Factors Associated with First Antenatal Care Booking among Pregnant Women at a Reproductive Health Clinic in Tanzania: A Cross Sectional Study

Background: Antenatal care (ANC) is a key basic intervention targeting maternal and perinatal morbidity and mortality. The World Health Organization (WHO) recommends the first ANC booking before 12 weeks of gestation. This enhances positive maternal and fetal outcomes through early detection of complications, prompt treatment, referral, and management of expected physiological changes. Despite high ANC coverage (98%), free contacts, and easy accessibility, little is known why few (24%) pregnant women in Tanzania book their first ANC-visit early. This study aimed to identify factors associated with first ANC booking among pregnant women in a Tanzanian reproductive health clinic. Methods: Systematic random sampling was used to recruit 311 eligible pregnant women. Study data were collected using a structured interviewer-administered questionnaire containing 22 closed ended questions. Data were analyzed using descriptive statistics. Frequency distribution tables and figures were generated. Multivariate analysis was used to assess the influence of the independent variables on the dependent variable. A p-value \u3c 0.05 was considered statistically significant. Results: In total, 311 pregnant women were interviewed; 31.2% (n = 97) booked their first ANC-visit within 12 weeks of gestation and 68.8% (n = 214) after 12 weeks of gestation. Early ANC booking was associated with tertiary education, planned pregnancy, earlier pregnancy recognition, and experience or presence of any complications. Commonly reported barriers to early ANC booking included not knowing the recommended time to initiate booking (37.6%), waiting for the fetus to move (28.6%), and previous experience of waiting a long time (15.8%). Conclusion: Most pregnant women booked their first ANC visit later than WHO and national recommendations. Women thus miss accurate early pregnancy assessment for better positive pregnancy outcomes