Conclusions
These findings are useful to inform planning of health education programmes on antenatal care and for the implementation of holistic interventions aimed at improving ANC adherence (early initiation and adequate attendance) for better health outcomes for women in South Africa as timing of initiation of antenatal care in previous pregnancies may influence timing of initiation in subsequent pregnancies.
Whilst the majority of women from the rural and urban sites attended ANC frequently, most women initiated ANC late with less than 50 % initiating at or before 16 weeks gestational age. In a country faced with a high HIV/AIDS disease burden, early ANC initiation is crucial as it facilitates early HIV testing and subsequently, early ART initiation for eligible women [5].