Utilisation of Antenatal Care Services and Associated Factors among Tribal Women in Sambalpur District, Odisha, India: A Prospective longitudinal Study

Introduction: Antenatal Care (ANC) is a crucial component for maternal and foetal healthcare, yet utilisation among tribal populations remains suboptimal due to socio-cultural, geographical, and economic barriers. The study focuses on three tribal blocks in the Sambalpur district, Odisha, namely Jamankira, Kuchinda, and Bamra, which have a significant tribal population. Aim: To estimate the utilisation of ANC services among the tribal women and to describe the factors associated with the utilisation of ANC services. Materials and Methods: A community-based prospective longitudinal study was conducted under the Department of Community Medicine in tribal villages, which are part of the blocks of Jamankira, Kuchinda, and Bamra of Sambalpur district, Odisha, India, from March 2023 to May 2025. A community-based sample of postpartum mothers (within one month of normal vaginal and caesarean delivery) was taken using the World Health Organisation (WHO) 30-cluster sampling technique. Data were collected using a pre-tested structured questionnaire, which included parameters like socioeconomic data, pregnancy history, timing of ANC registration, ANC services (laboratory tests, prophylactic measures like Iron and Folic acid (IFA) tablets, Calcium, deworming, Tetanus toxoid administration, and contraceptive use), and counselling regarding pregnancy. Chi-square test, Fisher’s-exact test was used to analyse the data in Statistical Package for Social Sciences (SPSS) version 30.0, and a p-value<0.05 was considered significant. Results: Out of 210 study participants (postpartum mothers), the majority of mothers were aged 25-29 years, 92 (43.8%), Hindu,189 (90%), and lived in three-generation families, 83 (39.5%). Most mothers had a high-school education, 129 (61.4%) and were unemployed, 127 (60.5%). Only 82 (39%) of mothers received comprehensive ANC (≥4 visits with IFA tablets, calcium, deworming, and counselling). Core investigations like blood sugar, urine routine and microscopy test, Human Immunodeficiency Virus (HIV) screening, and blood grouping were universally performed, but prophylactic measures like IFA, 139 (66.2%) and calcium supplementation, 119 (56.7%) had lower coverage. All participants, 210 (100%) received counselling on danger signs, breastfeeding, family planning, and postnatal care. Education, occupation, and parity significantly influenced ANC uptake (p<0.001). Early ANC registration (≤12 weeks) was significantly associated with higher education levels (p=0.027). Multiparous women and those with adverse obstetric histories (abortions, stillbirths) were less likely to receive comprehensive ANC. Conclusion: Despite high diagnostic and counselling coverage, comprehensive ANC utilisation remains low among tribal women in Sambalpur, Odisha. Socio-demographic factors like education and occupation, along with obstetric history, significantly influence ANC uptake. Targeted interventions are needed to improve awareness, accessibility, and adherence to ANC protocols.