Abstract
Introduction
Maternal mortality and child mortality are two major public health concerns. To address maternal and child mortality, the World Health Organization (WHO) 2006 recommended that all pregnant women receive antenatal care (ANC) at least four times during their pregnancy, within the first contact scheduled to take place in the first trimester (before 12 weeks), with regular visits on a schedule with healthcare providers. This approach can reduce the risk of death in mothers and children. Despite this, delays in ANC visits are still a problem for low- and lower-middle-income people in South Asian countries, including Cambodia. In the past, limited research has been conducted in Cambodia regarding the factors affecting the delayed timing of first ANC attendance among pregnant women (PW) living in Peri-Phnom Penh. Therefore, this study aims to determine the prevalence of and factors associated with delayed antenatal care visits among PW receiving ANC services at the Health Center in Phnom Penh, Cambodia.
Methods
A cross-sectional study was conducted at the Kriang Thnong Health Center in Phnom Penh via systematic random sampling to select PWs from the ANC register book between August and September 2023. In total, 315 pregnant women were included in the analysis. The data were subsequently re-entered into an Excel sheet, which was then, exported to STATA 14.2 for statistical analysis. Descriptive statistics were used to calculate the frequency and percentage of categorical variables. The chi-square test was used to identify factors associated with delayed first ANC, and a p value < 0.05 was considered statistically significant.
Results
Overall, 10.5% (33/315) had delayed first ANC visits. Approximately 133 pregnant women were checked for hemoglobin (anemia), HIV, STIs, and malaria. The findings indicated that 45.1% of the PW had anemia, and 5.3% of them were positive for STIs. Compared with older women, PW women were likely to have a greater percentage of delayed first ANC visits if they were aged younger than 20 years (11.6%) or 21--29 years (14.9%) (p value =0.011). Pregnant women who reported having a first child had a significantly higher percentage delayed first ANC visits (15.6% vs 3.7%) compared to those who had children more than two (p value = 0.001). A significantly higher percentage of PWs who reported having an abortion had delayed first ANC visits (14.6% vs. 2.0%) than did those without an abortion history (p value = 0.001).
Conclusion
Most pregnant women start their first antenatal care in the first trimester (before 12 weeks of gestational age). Women who were young and who had a first child were identified as having delayed first ANC visits. The provision of health education on the importance of attending the first ANC visit as per the WHO recommendations and strengthening women’s ANC visits and overall health within the community is recommended, particularly among younger women.