Nonadherence to the WHO 2016 Antenatal Care Model and Associated Factors Among Delivering and Postnatal Women in...

To reduce maternal and fetal mortality and morbidity, the World Health Organization (WHO) recommended eight or more antenatal care (ANC) contacts for pregnant mothers, known as the WHO 2016 ANC model. However, the effectiveness of the model depends on the adherence of pregnant mothers. Therefore, this study is aimed at assessing nonadherence to the 2016 ANC model and the associated factors among delivering and postnatal mothers in southern Ethiopia.

An institution-based cross-sectional study was conducted from August 25, 2024, to October 20, 2024, at Dilla University Teaching Hospital, Dilla town, southern Ethiopia. A systematic random sampling technique was used to select the study participants. A pretested questionnaire was used to collect data on KoboCollect, and data analysis was conducted using the Statistical Package for the Social Sciences (SPSS) Version 25. A descriptive analysis was conducted and presented in tables, graphs, charts, and bars. Bivariate and multivariate analyses were performed to identify associations between nonadherence to the 2016 ANC model and other factors. Multivariable analysis at the level of 95% confidence intervals of statistical significance was declared at a p value < 0.05.

In this study, 308 women participated, making a response rate of 95%. The mean age of study participants was 26.16 ± 5.51. Almost half (49.7%) of participants were housewives, 94 (30.5%) of the women attended secondary school, and 160 (51.9%) resided in urban settings. The study revealed that 45.5% (95% CI: 42.12, 56.3) of respondents were nonadherent to the WHO 2016 ANC model. Women who reside in rural settings (AOR: 2.4; 95% CL: 1.14-3.42), having no formal education (AOR: 2.4; 95% CI: 1.009-4.08), women's husbands being the principal income generator of the household (AOR: 2.01; 95% CI: 1.009-4.08), and women's husbands being head of the household (AOR: 11.53; 95% CI: 1.024-38.6) were significantly associated with nonadherence to the WHO 2016 model.

We found that nearly half of laboring and postnatal women were nonadherent to the newly recommended WHO 2016 eight-contact ANC model. Therefore, efforts should focus on women's economic empowerment and education, with particular emphasis on raising awareness about the importance of attending frequent ANC visits. Future researchers should consider conducting qualitative studies to better explore the reasons behind nonadherence to ANC.