Introduction: Antenatal care (ANC) contributes to the reduction of maternal and neonatal morbidity and mortality. The study aimed to investigate the determinants of the low proportion of pregnant women seen for first antenatal care in the first trimester of pregnancy at the urban medical center of Koudougou, Burkina Faso. Materials and Methods: This was a cross-sectional study with data collection from June 08 to August 18, 2021. It involved a sample of 302 participants including 280 pregnant women and 22 maternity providers. Semi-structured individual interviews, non-participant observation, and a literature review were used. Results: Pregnant women age 20 and over, knowledge of the date of their last menstrual period, and knowledge of the antenatal care calendar were associated with coming into contact (1) with Antenatal care in the first trimester of pregnancy. In addition, there was a lack of availability of antenatal care services, inadequate reception of clients, and shortages of health products. Conclusion: There is a need to revisit strategies for communicating with women about ANC, reorganizing ANC services, and improving ANC services.
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