Adherence to the WHO Eight-Contact Antenatal Care Model and Associated Factors Among Postpartum Mothers in Sululta District, Ethiopia: A Cross-Sectional Study.

BACKGROUND AND AIMS: Adequate antenatal care (ANC) contacts are essential for reducing complications during pregnancy and childbirth. Recognizing that inadequate ANC utilization is associated with high maternal mortality, the World Health Organization (WHO) revised its ANC guidelines in 2016, recommending at least eight ANC contacts for all pregnant women. Despite this recommendation, ANC coverage remains suboptimal globally, particularly in East Africa. In Ethiopia, especially in the Sululta district, evidence regarding adherence to the 8+ contact ANC model is limited. Therefore, this study aimed to assess adherence to the WHO-recommended eight-contact ANC model and identify its associated factors among postpartum mothers attending public health facilities in the Sululta district, Ethiopia, in 2024.

METHODS

An institution-based cross-sectional study was conducted in public health facilities of the Sululta district from October 10 to November 10, 2024. A total of 410 postpartum mothers were selected using systematic random sampling and all participants (100% response rate) provided complete data. Data were analyzed using logistic regression analysis. Variables with p value <0.05% and 95% confidence intervals (CI) were considered statistically significant.

RESULTS

Overall adherence to the WHO-recommended eight-contact ANC model was 25.4%(104/410; 95% CI: 21%-30%). Factors significantly associated with adherence included urban residence (AOR: 3.06; 95% CI: 1.17-8.03), previous cesarean delivery (AOR: 3.33; 95% CI: 1.39-7.97), history of obstetric complications (AOR: 6.16; 95% CI: 2.69-14.10), maternal satisfied with ANC services (AOR: 6.78; 95% CI: 2.46-18.66), and receiving ANC at a health center rather than a hospital (AOR: 2.95; 95% CI: 1.24-6.93).

CONCLUSION

Adherence to the WHO-recommended eight-contact ANC model was low among postpartum women in the Sululta district. Interventions led by the regional and district health offices, health facility managers, healthcare providers and community health extension workers should focus on improving maternal satisfaction with ANC service, reducing waiting times and increasing access for rural populations through targeted counseling and community awareness initiatives to enhance adherence.