Socio-demographic and pregnancy-related characteristics
Overall, this analysis included 1085 pregnant women between the ages of 15-43 years, median age 24 (IQR 21-28). At the time of the survey, the majority of the respondents were married (87%), not employed (89%), 25 years or older (49%), not in school (91%) and had previously been pregnant (78%) (Table 1). Approximately 65% of women confirmed their pregnancy in the first trimester. However, only 35% of the women presented for ANC early - in the first 12 weeks of pregnancy. Fifty-eight percent of the women presented for ANC during the second trimester, and 8% during the third trimester.
Twenty-two percent of women reported using a pregnancy self-test to confirm their pregnancy (Table 1). Of the 830 respondents who did not use a self-test: 85% confirmed their pregnancies at a public health facility, 9% at a private health facility, and 6% did not confirm their pregnancy. Users of pregnancy self-tests obtained their kits from a community pharmacy (77%), a public health facility (14%), a private health facility (7%), and stores (2%). The most frequent reasons for non-use of pregnancy self-tests included: not thinking it was necessary (57%), lack of knowledge on self-tests (26%), and lack of money to pay for a self-test (11%).
Prevalence and correlates of pregnancy self-testing
Table 2 shows the univariate and multivariable logistic regression results for variables associated with pregnancy self-testing. In the univariate analysis, self-test use was associated with employment status (OR=3.25, 95% CI 2.24, 4.72), education status (OR= 2.42, 95% CI 1.55, 3.80), gravidity (OR= 0.54, 95% CI 0.39, 0.74), travel time to health facility (OR= 1.72, 95% C 1.26, 2.35), partner’s education level (some high school [OR= 2.41, 95% CI 1.55, 3.75] and some college [OR= 8.00, 95% CI 5.07, 12.58]), and location of health facility (OR= 2.44, 95% CI 1.82, 3.26). In multivariate analyses, self-test use was more likely among women who were employed (aOR=2.43, 95% CI 1.53, 3.85), currently in school (aOR= 2.14, 95% CI 1.19, 3.85), had previous pregnancy complications (aOR=1.34, 95% CI 1.24, 2.53), and received services from urban health facilities (aOR=1.77, 95% CI 1.24, 2.53). Compared to women whose partners had a primary school education or less, self-test use was 2 times more likely among women whose partners had some high school education (aOR= 2.10, 95% CI 1.32, 3.34) and 6 times more likely among women whose partners had attended college (aOR=5.93, 95% CI 3.60, 9.76). Pregnancy self-testing was not associated with age, marital status, having had a prior pregnancy, and travel time to health facility.
Prevalence and correlates of early antenatal care attendance
Table 3 shows univariate and multivariable logistic regression results for variables associated with early ANC attendance. In the univariate analysis, early ANC was associated with pregnancy self-testing (OR= 1.50, 95% CI 1.12, 2.00), gravidity (OR= 0.65, 95% CI 0.49, 0.87), maternal age (being between 20-24 [OR=1.55, 95% CI 1.01, 2.39]), receiving services from an urban health facility (OR= 1.66, 95% CI 1.28, 2.15), having had previous pregnancy complications ( OR= 1.97, 95% CI 1.17, 3.32), and having a partner who had attended college (OR=2.04, 95% CI 1.43, 2.92). In multivariate analyses, women who initiated ANC early were more likely to have had prior pregnancy complications (aOR=2.18, 95% CI 1.22, 3.90), be pregnant for the first time (aOR=0.58 95 % CI 0.38, 0.87), have a partner who attended college (aOR=1.58, 95% CI 1.03, 2.40), and received services from an urban health facility (aOR=1.51, 95% CI 1.11, 2.05). Early ANC initiation was not associated with pregnancy self-test use, age, marital status, employment status, education status, and travel time to health facility.