Reasons for underutilisation of antenatal care services amongst women coming for delivery at Juba Teaching Hospital, South Sudan

Introduction: Antenatal care (ANC) is routine care provided for women during pregnancy to promote their overall health, that of their unborn babies, and to identify, prevent, and/or manage complications or problems as they arise. Its main components include risk assessment, health promotion and education, and therapeutic intervention. Although it has been found that 71% of pregnant women attend formal ANC clinics at least once, only 44% of them have four or more visits. This study aims to determine the reasons for underutilisation of ANC services amongst the women who came for labour and delivery services in the Department of Obstetrics and Gynaecology at Juba Teaching Hospital in Juba, South Sudan. Method: This prospective study was conducted from March 1st to May 31st, 2024. It included pregnant women who came for labour and delivery services at the hospital and who had zero to three ANC visits during their pregnancy. Data were collected by trained data collectors through direct patient interviews using a structured and pretested questionnaire and analysed using SPSS software. Results: The study interviewed 310 women, of whom 67 (21.6%) had no ANC visit, 165 (67.9%) had one, 43 (17.7%) had two, and 35 (14.4%) had three. The main reasons for discontinuing or not attending ANC were lack of finance (22.9%), long distance to health facilities (12.9%), high cost of service (11.3%), lack of transport (11%), and lack of family support (9.4%). Conclusion: Although we observed that most of those coming for delivery services had exceeded our cut-off of four ANC visits, we would expect far fewer to have had eight visits, as recommended by WHO in 2016.