ANTENATAL CARE UTILIZATION AND ITS EFFECTS ON BIRTH OUTCOMES AMONG PRIMIGRAVIDAS ATTENDING POSTNATAL CLINIC AT KERUGOYA HOSPITAL, KIRINYAGA COUNTY, KENYA
Naomi Jackline Wanjiru - Master of Science in Nursing (Midwifery/Obstetrics), School of Health Sciences of Kenyatta University, Kenya
Dr. Prsicilla Kabue (PhD, RN) - Department of Community and Reproductive Health Nursing, School of Health Sciences, Kenyatta University, Kenya
Elizabeth Kurwa Ambani (MPHE, RN) - Department of Community and Reproductive Health Nursing, School of Health Sciences, Kenyatta University, Kenya
ABSTRACT
Antenatal care (ANC) is essential for reducing maternal and neonatal complications, especially among primigravidas who lack prior obstetric experience. This study examined ANC utilization and its effects on birth outcomes among primigravidas attending the postnatal clinic at Kerugoya County Hospital in Kirinyaga County, Kenya. Using an analytical cross-sectional design, 72 primigravida women were selected through convenience sampling during their six-week postnatal visits. Data were collected using structured interviewer-led questionnaires and reviewed using SPSS version 26. The study assessed individual characteristics, healthcare provider attributes, and system-related factors influencing ANC utilization. Chi-square tests and logistic regression were used to determine the relationship between ANC utilization and birth outcomes. Findings revealed that only 15.3% of women-initiated ANC in the first trimester, and just 5.6% achieved more than six visits, despite WHO's eight-contact recommendation. Education level, age, and marital status were significantly associated with ANC utilization. Tertiary education and age between 28–37 years were strong predictors of higher ANC utilization. Logistic regression indicated that each additional ANC visit increased the odds of a favorable delivery outcome by 65%. Women with tertiary education and those without medical conditions during pregnancy also had better outcomes. Common barriers included long waiting times, travel costs, and missed services. Despite this, most participants reported satisfaction with care. The study concluded that increased ANC utilization significantly improves birth outcomes. It recommends targeted health education, improved staffing, and stronger healthcare infrastructure to boost ANC utilization. Interventions should focus on young, unmarried, and less-educated women to enhance early and consistent utilization. The findings underscore the need for policy reforms and community-based strategies to improve maternal health outcomes in low-resource settings.