Factors associated with the number and timing of antenatal care visits among married women in Cameroon: evidence from the 2018 Cameroon Demographic and Health Survey

Utilization of antenatal care (ANC) services, as part of reproductive health care, presents a lifesaving chance for health promotion and the early diagnosis and treatment of illnesses throughout pregnancy. This study examines the factors associated with the number and timing of ANC visits among married women in Cameroon using data from the 2018 Cameroon Demographic and Health Survey. The outcome variables were number of ANC visits, categorized as <8 visits or ≥8 visits, and the timing of first ANC visit, categorized as ≤3 months (early) or >3 months (late) (as per the new 2016 WHO recommendations). Descriptive statistics and binary logistic regression were used to analyse the data. Crude odds ratios (cOR) and adjusted odds ratios (aOR) and p-values with significance at <0.05 were used to interpret the results. The proportions of women who had ≥8 ANC visits and first ANC visit at ≤3 months gestation were 6.3% and 35.6% respectively. Women aged 35-39 at childbirth (aOR=3.99, 95% CI=1.30-12.23), middle wealth quintile women (aOR=3.22, 95% CI=1.01-10.27), women whose husbands had secondary (aOR=7.00, 95% CI=2.26-21.71) or higher (aOR=16.93, 95% CI=4.91-58.34) education were more likely to have ≥8 ANC visits. Early timing of first ANC visit was low among women with birth order 3-4 (aOR=0.63, 95% CI=0.46-0.85). Conversely, the likelihood of having early ANC visits was high among women whose pregnancies were intended (aOR=1.32, 95% CI=1.01-1.74), the richest women (aOR=3.89, 95% CI=2.30-6.57) and women whose husbands had secondary (aOR=2.41, 95% CI=1.70-3.64) or higher (aOR=3.12, 95% CI=2.40-7.46) education. The study highlights that age at childbirth, wealth, husband's educational attainment, birth order and pregnancy intention could influence the utilization of ANC services among married women in Cameroon. Hence, to improve attendance and early initiation of ANC, interventions should be targeted at empowering women financially and removing all financial barriers associated with accessing ANC, improving ANC education among women and encouraging male involvement in ANC education.