title: Factors that Influence Teenage Antenatal Care Utilization in John Taolo Gaetsewe (JTG) District of Northern Cape Province, South Africa: Underscoring the Need for Tackling Social Determinants of Health.
abstract: OBJECTIVE
  In resource-limited settings, the uptake of antenatal care visits among women, especially teenage pregnant women, is disturbingly low. Factors that influence the uptake of ANC services among teenage women is largely understudied and poorly understood in John Taolo Gaetsewe (JTG), a predominantly rural and poor district of South Africa. The aim of this study was to determine the factors that influence uptake of ANC services among teenage mothers in JTG district.
  
  
  METHODS
  A cross-sectional health facility-based study utilising mixed method was conducted in all public health facilities (n=44) at JTG district. Mother-infant pairs (n=383) who brought their infants for six-week first DPT immunisation during the study period were enrolled in the study. Structured questionnaires were used to collect data on demographic, socio-economic and uptake of ANC indicators.
  
  
  RESULTS
  Out of 272 respondent mothers, 18.68% were adolescent mothers (13-19 years). The logistic regression analysis shows that mother's age (OR=2.11; 95%CI = 1.04 - 4.27); distance to the nearest health facility (OR=3.38; 95%CI = 1.45-7.87); and client service satisfaction (OR=8.58; 95%CI =2.10-34.95 are significantly associated with poor uptake of ANC services.
  There is a need to improve the quality of adolescent reproductive health services tailored to their health and developmental needs. Moreover, addressing the social determinants of health that affect individual's healthy life style and health seeking behavior is critical.
authors.affiliation: Northern Cape Department of Health, Kimberley 8301, South Africa.
authors.forename: Eshetu Bekele
authors.initials: EB
authors.lastname: Worku
authors.affiliation: U.S. Centers for Disease Control and Prevention, Pretoria 0001, South Africa.
authors.forename: Selamawit Alemu
authors.initials: SA
authors.lastname: Woldesenbet
keywords: Antenatal Care Visits; John Taolo Gaetsewe; Social Determinants of Health; Teenage Pregnancy