Survival Analysis of Time to First Antenatal Care Visit among Pregnant Women in Ethiopia: Application of Parametric and Non-Parametric Model

Objective Antenatal care (ANC) involves monitoring pregnant women to ensure the health of both mother and fetus. This study aimed to assess the timing of the initial ANC visit and its determining factors among Ethiopian pregnant women. Material and Methods The analysis used data from the 2016 Ethiopian Demographic and Health Survey (EDHS), focusing on women aged 15-49 who had a live birth within five years prior to the survey across nine regional states and two city administrations. Descriptive statistics and parametric shared frailty models were applied to identify factors influencing the timing of the first ANC visit. Results Among 7,559 women, only 20.4% attended their first ANC visit within the recommended 12 weeks. The median time to the first ANC visit in Ethiopia was 18 weeks (4.5 months). Factors that delayed the first ANC visit included rural residence (□= 1.29), higher birth order (□= 1.06-1.21), and long distance to a health facility (□= 1.08). Conversely, factors that shortened the time to the first ANC visit included higher levels of maternal education (□= 0.87-0.91), higher wealth index (□= 0.86-0.87), media access (□= 0.92), and involvement in healthcare decisions (□< 1). Conclusion Rural residence, higher birth order, and long travel distances delay the first ANC visit, while higher education, urban residence, media access, and greater wealth accelerate it. The study recommends enhanced community education on the importance of early ANC visits through health extension workers and stakeholders.