Time to first antenatal care visit and its predictors among women in Kenya: Weibull gamma shared frailty model (based on the recent 2022 KDHS data)
Abstract Background The first trimester of pregnancy is critical for fetal development, making early antenatal care visits essential for timely check-ups and managing potential complications. However, delayed antenatal care initiation remains a public health challenge in sub-Saharan Africa, includin...
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BMC
2025-01-01
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| Series: | BMC Pregnancy and Childbirth |
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| Online Access: | https://doi.org/10.1186/s12884-025-07178-y |
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| author | Bizunesh Fantahun Kase Beminate Lemma Seifu Kusse Urmale Mare Abdu Hailu Shibeshi Hiwot Altaye Asebe Kebede Gemeda Zufan Alamrie Asmare Yordanos Sisay Asgedom Bezawit Melak Fente Afework Alemu Lombebo Tsion Mulat Tebeje |
| author_facet | Bizunesh Fantahun Kase Beminate Lemma Seifu Kusse Urmale Mare Abdu Hailu Shibeshi Hiwot Altaye Asebe Kebede Gemeda Zufan Alamrie Asmare Yordanos Sisay Asgedom Bezawit Melak Fente Afework Alemu Lombebo Tsion Mulat Tebeje |
| author_sort | Bizunesh Fantahun Kase |
| collection | DOAJ |
| description | Abstract Background The first trimester of pregnancy is critical for fetal development, making early antenatal care visits essential for timely check-ups and managing potential complications. However, delayed antenatal care initiation remains a public health challenge in sub-Saharan Africa, including Kenya. Therefore, this study aimed to assess and provide up-to-date information on time to first antenatal care visit and its predictors among women in Kenya, using data from the most recent 2022 Kenya Demographic and Health Survey (KDHS). Methods This community-based cross-sectional study analyzed data from 19,530 birth histories in the 2022 Kenya Demographic and Health Survey (KDHS). The primary outcome was the timing of the first antenatal care (ANC) visit, classified as timely if it occurred in the first trimester. Shared frailty survival models were used to account for the hierarchical data structure and unobserved heterogeneity, with the Weibull gamma model identified as the best fit based on Information Criteria (AIC), and Bayesian Information Criteria (BIC). Variables with p < 0.2 entered multivariable analysis, and results were reported as Adjusted Hazard Ratios (AHR) with 95% Confidence Intervals (CI) using the Weibull gamma model. Results The study found that the median time for the first antenatal care (ANC) visit in Kenya was four months. Significant predictors of ANC timing included women’s age (35–49 years: AHR 0.83; 95% CI: 0.72–0.95), education level (higher: AHR 1.45; 95% CI: 1.17–1.78), media exposure (yes: AHR 1.21; 95% CI: 1.05–1.39), parity (four or more children: AHR 0.81; 95% CI: 0.72–0.91), wealth status (richest: AHR 2.00; 95% CI: 1.63–2.43), desire for more children (did not want more: AHR 0.64; 95% CI: 0.54–0.77), residence (rural: AHR 1.22; 95% CI: 1.07–1.39), and religion (Islam: AHR 0.76; 95% CI: 0.64–0.89). Conclusion The median time for the first ANC visit exceeds the World Health Organization’s recommendation of initiating care within the first trimester. These findings underscore the need for targeted interventions to promote timely ANC, especially among women with limited media exposure, high parity, lower socioeconomic status, and specific religious followers. |
| format | Article |
| id | doaj-art-8f97a095761f4345a5febad4d5b0c38e |
| institution | Kabale University |
| issn | 1471-2393 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pregnancy and Childbirth |
| spelling | doaj-art-8f97a095761f4345a5febad4d5b0c38e2025-01-26T12:57:12ZengBMCBMC Pregnancy and Childbirth1471-23932025-01-0125111210.1186/s12884-025-07178-yTime to first antenatal care visit and its predictors among women in Kenya: Weibull gamma shared frailty model (based on the recent 2022 KDHS data)Bizunesh Fantahun Kase0Beminate Lemma Seifu1Kusse Urmale Mare2Abdu Hailu Shibeshi3Hiwot Altaye Asebe4Kebede Gemeda5Zufan Alamrie Asmare6Yordanos Sisay Asgedom7Bezawit Melak Fente8Afework Alemu Lombebo9Tsion Mulat Tebeje10Department of Public Health, College of Medicine and Health Sciences, Samara UniversityDepartment of Public Health, College of Medicine and Health Sciences, Samara UniversityDepartment of Nursing, College of Medicine and Health Sciences, Samara UniversityDepartment of Statistics, College of Natural and Computational Science, Samara UniversityDepartment of Public Health, College of Medicine and Health Sciences, Samara UniversityDepartment of Nursing, College of Medicine and Health Sciences, Samara UniversityDepartment of Ophthalmology, School of Medicine and Health Science, Debre Tabor UniversityDepartment of Epidemiology and Biostatistics, College of Health Sciences and Medicine, Wolaita Sodo UniversityDepartment of General Midwifery, School of Midwifery, College of Medicine & Health Sciences, University of GondarSchool of Medicine, College of Health Science and Medicine, Wolaita Sodo UniversitySchool of Public Health, College of health sciences and Medicine, Dilla UniversityAbstract Background The first trimester of pregnancy is critical for fetal development, making early antenatal care visits essential for timely check-ups and managing potential complications. However, delayed antenatal care initiation remains a public health challenge in sub-Saharan Africa, including Kenya. Therefore, this study aimed to assess and provide up-to-date information on time to first antenatal care visit and its predictors among women in Kenya, using data from the most recent 2022 Kenya Demographic and Health Survey (KDHS). Methods This community-based cross-sectional study analyzed data from 19,530 birth histories in the 2022 Kenya Demographic and Health Survey (KDHS). The primary outcome was the timing of the first antenatal care (ANC) visit, classified as timely if it occurred in the first trimester. Shared frailty survival models were used to account for the hierarchical data structure and unobserved heterogeneity, with the Weibull gamma model identified as the best fit based on Information Criteria (AIC), and Bayesian Information Criteria (BIC). Variables with p < 0.2 entered multivariable analysis, and results were reported as Adjusted Hazard Ratios (AHR) with 95% Confidence Intervals (CI) using the Weibull gamma model. Results The study found that the median time for the first antenatal care (ANC) visit in Kenya was four months. Significant predictors of ANC timing included women’s age (35–49 years: AHR 0.83; 95% CI: 0.72–0.95), education level (higher: AHR 1.45; 95% CI: 1.17–1.78), media exposure (yes: AHR 1.21; 95% CI: 1.05–1.39), parity (four or more children: AHR 0.81; 95% CI: 0.72–0.91), wealth status (richest: AHR 2.00; 95% CI: 1.63–2.43), desire for more children (did not want more: AHR 0.64; 95% CI: 0.54–0.77), residence (rural: AHR 1.22; 95% CI: 1.07–1.39), and religion (Islam: AHR 0.76; 95% CI: 0.64–0.89). Conclusion The median time for the first ANC visit exceeds the World Health Organization’s recommendation of initiating care within the first trimester. These findings underscore the need for targeted interventions to promote timely ANC, especially among women with limited media exposure, high parity, lower socioeconomic status, and specific religious followers.https://doi.org/10.1186/s12884-025-07178-yFirst antenatal care visitKenyaWeibull gamma shared frailty model |
| spellingShingle | Bizunesh Fantahun Kase Beminate Lemma Seifu Kusse Urmale Mare Abdu Hailu Shibeshi Hiwot Altaye Asebe Kebede Gemeda Zufan Alamrie Asmare Yordanos Sisay Asgedom Bezawit Melak Fente Afework Alemu Lombebo Tsion Mulat Tebeje Time to first antenatal care visit and its predictors among women in Kenya: Weibull gamma shared frailty model (based on the recent 2022 KDHS data) BMC Pregnancy and Childbirth First antenatal care visit Kenya Weibull gamma shared frailty model |
| title | Time to first antenatal care visit and its predictors among women in Kenya: Weibull gamma shared frailty model (based on the recent 2022 KDHS data) |
| title_full | Time to first antenatal care visit and its predictors among women in Kenya: Weibull gamma shared frailty model (based on the recent 2022 KDHS data) |
| title_fullStr | Time to first antenatal care visit and its predictors among women in Kenya: Weibull gamma shared frailty model (based on the recent 2022 KDHS data) |
| title_full_unstemmed | Time to first antenatal care visit and its predictors among women in Kenya: Weibull gamma shared frailty model (based on the recent 2022 KDHS data) |
| title_short | Time to first antenatal care visit and its predictors among women in Kenya: Weibull gamma shared frailty model (based on the recent 2022 KDHS data) |
| title_sort | time to first antenatal care visit and its predictors among women in kenya weibull gamma shared frailty model based on the recent 2022 kdhs data |
| topic | First antenatal care visit Kenya Weibull gamma shared frailty model |
| url | https://doi.org/10.1186/s12884-025-07178-y |
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