Compliance with the WHO recommended 8+ antenatal care contacts schedule among postpartum mothers in eastern Uganda: A cross-sectional study

Background The World Health Organization (WHO) recommends at least 8 antenatal care (ANC) contacts during pregnancy, but many women in low and middle-income countries do not adhere to this schedule, which may contribute to high rates of maternal and neonatal mortality. This study assessed compliance to the WHO recommended 8+ ANC contacts schedule and associated factors among postpartum mothers in eastern Uganda. Methods This was a cross-sectional multicenter study conducted between July and August 2022 at four selected hospitals in Eastern Uganda using quantitative techniques. We recruited postnatal mothers who had given birth within 48 hours with records of their ANC contacts. Compliance to the WHO recommended 8+ ANC contacts schedule was defined as having received the recommended ANC contacts as per the gestational age at childbirth following the current ANC for a positive pregnancy experience WHO guidelines. We conducted multivariable logistic regression analysis to assess the association between compliance to the WHO recommended 8+ ANC contacts schedule and selected independent variables. Results A total of 1104 postpartum mothers participated in the study with a mean age (± standard deviation) of 26 ± 6.4 years, and a majority had given birth from a referral hospital (n = 624 56.5%). Compliance to the WHO recommended 8+ ANC contacts schedule was low (n = 258, 23.4%), and only 23.2% (196) of the women had attended their first antenatal care contact within the first trimester. Factors associated with compliance to the WHO recommended 8+ ANC contacts were: attending the first antenatal care contact within 12 weeks of gestation [AOR: 6.42; 95% CI: (4.43 to 9.33)], having 2 to 4 children [AOR: 0.65; 95% CI: (0.44 to 0.94)], having a spouse who is unemployed [AOR: 1.71; 95% CI: (0.53 to1.08)] and having insurance coverage [AOR: 2.31; 95% CI: (1.17 to 4.57)]. Conclusion Compliance with the 8+ ANC contacts schedule remains very low. Efforts should focus on increasing health education, particularly for multiparous women, and encouraging mothers to begin ANC in their first trimester. Exploring the dynamics of partner support, especially with employment status, may offer insights into improving ANC attendance.