Introductions Timely initiation of antenatal care (ANC), defined as attending the first visit within the first 12 weeks of gestation, is essential for optimizing maternal and neonatal health. Despite its benefits, delayed ANC initiation remains a significant challenge in low-resource settings, including Ethiopia, with limited data on its prevalence and determinants in specific regions. Objective To assess the prevalence and determinants of timely initiation of antenatal care among pregnant women attending public health facilities in, Ethiopia, in 2025. Methods A facility-based cross-sectional study was conducted from November 1, 2024 to February 1, 2025, across selected public health institutions. A total of 857 pregnant women mixed residence (both urban and rural) were recruited using systematic random sampling. Data were collected via a structured, interviewer-administered questionnaire based on validated tools and WHO recommendations. Kobo Toolbox supported real-time electronic data collection. Data analysis was performed using SPSS version 27. Bivariable and multivariable logistic regression analyses identified factors associated with timely ANC initiation. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were calculated; significance was set at p < 0.05. Results Only 29.4% (95% CI: 26.4%–32.4%) of women-initiated ANC timely. Positive predictors included preconception care utilization (AOR: 2.1; 95% CI: 1.21–3.83), paternal involvement (AOR: 3.3; 95% CI: 2.03–5.28), good knowledge of ANC (AOR: 3.3; 95% CI: 2.29–4.77), and use of a self-pregnancy test (AOR: 3.2; 95% CI: 1.68–6.12). Conversely, being internally displaced (AOR: 0.22; 95% CI: 0.103–0.47), using hormonal contraception prior to pregnancy (AOR: 0.29; 95% CI: 0.12–0.78), and having a short inter-pregnancy interval (AOR: 0.58; 95% CI: 0.38–0.88) were significantly associated with delayed ANC initiation. Conclusion Timely ANC initiation remains suboptimal. Interventions targeting awareness, preconception care, and support for displaced populations are critical to improving timely ANC uptake and maternal health outcomes.
Kebede et al. (Thu,) studied this question.