Determinants of Delayed Antenatal Care Initiation among Low-Income Families in Indonesia

Objective: Ensuring proper and timely antenatal care (ANC) can reduce poor birth outcomes among low-income families. This study examined the determinants of delayed ANC initiation among low-income families in Indonesia. Material and Methods: The study examined 25,073 women. We used delayed ANC initiation as a dependent variable and eight independent variables: residence, age, marital status, education, employment, parity, insurance, and wealth. In the last step, the research employed binary logistic regression.Results: 26.4% of women among low-income families delayed ANC initiation. Women in rural areas were 1.091 times more likely than those in urban areas to delay ANC initiation (95% CI 1.087-1.096). All age groups were less likely to delay ANC initiation than those aged ≤ 19. Divorced/widowed women were 1.390 times more likely than those married to delay ANC initiation (95% CI 1.373-1.407). Women at all education levels were more likely to delay ANC initiation than women with a college education. Employed women were 1.030 times more likely than unemployed women to delay ANC initiation (95% CI 1.026-1.034). The poorest were 1.538 times more likely to delay ANC initiation than the poorer (95% CI 1.532-1.544). Women with any insurance type were less likely than those without insurance to delay ANC initiation. Women with all parity types were more likely than primiparous women to delay ANC initiation.Conclusion: Delayed ANC initiation among low-income families in Indonesia is driven by multiple socioeconomic and structural factors. Targeted and context-specific policies are needed to improve early ANC uptake.