganda: a facility-based cross-sectional study.

Authors

  • Godfrey Nyesiga Department of Public Health, Faculty of Health Sciences, Bishop Stuart University, Mbarara, Uganda
  • Elizabeth Ninsiima Department of Public Health, Faculty Health sciences, Bishop Stuart University, Mbarara city, Uganda, Department of Clinical Research, SRF Research and Training Centres, Mbarara, Uganda, Department of Clinical Research, Soar Research Foundation, Mbarara, Uganda
  • Jackson Musiime S Department of Public Health, Faculty of Health Sciences, Bishop Stuart University, Mbarara, Uganda
  • Francis Kazibwe Department of Public Health, Faculty of Health Sciences, Bishop Stuart University, Mbarara, Uganda

DOI:

https://doi.org/10.51168/bvfye104

Keywords:

Antenatal care, late ANC initiation, first trimester, maternal health, pregnancy, Uganda, Ntungamo District

Abstract

Background and Objective

Late initiation of antenatal care remains a concern in Uganda. This study determined the prevalence of late ANC initiation and identified factors associated with late initiation among women attending Itojo Hospital, Ntungamo District, southwestern Uganda.

Methods

A facility-based cross-sectional study was conducted among 356 women attending ANC, maternity and labour services at Itojo Hospital. Participants were enrolled consecutively. Data were collected using a structured interviewer-administered questionnaire and analysed using descriptive, bivariate and multivariable methods. Crude and adjusted prevalence ratios (cPRs and aPRs) with 95% confidence intervals (CIs) were estimated, with statistical significance at p<0.05.

Results

Among the 356 women, 109 (30.6%) initiated ANC after 12 weeks of gestation. Late initiation was independently associated with age, education, occupation, travel time and distance from the health facility. Women aged 30–34 years (aPR=1.77, 95% CI: 1.17–2.68) and 40–44 years (aPR=2.90, 95% CI: 1.48–5.68), those with primary education (aPR=3.66, 95% CI: 1.57–8.52), and students (aPR=2.47, 95% CI: 1.09–5.60) had higher prevalence of late initiation. Longer travel time was also associated with higher prevalence. Partner decision-making was associated with lower prevalence (aPR=0.20, 95% CI: 0.11–0.34), whereas family influence and requiring permission to attend ANC were associated with higher prevalence. Perceived facility accessibility (aPR=0.47, 95% CI: 0.32–0.70) and affordability (aPR=0.53, 95% CI: 0.30–0.93) were associated with lower prevalence.

Conclusion

Nearly one in three women initiated ANC late, indicating a substantial gap in timely ANC initiation. The hospital and district authorities should strengthen early pregnancy identification, community education, supportive household involvement and measures addressing physical and financial barriers to ANC.

Author Biographies

  • Godfrey Nyesiga, Department of Public Health, Faculty of Health Sciences, Bishop Stuart University, Mbarara, Uganda

    is a professional soldier who has served since 1996 and has participated in peacekeeping missions in different countries. He has pursued training in public health, including a Bachelor of Public Health and a Master of Public Health. His interests include public health and contributing to health-related research and community wellbeing.

  • Elizabeth Ninsiima, Department of Public Health, Faculty Health sciences, Bishop Stuart University, Mbarara city, Uganda, Department of Clinical Research, SRF Research and Training Centres, Mbarara, Uganda, Department of Clinical Research, Soar Research Foundation, Mbarara, Uganda

    is a Research and Community Engagement Officer at SRF Research and Training Centres (SRF-RTC) in Mbarara, Uganda. She holds a Bachelor of Environmental Science from Makerere University and is pursuing a Master of Public Health at Bishop Stuart University, Mbarara. She has experience in data management, research coordination, qualitative data translation and transcription, and supporting HIV-related programme implementation.

  • Francis Kazibwe, Department of Public Health, Faculty of Health Sciences, Bishop Stuart University, Mbarara, Uganda

    is a Public Health Specialist, Assistant Lecturer at Bishop Stuart University, and Medical Director at Musmush Medical Centre in Mbarara, Uganda. His professional and research interests include public health, health service delivery, quality improvement, healthcare access, and health information systems. His research has included patient flow and quality of care among older adults in outpatient settings in southwestern Uganda, mobile telehealth systems and information accessibility, and the experiences and support needs of doctoral students in southwestern Uganda. He has experience in quantitative and

    qualitative research and contributes to public health teaching, research, and healthcare delivery

References

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Published

2026-10-01

Issue

Vol. 7 No. 3 (2026): September 2026 issue

Section

Section of Obstetrics and Gynecology Research

License

Copyright (c) 2026 Godfrey Nyesiga, Elizabeth Ninsiima, Jackson Musiime S, Francis Kazibwe

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

How to Cite

Godfrey, Ninsiima, E., Jackson, & Francis. (2026). Late initiation of antenatal care and associated factors among women attending Itojo hospital, southwestern Uganda: a facility-based cross-sectional study. Student’s Journal of Health Research Africa, 7(3), 13. https://doi.org/10.51168/bvfye104

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