Determinants of Late Antenatal Care Booking Among Women of Reproductive Age in Lufwanyama District, Zambia.

Antenatal care (ANC) is one of the most effective interventions for reducing preventable maternal and newborn morbidity and mortality because it facilitates early detection and management of pregnancy-related complications, provides health education, and promotes birth preparedness (WHO, 2021). When ANC is initiated late, women are more likely to miss important preventive and treatment services such as screening for anaemia, hypertensive disorders of pregnancy, HIV, and other conditions that may threaten the health of both mother and baby.
Despite the known benefits of early ANC attendance, only 39.5% of pregnant women in Lufwanyama District initiate ANC during the first trimester (DHIS2, 2025.) This indicates that many women continue to access ANC services late, potentially increasing their risk of adverse maternal and neonatal outcomes.
This study was therefore, aimed at determining the factors associated with late antenatal care attendance among women of childbearing age (15–49 years) in Lufwanyama District, Zambia.
A cross-sectional study design was used in this study. Data was collected from Maternal and Child Health (MCH) facility antenatal registers and questionnaires were administered to 302 pregnant women. Collected data was analyzed using Stata version 15 where factors associated with late antenatal care attendance among women of childbearing age were determined. Logistic regression was used to test the association between the outcome and explanatory variables using bivariate and multivariate analysis. A P-value < 0.05 was considered statistically significant.
From this study, education level and peer influence were found to be significant predictors. After adjustment, women with secondary education had reduced odds of late ANC initiation (aOR = 0.312; 95% CI: 0.097–1.006; p = 0.050) However, because the confidence interval includes 1.00, this borderline result should be interpreted with caution, while those influenced by peers who did not register for ANC had increased odds of late initiation (aOR = 3.670; 95% CI: 1.066–12.630; p = 0.039).
The study concluded that peer norms and educational attainment are key determinants of late ANC attendance. Interventions aimed at improving positive community norms and promoting female education may enhance timely ANC use.

Antenatal care, Late ANC initiation, Logistic regression, Education level, Peer influence, Maternal health

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