Publication:

Antenatal care utilization among pregnant women in the third trimester in Wajir East Sub-County, Wajir County, Kenya

Background Antenatal care (ANC) is essential for maternal health, as it facilitates better pregnancy outcomes.  This study aims to examine the determinants of ANC utilization among pregnant women in their third trimester in Wajir East Sub-county, Wajir County, Kenya.

Methods A community-based cross-sectional analytical design across 30 villages and linked health facilities (including Wajir County Referral Hospital) between July 2025 and September 2025, targeting 221 pregnant women in their third trimester.  Systematic sampling was employed to recruit participants, and data were collected using structured questionnaires, of which 216 completed ones were analyzed. Descriptive statistics and logistic regression were used to assess utilization patterns and determinants. Key informant interviews with CHVs and facility staff provided qualitative insights.

Results Third-trimester ANC attendance was low: 26.9% of women reported one visit, 50.5% reported two visits, and only 1.4% attended four or more visits. Major barriers included distance to health facilities (68.1%), lack of transport (51.4%), and financial constraints (28.7%). CHV and family support were key facilitators. Unemployment significantly reduced the odds of adequate ANC utilization (AOR=0.09, p=0.046). College/University education showed a significant association in the bivariate analysis (OR=0.16, p=0.023).

Conclusions Most women attended only one or two ANC visits. Sociodemographic factors, especially education level and household income, had a significant impact on the use of ANC. Distance to health facilities, lack of transport, financial constraints, and cultural norms are major facilitators and barriers to ANC utilization.