Antenatal Care: Utilization Rate and Barriers in Bosaso-Somalia, 2019

Mothers and children are among the most vulnerable population groups requiring special attention and care. The fourth and fifth Millennium Development Goals (MDGs) address child mortality and maternal health, respectively. Although maternal mortality rate (MMR) has declined globally between 1990 and 2015 by 44%, the World Health Organization (WHO) estimates that 99% of global maternal mortality takes place in the developing countries. Somalia has one of the highest maternal and child mortality rates in the world, with 732 mothers dying in every 100,000 live births. Mainly, such high MMR is the outcome of the devastating civil wars that disrupted the country’s health infrastructure with limited antenatal care (ANC) coverage (26% only). We conducted a community-based cross-sectional study using a quantitative approach to identify ANC utilization rate and barriers among mothers having a child less than one year of age in Bosaso from October – November 2019. A sample size of 384 mothers was interviewed by using a structured questionnaire, and SPSS was used to analyze the collected data. This study found that (84.1%) of the respondents utilized ANC services during their last pregnancy, but only 28% of them completed the recommended number of ANC visits for pregnant women. The main barriers hindering the utilization of ANC services were identified to be distance of the health centers, financial constraints, inadequate knowledge and attitude of the respondents and their husbands, poor attitude of the healthcare providers, and time and family-related issues. Based on the findings of the study, we recommend uplifting the awareness of the family/mothers for the utilization of antenatal care services in health facilities.