{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T18:21:24Z","timestamp":1791397284847,"version":"4.3.3"},"reference-count":76,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"The Project for Human Resource Development Scholarship, Japan"},{"name":"Nagasaki University School of Tropical Medicine and Global Health, Japan","id":[{"id":"https:\/\/ror.org\/058h74p94","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Antenatal care (ANC) supports skilled delivery and maternal survival, but evidence on how Ghana\u2019s Community-Based Health Planning and Services (CHPS) policy influences ANC access is limited. This study assessed factors associated with ANC access in the Twifo Hemang Lower Denkyira District, Central Region, Ghana.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In a cross-sectional study, we examined 310 women aged 15\u201349 years, having children less than 12 months, using a structured questionnaire administered through interviews. ANC initiation was defined as early when the first ANC visit occurred at 0\u201312 weeks\u2019 gestation (first trimester) and late when it occurred at 13 weeks or later. We performed univariate and multivariate logistic regression analyses in Stata 17 and reported adjusted odds ratios (AORs) and 95% confidence intervals (CIs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>ANC attendance was 93.9%, and 69.1% of women initiated ANC early. Unmarried women (AOR\u2009=\u20090.125, 95%CI:0.012\u20130.926, p\u2009=\u20090.047) and women who delivered at home (AOR\u2009=\u20090.013, 95%CI:0.001\u20130.176, p\u2009=\u20090.001) had lower odds of attending at least one ANC visit. Late ANC initiation was associated with household size of 11 or more members (AOR\u2009=\u20093.848, 95%CI:1.914\u20136.211, p\u2009=\u20090.046), fewer than four ANC contacts (AOR\u2009=\u20096.332, 95% CI: 2.049\u20139.571, p\u2009=\u20090.001), and CHPS staff home visits (AOR\u2009=\u20091.813, 95%CI:1.014\u20133.243, p\u2009=\u20090.045). Higher monthly income was associated with lower odds of late ANC initiation (AOR\u2009=\u20090.123, 95%CI:0.024\u20130.630, p\u2009=\u20090.012). ANC and pregnancy knowledge, receiving care in a CHPS zone, and distance to a CHPS zone were not significantly associated with ANC attendance or timing after adjustment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>ANC attendance and early initiation were relatively high. However, marital status, place of delivery, household size, income, ANC contacts, and CHPS home visits were associated with ANC access. Strengthening community-based and multisectoral interventions may improve timely ANC use and maternal health outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0359892","type":"journal-article","created":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T17:38:16Z","timestamp":1791394696000},"page":"e0359892","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["A cross-sectional study to evaluate access to antenatal care services in Twifo Hemang Lower Denkyira district of Ghana"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-7037-2108","authenticated-orcid":true,"given":"John","family":"Hammond","sequence":"first","affiliation":[{"name":"Central Regional Health Directorate, Ghana Health Service","place":["Cape Coast, Central Region, Ghana"]},{"name":"Nagasaki University","place":["Nagasaki, Japan"],"department":["School of Tropical Medicine and Global Health"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-8496-4099","authenticated-orcid":true,"given":"Silas","family":"Adjei-Gyamfi","sequence":"additional","affiliation":[{"name":"Nagasaki University","place":["Nagasaki, Japan"],"department":["School of Tropical Medicine and Global Health"]},{"name":"Auckland University of Technology","place":["Auckland, New Zealand"],"department":["Faculty of Health and Environmental Sciences"]},{"name":"Savelugu Municipal Hospital, Ghana Health Service","place":["Savelugu, Northern Region, Ghana"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doreen","family":"Brew Daniels","sequence":"additional","affiliation":[{"name":"Elmina Polyclinic, Ghana Health Service","place":["Elmina, Central Region, Ghana"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Godfred Kwabena","family":"Sarpong","sequence":"additional","affiliation":[{"name":"Central Regional Health Directorate, Ghana Health Service","place":["Cape Coast, Central Region, Ghana"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5910-3379","authenticated-orcid":true,"given":"Hirotsugu","family":"Aiga","sequence":"additional","affiliation":[{"name":"Nagasaki University","place":["Nagasaki, Japan"],"department":["School of Tropical Medicine and Global Health"]},{"name":"Nagasaki University","place":["Nagasaki, Japan"],"department":["Institute of Tropical Medicine (NEKKEN)"]},{"name":"Nagasaki University","place":["Nagasaki, Japan"],"department":["Inter-Faculty Initiative for Planetary Health (IIPH)"]},{"name":"International Cooperation Agency (JICA)","place":["Tokyo, Japan"],"department":["Japan Human Development Department"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsunoneri","family":"Aoki","sequence":"additional","affiliation":[{"name":"Nagasaki University","place":["Nagasaki, Japan"],"department":["School of Tropical Medicine and Global Health"]},{"name":"Japan International Cooperation Agency (JICA) Palau Country Office","place":["Koror, Palau"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,10,7]]},"reference":[{"key":"pone.0359892.ref001","year":"2012"},{"key":"pone.0359892.ref002","year":"1978"},{"key":"pone.0359892.ref003","year":"2017"},{"key":"pone.0359892.ref004","volume-title":"WHO recommendations on antenatal care for a positive pregnancy experience","author":"World Health Organization (WHO)","year":"2016"},{"issue":"4","key":"pone.0359892.ref005","doi-asserted-by":"crossref","first-page":"532","DOI":"10.1080\/17441692.2020.1839926","article-title":"Socio-cultural factors influencing the decision of women to seek care during pregnancy and delivery: A qualitative study in South Tongu District, Ghana","volume":"16","author":"L Barbi","year":"2021","journal-title":"Glob Public Health"},{"issue":"1","key":"pone.0359892.ref006","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1186\/s13690-025-01608-1","article-title":"Determinants of antenatal care service utilisation in sub-Saharan Africa: An analysis of demographic and health surveys data (2015-2022)","volume":"83","author":"BA Ayele","year":"2025","journal-title":"Arch Public Health"},{"key":"pone.0359892.ref007","year":"2006"},{"key":"pone.0359892.ref008","author":"UNICEF","year":"2022"},{"issue":"1","key":"pone.0359892.ref009","doi-asserted-by":"crossref","first-page":"1291879","DOI":"10.1080\/16549716.2017.1291879","article-title":"Determinants of attending antenatal care at least four times in rural Ghana: Analysis of a cross-sectional survey","volume":"10","author":"E Sakeah","year":"2017","journal-title":"Glob Health Action"},{"key":"pone.0359892.ref010","unstructured":"World Health Organization (WHO). Maternal mortality evidence brief progress towards achieving the sustainable development goals. 2019."},{"issue":"1","key":"pone.0359892.ref011","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1186\/s41043-023-00431-0","article-title":"Maternal risk factors for low birthweight and macrosomia: A cross-sectional study in Northern Region, Ghana","volume":"42","author":"S Adjei-Gyamfi","year":"2023","journal-title":"J Health Popul Nutr"},{"issue":"04","key":"pone.0359892.ref012","doi-asserted-by":"crossref","DOI":"10.26502\/jppch.74050169","article-title":"Prevalence and associated risk factors of preterm and post-term births in Northern Ghana: A retrospective study in savelugu municipality","volume":"07","author":"S Adjei-Gyamfi","year":"2023","journal-title":"J Pediatr Perinatol Child Health"},{"issue":"6","key":"pone.0359892.ref013","article-title":"Global causes of maternal death: A WHO systematic analysis","volume":"2","author":"L Say","year":"2014","journal-title":"Lancet Glob Health"},{"issue":"2","key":"pone.0359892.ref014","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0117996","article-title":"Rural\/urban and socioeconomic differentials in quality of antenatal care in Ghana","volume":"10","author":"PA Afulani","year":"2015","journal-title":"PLoS One"},{"issue":"1","key":"pone.0359892.ref015","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1186\/s12884-017-1246-3","article-title":"Factors influencing utilisation of maternal health services by adolescent mothers in Low-and middle-income countries: A systematic review","volume":"17","author":"OE Banke-Thomas","year":"2017","journal-title":"BMC Pregnancy Childbirth"},{"key":"pone.0359892.ref016","doi-asserted-by":"crossref","first-page":"101","DOI":"10.3389\/fpubh.2018.00101","article-title":"Maternal death in rural Ghana: A case study in the upper East Region of Ghana","volume":"6","author":"PA Apanga","year":"2018","journal-title":"Front Public Health"},{"key":"pone.0359892.ref017","volume-title":"United Nations (UN). The Millennium Development Goals Report 2013","year":"2013"},{"key":"pone.0359892.ref018","doi-asserted-by":"crossref","DOI":"10.1017\/S1463423619000185","article-title":"Access to primary health care among women: The role of Ghana\u2019s community-based health planning and services policy","volume":"20","author":"JA Braimah","year":"2019","journal-title":"Prim Health Care Res Dev"},{"issue":"1","key":"pone.0359892.ref019","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1186\/s12939-019-1043-x","article-title":"Socioeconomic inequalities in maternal health care utilization in Ghana","volume":"18","author":"J Novignon","year":"2019","journal-title":"Int J Equity Health"},{"key":"pone.0359892.ref020","author":"Ministry of Health (MoH) - Ghana","year":"2014"},{"key":"pone.0359892.ref021","volume-title":"Ghana Health Services (GHS). Community-based health planning and services (CHPS) implementation guidelines","year":"2016"},{"key":"pone.0359892.ref022","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1186\/1471-2458-14-344","article-title":"Using the community-based health planning and services program to promote skilled delivery in rural Ghana: Socio-demographic factors that influence women utilization of skilled attendants at birth in northern Ghana","volume":"14","author":"E Sakeah","year":"2014","journal-title":"BMC Public Health"},{"issue":"1","key":"pone.0359892.ref023","doi-asserted-by":"crossref","first-page":"117","DOI":"10.9745\/GHSP-D-12-00012","article-title":"Lessons learned from scaling up a community-based health program in the Upper East Region of northern Ghana","volume":"1","author":"JK Awoonor-Williams","year":"2013","journal-title":"Glob Health Sci Pract"},{"key":"pone.0359892.ref024","year":"2018"},{"key":"pone.0359892.ref025","volume-title":"World Health Organization (WHO). World Health Statistics 2019: Monitoring Health for the Sustainable Development Goals","year":"2019"},{"issue":"3","key":"pone.0359892.ref026","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0120556","article-title":"Evaluating the impact of the community-based health planning and services initiative on uptake of skilled birth care in Ghana","volume":"10","author":"FA Johnson","year":"2015","journal-title":"PLoS One"},{"key":"pone.0359892.ref027","unstructured":"Ghana Health Service. DHIMS: District Information Management Systems version 2. 2021."},{"key":"pone.0359892.ref028","author":"Ghana Statistical Service","year":"2021"},{"issue":"3","key":"pone.0359892.ref029","doi-asserted-by":"crossref","first-page":"261","DOI":"10.4103\/0019-5154.182410","article-title":"Methodology Series Module 3: Cross-sectional Studies","volume":"61","author":"MS Setia","year":"2016","journal-title":"Indian J Dermatol"},{"key":"pone.0359892.ref030","article-title":"Cross sectional studies: Advantages and disadvantages","volume":"348","author":"P Sedgwick","year":"2014","journal-title":"BMJ"},{"key":"pone.0359892.ref031","volume-title":"Sampling Techniques","author":"WG Cochran","year":"1977","edition":"3"},{"issue":"2","key":"pone.0359892.ref032","doi-asserted-by":"crossref","first-page":"121","DOI":"10.4103\/0253-7176.116232","article-title":"How to calculate sample size for different study designs in medical research?","volume":"35","author":"J Charan","year":"2013","journal-title":"Indian J Psychol Med"},{"key":"pone.0359892.ref033","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1186\/1472-698X-13-49","article-title":"Barriers to using skilled birth attendants\u2019 services in mid- and far-western Nepal: A cross-sectional study","volume":"13","author":"B Choulagai","year":"2013","journal-title":"BMC Int Health Hum Rights"},{"issue":"7","key":"pone.0359892.ref034","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0234575","article-title":"Women\u2019s knowledge and its associated factors regarding optimum utilisation of antenatal care in rural Ghana: A cross-sectional study","volume":"15","author":"A Afaya","year":"2020","journal-title":"PLoS One"},{"key":"pone.0359892.ref035","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1016\/j.socscimed.2013.06.012","article-title":"Travel time to maternity care and its effect on utilization in rural Ghana: A multilevel analysis","volume":"93","author":"SH Masters","year":"2013","journal-title":"Soc Sci Med"},{"issue":"1","key":"pone.0359892.ref036","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1186\/1476-072X-11-15","article-title":"Measuring geographic access to health care: Raster and network-based methods","volume":"11","author":"PL Delamater","year":"2012","journal-title":"Int J Health Geogr"},{"key":"pone.0359892.ref037","doi-asserted-by":"crossref","DOI":"10.1136\/bmjgh-2019-002020","article-title":"The influence of distance and quality on utilisation of birthing services at health facilities in Eastern Region, Ghana","volume":"4","author":"W Dotse-Gborgbortsi","year":"2020","journal-title":"BMJ Glob Health"},{"issue":"12","key":"pone.0359892.ref038","doi-asserted-by":"crossref","first-page":"1373","DOI":"10.1016\/S0895-4356(96)00236-3","article-title":"A simulation study of the number of events per variable in logistic regression analysis","volume":"49","author":"P Peduzzi","year":"1996","journal-title":"J Clin Epidemiol"},{"key":"pone.0359892.ref039","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1186\/1751-0473-3-17","article-title":"Purposeful selection of variables in logistic regression","volume":"3","author":"Z Bursac","year":"2008","journal-title":"Source Code Biol Med"},{"issue":"1","key":"pone.0359892.ref040","doi-asserted-by":"crossref","DOI":"10.1186\/s12884-022-04404-9","article-title":"Trends in antenatal care visits and associated factors in Ghana from 2006 to 2018","volume":"22","author":"PA Duodu","year":"2022","journal-title":"BMC Pregnancy Childbirth"},{"issue":"1","key":"pone.0359892.ref041","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1186\/s12884-018-1749-6","article-title":"They receive antenatal care in health facilities, yet do not deliver there: Predictors of health facility delivery by women in rural Ghana","volume":"18","author":"M Boah","year":"2018","journal-title":"BMC Pregnancy 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Nonvignon","year":"2018"},{"issue":"1","key":"pone.0359892.ref046","doi-asserted-by":"crossref","first-page":"1956754","DOI":"10.1080\/16549716.2021.1956754","article-title":"The relationship between time spent during the first ANC contact, home visits and adherence to ANC contacts in Ghana","volume":"14","author":"MT Kumbeni","year":"2021","journal-title":"Glob Health Action"},{"issue":"1","key":"pone.0359892.ref047","doi-asserted-by":"crossref","first-page":"1916","DOI":"10.1186\/s12889-020-10017-8","article-title":"Barriers to accessing healthcare among women in Ghana: A multilevel modelling","volume":"20","author":"A-A Seidu","year":"2020","journal-title":"BMC Public Health"},{"issue":"4","key":"pone.0359892.ref048","first-page":"1","article-title":"Focused antenatal care service utilization and associated factors in Dejen and Aneded districts, Northwest Ethiopia","volume":"4","author":"T Getachew","year":"2014","journal-title":"Prim Heal Care Open Access"},{"key":"pone.0359892.ref049","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1186\/1471-2393-14-161","article-title":"Determinants of maternal health service utilization in Ethiopia: analysis of the 2011 Ethiopian Demographic and Health Survey","volume":"14","author":"SM Tarekegn","year":"2014","journal-title":"BMC Pregnancy Childbirth"},{"key":"pone.0359892.ref050","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1186\/1475-9276-12-30","article-title":"Determinants of antenatal and delivery care utilization in Tigray region, Ethiopia: A cross-sectional study","volume":"12","author":"Y Tsegay","year":"2013","journal-title":"Int J Equity Health"},{"issue":"1","key":"pone.0359892.ref051","doi-asserted-by":"crossref","first-page":"1094","DOI":"10.1186\/s12889-019-7400-2","article-title":"\u201cNo visible signs of pregnancy, no sickness, no antenatal care\u201d: Initiation of antenatal care in a rural district in Northern Ghana","volume":"19","author":"AM Kotoh","year":"2019","journal-title":"BMC Public Health"},{"issue":"1","key":"pone.0359892.ref052","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1186\/s13104-017-2591-z","article-title":"Socio-demographic determinants of skilled birth attendant at delivery in rural southern Ghana","volume":"10","author":"AK Manyeh","year":"2017","journal-title":"BMC Res Notes"},{"issue":"1","key":"pone.0359892.ref053","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12889-019-7253-8","article-title":"Factors determining choice of place of delivery: Analytical cross-sectional study of mothers in Akordet town, Eritrea","volume":"19","author":"NK Gebregziabher","year":"2019","journal-title":"BMC Public Health"},{"issue":"1","key":"pone.0359892.ref054","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1186\/s12978-020-0907-2","article-title":"A qualitative study on acceptability of the mistreatment of women during childbirth in Myanmar","volume":"17","author":"TM Maung","year":"2020","journal-title":"Reprod Health"},{"issue":"6","key":"pone.0359892.ref055","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1001847","article-title":"The mistreatment of women during childbirth in health facilities globally: A mixed-methods systematic review","volume":"12","author":"MA Bohren","year":"2015","journal-title":"PLoS Med"},{"issue":"12","key":"pone.0359892.ref056","doi-asserted-by":"crossref","first-page":"2930","DOI":"10.1016\/j.socscimed.2005.11.034","article-title":"Challenges to the reproductive-health needs of African women: On religion and maternal health utilization in Ghana","volume":"62","author":"SO Gyimah","year":"2006","journal-title":"Soc Sci Med"},{"issue":"12","key":"pone.0359892.ref057","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0261316","article-title":"Why do women attend antenatal care but give birth at home? a qualitative study in a rural Ghanaian District","volume":"16","author":"KA 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Tola","year":"2021","journal-title":"PLoS One"},{"key":"pone.0359892.ref061","first-page":"866030","article-title":"Level of late initiation of antenatal care visit and associated factors amongst antenatal care attendant mothers in Gedo General Hospital, West Shoa Zone, Oromia Region, Ethiopia","volume":"1","author":"L Chen","year":"2022","journal-title":"Front Public Heal"},{"issue":"1","key":"pone.0359892.ref062","doi-asserted-by":"crossref","first-page":"108","DOI":"10.4314\/star.v3i1.17","article-title":"Factors Associated with Late Initiation of Antenatal Care among Pregnant Women Attending Antenatal Clinic at Public Health Centers in Kembata Tembaro Zone, Southern Ethiopia","volume":"3","author":"T Tekelab","year":"2014","journal-title":"Sci Technol Arts Res J"},{"issue":"1","key":"pone.0359892.ref063","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12978-021-01124-9","article-title":"Predictors of skilled birth attendance among married women in Cameroon: Further analysis of 2018 Cameroon Demographic and Health Survey","volume":"18","author":"S Yaya","year":"2021","journal-title":"Reprod Health"},{"key":"pone.0359892.ref064","article-title":"Factors associated with socio-demographic characteristics and antenatal care and iron supplement use in Ethiopia, Kenya, and Senegal","author":"A Verney","year":"2018","journal-title":"Matern Child Nutr"},{"issue":"1","key":"pone.0359892.ref065","doi-asserted-by":"crossref","first-page":"010502","DOI":"10.7189\/jogh.10.010502","article-title":"Timing and number of antenatal care contacts in low and middle-income countries: Analysis in the Countdown to 2030 priority countries","volume":"10","author":"SS Jiwani","year":"2020","journal-title":"J Glob Health"},{"key":"pone.0359892.ref066","first-page":"12","author":"World Health Organization","year":"2019"},{"issue":"6","key":"pone.0359892.ref067","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0011190","article-title":"Economic status, education and 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Community mobilization and home visits: key pillars of the community-based health planning and services (CHPS) program in Ghana. 2015."},{"issue":"1","key":"pone.0359892.ref070","doi-asserted-by":"crossref","DOI":"10.1136\/bmjgh-2018-001172","article-title":"The impact of universal home visits with pregnant women and their spouses on maternal outcomes: A cluster randomised controlled trial in Bauchi State, Nigeria","volume":"4","author":"A Cockcroft","year":"2019","journal-title":"BMJ Glob Health"},{"key":"pone.0359892.ref071","doi-asserted-by":"crossref","first-page":"184","DOI":"10.11604\/pamj.2017.27.184.10926","article-title":"Factors determining late antenatal care booking and the content of care among pregnant mother attending antenatal care services in East Wollega administrative zone, West Ethiopia","volume":"27","author":"E Ejeta","year":"2017","journal-title":"Pan Afr Med J"},{"key":"pone.0359892.ref072","doi-asserted-by":"crossref","first-page":"971506","DOI":"10.1155\/2015\/971506","article-title":"Timing of first antenatal care attendance and associated factors among pregnant women in Arba Minch Town and Arba Minch District, Gamo Gofa Zone, south Ethiopia","volume":"2015","author":"F Gebremeskel","year":"2015","journal-title":"J Environ Public Health"},{"issue":"10136","key":"pone.0359892.ref073","doi-asserted-by":"crossref","first-page":"2236","DOI":"10.1016\/S0140-6736(18)30994-2","article-title":"Measuring performance on the Healthcare Access and Quality Index for 195 countries and territories and selected subnational locations: A systematic analysis from the Global Burden of Disease Study 2016","volume":"391","author":"N Fullman","year":"2018","journal-title":"Lancet"},{"key":"pone.0359892.ref074","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1186\/1471-2393-13-121","article-title":"Timing and reasons for coming late for the first antenatal care visit by pregnant women at Mulago hospital, Kampala Uganda","volume":"13","author":"I Kisuule","year":"2013","journal-title":"BMC Pregnancy Childbirth"},{"issue":"1","key":"pone.0359892.ref075","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12978-018-0542-3","article-title":"Determinants of antenatal care attendance among women residing in highly disadvantaged communities in northern Jordan: A cross-sectional study","volume":"15","author":"HH Hijazi","year":"2018","journal-title":"Reprod Health"},{"key":"pone.0359892.ref076","doi-asserted-by":"crossref","DOI":"10.1002\/9781118548387","volume-title":"Applied logistic regression","author":"DWJ Hosmer","year":"2013","edition":"3"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0359892","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T17:38:28Z","timestamp":1791394708000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0359892"}},"subtitle":[],"editor":[{"given":"Joshua","family":"Sumankuuro","sequence":"first","affiliation":[{"name":"Simon Diedong Dombo University of Business and Integrated Development Studies","place":["GHANA"]}],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,10,7]]},"references-count":76,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2026,10,7]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0359892","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,7]]}}}