BACKGROUND INFORMATION

Antenatal clinic is a type of preventive health care. Its goal is to provide regular check-ups that allow doctors or midwives to treat and prevent potential health problems throughout the course of the pregnancy and to promote healthy lifestyles that benefit both mother and child(1)Early commencement of antenatal care by pregnant women as well as regular visits has the potential to affect maternal and fetal outcome positively. In the United States of America and the United Kingdom, the recommended gestational age for booking is within the first twelve weeks of pregnancy(2). Opportunities for Africa’s Newborns 51Antenatal care (ANC) coverage is a success story in Africa, since over two-thirds of pregnant women (69%) have at least one ANC contact. However, to achieve the full life-saving potential that ANC promises for women and babies, four visits providing essential evidence-based interventions – a package often called focused antenatal care – are required. Essential interventions in ANC include identification and management of obstetric complications such as pre-eclampsia, tetanus toxoid immunization, intermittent preventive treatment for malaria during pregnancy (IPTp)(3), and identification and management of infections including HIV, syphilis and other sexually transmitted infections (STIs).ANC is also an opportunity to promote the use of skilled attendance at birth and healthy behaviors such as breastfeeding, early postnatal care, and planning for optimal pregnancy spacing Many developing countries including Tanzania do not have national guidelines on antenatal care but commencement of antenatal care within the first 14 weeks of gestation is widely accepted as early and many previous workers have defined booking after the 14th week of pregnancy as late. Commencement of focused antenatal care before 14 weeks of gestation allows for early commencement of health education and counselling on expected physiological changes, the normal course and possible complications of pregnancy, labor and puerperium. Similarly, it aids early documentation of the woman's baseline physiological and laboratory parameters for subsequent comparison and early detection of anomalies with the progress of pregnancy. It also provides opportunities for preventive health care services such as immunization against neonatal tetanus(4), prophylactic treatment of malaria through the use of intermittent presumptive treatment approach, and HIV counselling and testing. Another advantage is the early detection of modifiable pre-existing medical conditions that may influence the course and outcome of pregnancy such as cervical incompetence, chronic hypertension and diabetes mellitus(5). Previous studies indicate that the vast majority of Tanzania women who utilize modern antenatal care book late, which is in sharp contrast with findings in most developed countries(6). While studies from most developed countries have established that socially disadvantaged women such as teenagers, unmarried women and women with lower level of education and lower socioeconomic class are more likely to book late for antenatal care(7), studies from sub-Saharan Africa suggest that these may not be the major determinants in African. Women Previous studies from Tanzania are inconclusive. While some workers found no statistically significant effect of age, parity, level of education and socioeconomic class as well as incidence of previous obstetric complications between women who registered early and those who booked late, others have reported these as significant. It is important to book early in the antenatal clinic for the best outcomes of both of the mother and the fetus. Booking late will leads to the problems either to the mother, fetus or both. Hence this study will be beneficial in determine the reasons related with late ANC booking at makongoro health Centre in mwanza(3).

PROBLEM STATEMENT

Despite of having a national guideline of antenatal care, the majority of pregnant women they have no good attendance or sometimes do not attend at all and sometimes they can book late. This has been attributed by various factors. According to the studies some of the factors causing late booking have been addressed while others are not yet addressed. Example social cultural factors have been addressed as the main cause of late booking in the previous studies. The purpose of this study is to assess how economic status, occupation and education levels of the pregnant women associate with late antenatal clinic (ANC) booking.

RATIONALE OF THE STUDY

This study will help to educate the community about the importance of antenatal care as well as why it’s important to book early. Also, this study will help to address the main cause of late antenatal booking which will help the government and health care providers to reduce the morbidity and mortality related to pregnancy.

RESEARCH HYPOTHESIS

Factors associated with late antenatal clinic booking among pregnant women at makongoro health Centre.

OBJECTIVES

Broad objective

To assess the main factors associated with late antenatal clinic booking among pregnant women.

Specific objectives

 To determine the prevalence of late antenatal clinic booking among the pregnant women
 To assess how occupation of the pregnant women leads to late antenatal care booking.
 To assess the awareness of pregnant women on the advantages of booking early ANC.