Determinants of Antenatal Healthcare Services Utilisation: A Case of Dodoma, Tanzania

Abstract

Background: Antenatal Care (ANC) coverage is a key determinant of maternal and perinatal morbidity and mortality. Low utilization of ANC services and high Maternal Mortality Ratio (MMR) have been reported in the East African Region. Due to the paucity of information on the determinants of ANC utilization in this region, we conducted the study aiming at exploring factors influencing the utilization of ANC services. We further sought opinions that will aid the improvement of utilization of ANC services.
Methods: A triangulation mixed-method study was conducted in August 2021 among forty-five women and ten healthcare providers in a selected health center located in Dodoma Urban District, Tanzania. Information was gathered using semi-structured questionnaires and in-depth interviews. Quantitative data were analysed using IBM SPSS Statistics. The relationship between the outcome variable and the predictor variables was assessed by either the Chi-square test or Fisher’s exact test and a p value<.05 was considered statistically significant. Manual thematic analysis was used for qualitative data after thorough transcript and documentary reviews.
Results: Almost half (48.9%) of the interviewed women attended ANC services at least once during their last pregnancy. Women who reported having a low income and those who spent more than an hour reaching the health facility had poor ANC attendance (p value<.05). The main themed factors that negatively impacted ANC utilization included cultural practices and gender norms, poor communication between partners, and long waiting time at the ANC clinics.
Conclusion: Utilization of ANC services was found to be low among women living in Dodoma Urban District. ANC attendance varied with the level of income and the time women spent reachingt the health facility. Cultural practices and gender norms, communication between spouses, and service waiting time were mentioned to influence ANC attendance.
Recommendations: Public and private sectors should invest in maternal health, provide affordable services and formulate strategies to improve the accessibility of ANC services. Interventions should target women of low socio-economic class and those living in remote areas. Moreover, schemes to address the sociocultural barriers to ANC utilization need to be formulated.