Timeliness of antenatal care initiation and its associated factors among pregnant women: Evidence from the 2022 Tdhs-Mis

Reducing maternal mortality and enhancing women's healthcare are key targets of the Third Sustainable Development Goal (SDG), aiming to lower the global maternal mortality ratio (MMR) to 70 per 100,000 live births by 2030. This study examines predictors of the timing of the first antenatal care (ANC) visit among pregnant women in Tanzania. It was pegged on three theoretical frameworks: the Health Belief Model (HBM), the Theory of Planned Behavior (TPB), and Andersen's Behavioral Model. A cross-sectional analysis was conducted using 2022 Tanzania Demographic and Health Survey data. The study population included adult women aged 15–49 years. Data were weighted to reflect the complex survey design. The study employed descriptive statistics to assess ANC initiation across trimesters, log-rank tests to select variables, and multivariate Cox proportional hazards regression to identify timing-related factors. Of 5,195 women, 66% initiated ANC after three months, while 34% did so within the recommended period. Older women (35–49 years) delayed their ANC by 43.7% compared to those aged 15–24 (AHR: 0.77, 95% CI: 0.67–0.90, p < 0.001). Education shortened ANC timing: primary (AHR: 1.27, p = 0.003), secondary (AHR: 1.30, p = 0.007), and higher (AHR: 1.80, p = 0.008). Proximity to health facilities (AHR: 1.11, p < 0.074), employment (AHR: 1.02, p < 0.08), and media exposure (radio: AHR: 1.13, p = 0.067; TV: AHR: 1.18, p = 0.028) showed a non-significant trend toward earlier ANC. Age, education, distance to facilities, employment, and media exposure significantly influence ANC timing. Health literacy promotion and media campaigns are recommended to enhance timely ANC initiation.