Since 2001 the Uganda government has been implementing a
minimum public-healthcare package for prevention of
anaemia among pregnant women. The results of this study indicate
that the uptake of this package has been inadequate. The minimum
public healthcare package is available at health centres and,
therefore, requires pregnant women to make regular ANC visits.
Due to low rates of ANC visits, most pregnant women miss
anaemia interventions and health education sessions. The low ANC attendance registered in this study is consistent with those of
the recent UDHS which reported that only 17% of women have
their first ANC visit in the first trimester and only 47.2% have
four or more antenatal visits as recommended by the Uganda
Reproductive Health Policy Guidelines22. A number of studies
have assessed factors leading to low and late ANC in Africa.
According to Asiimwe, affordability in terms of physical inability
to travel long distances, transport and other related costs explains
the limitations to more ANC visits, even when free health services
are available23. Additionally, late ANC attendance is associated
with a perceived lack of services and relevant medicines at these
health centres24. This study established that more than half of the
pregnant women in Kiboga are more than a one hour’s walk
(5 km) away from the nearest healthcare facility. The results also
showed that the ANC services received by the women were not at
a satisfactory standard. Such factors were possible reasons for the
low ANC attendance in Kiboga. According to a study by
Mwadime, almost 80% of the women complained of long waiting
times at the ANC clinics, but said that they did not mind this as
long as they received the services and 'medicines' they expected25.
It is important to ensure that the pregnant women receive all
required ANC services at healthcare centres after travelling long
distances.