“Predictors for delayed first antenatal care visit in rural area of Rwanda: Analysis of secondary data using Rwanda Demographic Health Survey 2019-2020”

Introduction: Timely commencement of antenatal care (ANC) improves maternal outcomes by reducing complications that often result in death. According to the World Health Organization, 800 women died daily in 2020 from preventable complications related to pregnancy and childbirth, with 95% occurring in developing countries. Despite efforts by the Rwandan government to promote maternal health, delayed ANC visits remain prevalent in rural areas. This study aimed to determine the prevalence and predictors of delayed first ANC visits in rural Rwanda . Methods: : This cross-sectional study used Rwanda Demographic and Health Survey (RDHS) data, enrolling 4039 women who had been pregnant within five years before the survey. Logistic regression modeling identified socio-demographic and maternal characteristics associated with delayed first ANC visits . Results: : The prevalence of delayed first ANC visits was 40.2%. After adjustment in a multivariate regression model, factors associated with delay included low wealth index, marital status, maternal age (25-34 and 35-49), having 2-4 or more than 4 children, and occupation. Health insurance coverage was a protective factor against delays . Conclusion: The findings highlight the need for interventions at multiple levels to increase timely uptake of first antenatal care visit, as the study revealed that socio-demographic and maternal factors significantly influence delays in initiating ANC .