Correlates of late initiation and underutilisation of the recommended eight or more antenatal care visits among women of reproductive age: insights from the 2019 Ghana Malaria Indicator Survey

OBJECTIVE: This study assessed the correlates of late initiation and underutilisation of the WHO’s recommended eight or more antenatal care visits among women in Ghana. DESIGN: We analysed secondary data from 2163 women in the 2019 Ghana Malaria Indicator Survey, which collected data on malaria and antenatal care indicators among women of reproductive age across the previous 10 regions of Ghana. SETTING AND PARTICIPANTS: Women of reproductive age across the 10 regions of Ghana. MAIN OUTCOME MEASURES: Late initiation and underutilisation of the recommended eight or more antenatal care visits among women of reproductive age. RESULTS: About half (49%) of the participants were between the ages of 25 and 34 years; mean (±SD)=30 (±7.10). The majority (57%) of the participants obtained less than eight antenatal care visits, while 32% initiated antenatal care visits after the first trimester. The significant factors associated with the late initiation of antenatal care visits were age, region and parity (p<0.05). Factors associated with underutilisation of the recommended eight or more antenatal care visits were marital status, wealth index, parity, region and place of residence (p<0.05). CONCLUSION: A majority of the women underused antenatal care services. A significant minority of the women started antenatal care visits late. Socio-demographic factors, parity and socioeconomic factors were identified as the significant factors associated with the late initiation and underutilisation of antenatal care services. Maternal health interventions should prioritise young, multiparous and poor women.