Introduction: One of the most important strategies to lower mother and newborn fatalities worldwide is providing quality Antenatal care (ANC). The utilization of quality ANC by women of reproductive age and associated factors remains unclear in many developing countries. Therefore, the purpose of this study was to determine the factors associated with the utilization of quality ANC in Kenya.   Methods:  We analyzed Secondary data from the Kenya Demographic Health Survey (KDHS) 2022, which included 11,863 women. Participants were selected using a two-stage stratified sampling design. Using SPSS, version 20, univariate and multivariable logistic regression was used to analyze the data. Results: Of the 11,863 women, 61.2% (95% CI: 59.7-62.6) received quality ANC. Older mothers (aged 20–34) had a 1.82 (95%CI: 1.15-2.87) times higher likelihood of receiving quality ANC when compared with younger mothers (15–19 years old). Participating mothers who had attended 4 or more ANC visits were 1.42 (95%CI: 1.14-1.79) times more likely to receive quality ANC than those who attended 3 or fewer visits. Comparing participants with and without media access, those with media access were 1.47 (95%CI: 1.06-2.03) times more likely to receive quality ANC. Furthermore, the likelihood of receiving quality ANC was 1.93 (95%CI: 1.21-3.08) and 1.44 (95%CI: 1.01-2.06) times higher for participants in the richest and richer quintiles, respectively, than for those in the poorest quintile. On the contrary, the odds of receiving quality ANC were 0.25 (95%CI: 0.15-0.31) to 0.64 (95%CI: 0.44-0.92) times lower for participating mothers from all other Kenyan regions than for those from the coastal region. Participants whose husbands or partners made decisions for them to seek healthcare, compared with those who made decisions independently were 0.74 (95%CI: 0.58-0.95) times less likely to receive quality antenatal care.  Conclusion: The study revealed that about 60% of mothers received quality ANC. Several factors associated with quality ANC were identified: age, region, maternal education, health-seeking decision-making, access to media (TV), time to the health facility, ANC visits, and ANC providers (doctor and nurse/midwife/clinical officer). Maternal health improvement programs should prioritize promoting access to education for girls. Additionally, interventions should focus on promoting shared decision-making and autonomy in healthcare-seeking behaviors among pregnant women and their partners, increasing access to care provided by skilled health workers, and addressing regional disparities in healthcare delivery.

The authors have declared no competing interest.

There was no funding for this study.

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

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The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

The Institutional Review Board of the Inner-City Fund (ICF) granted ethical approval for the 2022 KDHS. Whereas the Kenya National Bureau of Statistics carried out the study in collaboration with other development partners. Since this study is based on secondary data from the KDHS that is publicly available, no ethical approval was required for its analysis, however, MEASURE DHS provided authorization to use the KDHS datasets (https://www.dhsprogram.com/data/available-datasets.cfm).

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I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

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I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

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The Institutional Review Board of the Inner-City Fund (ICF) granted ethical approval for the 2022 KDHS. Whereas the Kenya National Bureau of Statistics carried out the study in collaboration with other development partners. Since this study is based on secondary data from the KDHS that is publicly available, no ethical approval was required for its analysis, however, MEASURE DHS provided authorization to use the KDHS datasets (https://www.dhsprogram.com/data/available-datasets.cfm). Both from human participants and from legally appointed representatives of minor participants, written informed consent was acquired.

https://www.dhsprogram.com/data/available-datasets.cfm