Department of Midwifery and Maternal Health

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    MAGNITUDE AND ASSOCIATED FACTORS OF LOW BIRTH WEIGHT AMONG NEWBORNS DELIVERED IN PUBLIC HOSPITALS OF TIGRAY DURING CONFLICT TIME.
    (Mekelle University, 2025-06-21) SAMSON HADUSH
    Background: Birth weight is a critical determinant of perinatal survival and significantly influences infant morbidity and mortality. Low birth weight remains a serious global health issue, particularly in developing countries like Ethiopia, where research on low birth weight and its determinants is limited. This lack of data hampers efforts to address the underlying factors contributing to low birth weight and improve maternal and child health outcomes. The war in Tigray has disrupted healthcare services, potentially exacerbating the challenges associated with maternal health that leads low birth weights. Understanding the factors contributing to LBW will help to identify the impact of conflict on maternal and infant health and ensure that vulnerable populations receive the necessary support. Thus, the objective of this study aimed at identifying the magnitude and associated factors of LBW among newborns delivered at public health facilities in Tigray, Ethiopia Method: A Hospital based cross-sectional study design was applied from November 2024 – December 2024. A total of 540 newborn birth records were selected using systematic random sampling technique, and data was collected using data kobo tool. Six BSc degree holders were employed for data collection and the data collection period was entirely supervised by one masters’ degree holder and myself. Data was entered into Epi info 7, then exported to SPSS version 23. Binary logistic regression model was used to assess the associated factors of low birth weight. The results are presented as crude odds ratios (P<0.25) and adjusted odds ratios (AOR) (P<0.05) together with their corresponding 95% confidence intervals. Results: A total of 540 maternal cards were reviewed during the study period, with 95.8% rate of complete cards. In logistic regression model, significant association was found with Unplanned Pregnancy (AOR=10.4, 95% CI 5.10 - 21.26), No Antenatal care follow up (AOR=3.6, 95% CI 1.35 – 9.837), Gestational age <37 weeks (AOR=6.5, 95% CI 3.32 – 12.67), Obstetric complication (AOR=2.5, 95% CI 1.24 – 4.97), Medical complication (AOR=2.9, 95% CI 1.02 – 8.32), Maternal Anemia (AOR=3.3, 95% CI 2.37 – 46.49.26) and Acute malnutrition (AOR=2.8, 95% CI 1.31 – 9.94). Conclusion: The study finding indicated that a significant number of newborns measured low birthweight. The study identified factors such as pregnancy plan, ANC follow up, Obstetric and Medical condition during pregnancy, maternal acute malnutrition, Maternal Anemia and Gestational Age had significant association. Based on study findings, I recommend Tigray government and regional health bureau to make sure accessible health care system and advocating to nongovernmental organizations to support in recovering health care system which is destructed, Health care providers to counsel and provide comprehensive health care, particularly during pregnancy and before pregnancy.
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    Determinants of stillbirth among mothers who gave birth in public hospitals of Tigray, Ethiopia 2024/25
    (Mekelle University, 2025-05-28) LEAKE GEBRESILASIE
    Background Each stillbirth is a devastating experience causing untold heartbreak for millions of families around the world. Stillbirth is also a global health crisis that affects millions of families each year. Globally, 1.9 million children are stillborn at 28 weeks or more of gestation every year. Stillbirth has wide-reaching consequences for parents, care providers, communities, society and the country as whole but still it is among the least studied in Ethiopia, only few studies have tried to examine the determinant of still birth. Specifically researches on risk factors for stillbirth in tigray region remain scant. Objective: To assess the determinants of stillbirth among mothers who gave birth in public hospitals of Tigray, northern Ethiopia, 2024/25. Methods: Institutional based an unmatched case control study using secondary data as a source of information was conducted. A total 350 samples (72 cases and 278controls) were recruited. A simple random and systematic random sampling technique was used to recruit cases and controls respectively from respective selected hospitals. Cases were all mothers who gave still birth and Controls were all mothers who gave live birth at public hospitals of tigray. The data was collected using structured questionnaire checklist. P-value < 0.2 in bivariable logistic regression was selected for multivariable logistic regressions analysis. The strength of association between exposure and outcome variable was declared with AOR, 95% CI with p value <0.05. Results: Mothers who had ante partum hemorrhage (AOR=4.66, 95%CI:1.84, 11.79), who did not attending antenatal care (AOR=2.68, 95%CI: 1.27, 5.65), induced labour (AOR=6.42, 95% CI:2.77, 14.91), instrumental delivery (AOR=2.6, 95%CI:1.05, 6.46), congenital anomaly (AOR=12.24, 95%CI:4.17, 35.94), baby born before 37 week of gestation (AOR=6.47, 95%CI:2.31, 18.14), baby born beyond 42 week of gestation (AOR=5.94, 95%CI:2.06, 17.00) and baby born with < 2500 gram(AOR=3.6, 95%CI:2.32, 9.89) were significantly associated with stillbirth. Conclusion and recommendation: Having ante partum hemorrhage, did not attending antenatal care , induced labour , instrumental delivery , congenital anomaly , baby born before 37 week of gestation , baby born beyond 42 week of gestation and baby born with weight of < 2500 gram were positively associated with stillbirth. Pregnant women should be identified early and provide comprehensive prenatal and preconception care.
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    DETERMINANTS OF PREMATURE RUPTURE OF MEMBRANE AMONG PREGNANT WOMEN ADMITTED TO PUBLIC HOSPITALS OF CENTRAL ZONE OF TIGRAY, NORTHERN ETHIOPIA, UNMATCHED CASE CONTROL STUDY 2024/25
    (Mekelle University, 2025-05-28) NIGUSALEM TAKELE
    Back ground Pre-labor rupture of membrane is rupture of membranes before to the onset of labor[1]. Premature rupture of membranes, occurring in 1–4% of pregnancies globally, remains a significant obstetric complication affecting both developed and developing countries. It contributes to maternal and neonatal morbidity, mortality, and economic burdens. Despite existing interventions, premature rupture of membranes (PROM) continues to be a public health concern. In Ethiopia, particularly in the war affected Tigray, there is limited evidence on its determinants. Identifying these factors is essential to guide effective prevention and management strategies. Objective: To identify the determinants of premature rupture of membrane among pregnant women admitted to public hospitals in the central zone of Tigray, northern, Ethiopia ,in 2024/2025. Methods: A hospital-based unmatched case–control study was conducted on 264 pregnant women (88 cases and 176 controls) admitted to public hospitals from December 1,2024 –January 30, 2025.Pregnant women admitted to maternity wards of selected hospitals with a painless gush of fluid spilling out from the vaginal canal were considered as PROM. Interviewer-administered questionnaires tools were used to collect data. The data was coded and entered into Epi-info version 7 and exported to SPSS version 27 for analysis. Binary logistic regression was used to test the association between the dependent and independent variable. P value less than 0.25 in bivariable analysis were entered to multivariable analysis to identify the determinants of PROM. Level of significance was declared at P-VALUE <0.05. Odds ratio with 95% confidence interval were used to determine the strength of the association. Result: The study identified several factors significantly associated with PROM. Pregnant women without antenatal care were 4.45 times more likely to experience PROM (AOR = 4.45, 95% CI: 1.78–11.07). A previous history of PROM also showed a strong association (AOR = 3.40, 95% CI: 1.22–9.48). Women with a mid-upper arm circumference (MUAC) below 23 had higher odds of PROM (AOR = 3.18, 95% CI: 1.68–5.99). Additionally, abnormal vaginal discharge (AOR = 3.31, 95% CI: 1.26–8.66), polyhydramnios (AOR = 4.22, 95% CI: 1.41–12.64), and urinary tract infection (UTI) (AOR = 1.59, 95% CI: 0.71–3.61) were identified as contributing factors, although the association with UTI did not reach statistical significance. Conclusion: Antenatal care follow-up, history of PROM, abnormal vaginal discharge, low mid-upper arm circumference (MUAC), and polyhydramnios were identified as significant determinants of premature rupture of membranes. Strengthening antenatal care services and addressing modifiable risk factors through early detection and management may help reduce the occurrence of PROM and its associated complication
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    PREVALENCE AND ASSOCIATED FACTORS OF SEXUALLY TRANSMITTED INFECTIONS AMONG PREGNANT WOMEN ATTENDING ANTENATAL CARE IN PUBLIC HOSPITALS, CENTRAL ZONE OFTIGRAY, ETHIOPIA, 2024/25
    (Mekelle University, 2024-12-15) YOSEPH GIRMAY
    Background – Sexually transmitted infections (STIs) during pregnancy are a significant public health concern, leading to severe maternal and neonatal complications such as preterm labor, stillbirth, low birth weight, and congenital infections. In developing countries, including post-conflict settings like Tigray, the burden of STIs is often heightened due to weakened health services, increased sexual violence, and limited access to affordable and reliable diagnostic tools. These challenges hinder timely diagnosis and treatment, exacerbating adverse pregnancy outcomes. Objective - To assess the prevalence and associated factors of sexually transmitted infections among pregnant women attending antenatal care in public hospitals located in the Central Zone of Tigray, Ethiopia, 2024/25. Method: - A facility based cross-sectional quantitative study was conducted among 312 pregnant women receiving antenatal care at selected public hospitals in the Central Zone of Tigray, A 1.5 design effect was applied to account for potential errors from the two stage sampling technique. Data were collected from November 15 to December 15, 2024, using pretested, structured face-to-face interviews. Data analysis was entered in to Epi Info version 7.2.2.2 and analyzed with SPSS version 25. Descriptive statistics summarized key variables, while bivariate and multivariable logistic regression analyses were used to calculate crude and adjusted odds ratios. Statistical significance was set at a 95% confidence interval with a p-value less than 0.05. Result: The Prevalence of STI and associated Syndromes were 21.8%, 95% CI: 16.9-26.6). Out of the 312 respondents; Sixty eight of them reported were they have at least one of the syndromes. Age AOR = 6.341, 95% CI:(2.439-16.488), History of Abortion AOR= 5.3%, 95%CI: (1.73-16.19), Having multiple sexual partners (AOR=4.6%, 95 % CI: 1.45 - 14.73), History of STI AOR 6.9%, 95% CI: (2.79 - 17.14), and drinking of alcohol AOR 4.1% 95% CI; 1.66-10.12); have a strong association to be diagnosed with STI syndromes. However, being married found to be a protective factor from contracting of STI than unmarried women. Conclusion; in this Study, STI found to be a major health problem among pregnant women since found one in five. Therefore, pregnant women with the determined factors have to receive an attention to halt the potential problem. Hence, raising community awareness through mass media and provision of STI preventive materials is crucial to mitigate the possible adverse pregnancy outcomes.
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    DETERMINANTS OF PREMATURE RUPTURE OF MEMBRANES AMONG PREGNANT MOTHERS ATTENDING PUBLIC HOSPITALS OF CENTRAL ZONE, TIGRAY, ETHIOPIA, 2024; UNMACHED CASE-CONTROL STUDY
    (Mekelle University, 2025-01-28) GEBREMARIAM KIFLE
    Background: Premature rupture of membranes is a condition in which the fetal membranes rupture before the onset of labor and after 28 weeks of gestational age. It complicates 5-10% of all pregnancy, and it is an important cause of perinatal, neonatal, and maternal morbidity and mortality both in developed and developing countries. Though some studies were conducted in Ethiopia on the determinants of premature rupture of membranes there was limited study in the Tigray region, particularly in the study area Objective: To identify determinants of premature rupture of membranes among pregnant mothers admitted to public hospitals in the Central Zone, Tigray, Ethiopia,2024 Methods: A hospital based unmatched case-control study design was conducted from August 1 to September 30, 2024, in public hospitals of Central Zone of Tigray, Ethiopia. All cases admitted at the time of data collection were included until the desired sample size was met, and controls were selected by systematic random sampling. Data were collected using a structured and pre-tested questionnaire by trained midwives then data were entered into Epi Data Version 4.7 and exported to Statistical Package for Social Sciences Version 27. Logistic regression was employed to identify determinant variables. Variables with a p value of less than 0.05 with a 95% confidence interval were used as a statistically significant association in a multivariable logistic regression. Result: A total of 363 participants (121 cases and 242 controls) were included in the study. Rural residence (AOR=2.17,95 % CI: 1.31-3.59, p-value=0.003), having multiple fetus (AOR=2.44,95% CI: 1.01-5.89, p-value=0.047), history of Premature rupture of membrane (AOR=2.76,95% CI: 1.42-5.38, p-value=0.003), and Mid-upper arm circumference <23cm (AOR=2.79,95% CI: 1.59-4.89, p-value=0.001) were identified as determinants of premature rupture of membrane. Conclusion and recommendation: The identified determinants of premature rupture of membranes were rural residence, multiple gestation, history of Premature rupture of membrane, and Mid-upper arm circumference <23 cm. Therefore, pregnant women who live in rural areas, have multiple pregnancy and had history of premature rupture of membranes should be well followed up during pregnancy. Moreover, early nutritional screening, counseling and intervention should be strengthened during prenatal care.
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    MAGNITUDE AND DETERMINANTS OF LOW BIRTH WEIGHT AMONG NEWBORN BABIES IN PUBLIC HOSPITALS OF MEKELLE CITY, TIGRAY REGION, ETHIOPIA, 2024
    (Mekelle University, 2024-06-28) DESTA FITSUM
    Background: Low birth weight is a serious global public health issue which is associated with increased risks of neonatal morbidity, mortality, and later health complications. Low birth weight is present in over 20 million neonates annually, and the vast majority live in low and middle-income countries, particularly in Sub-Saharan Africa. In Ethiopia, the prevalence of Low birth weight is strongly heterogeneous by place, and the prevalence has been between 7.8% and 40%. It has remained a challenge despite global efforts through comprehensive maternal and newborn care. This study addresses the persistent challenge of low birth weight in Ethiopia by identifying context specific risk factors, offering critical evidence to guide targeted interventions and reduce neonatal morbidity and mortality in high burden, resource limited settings. Objective: The objective of this study was to assess the magnitude and determinant factors of low birth weight among newborn babies in public hospitals in Mekelle City, Tigray, Ethiopia, in 2024. Methods: An institutional-based cross-sectional study was conducted. A total sample size of 383 was determined by using Epi Info version 7.2. Participants were selected using systematic random sampling. Data were collected using a semi-structured interviewer-administered questionnaire, that was pre-tested on 5% of the total sample outside the study area to ensure clarity, consistency. The collected data were entered into Epi Info version 7.2, then exported to SPSS version 27 for analysis. Both bivariate and multivariable logistic regression analyses were conducted and variables with a p-value less than 0.2 in the bivariate analysis were entered into the multivariable model. Adjusted odds ratios with 95% confidence intervals were calculated to assess the strength of associations, and statistical significance was determined at a p-value less than 0.05. Ethical clearance was obtained from the Institutional Review Board (IRB) of Mekelle University, and informed consent was secured from all participants. Result: The prevalence of low birth weight is 13.1%. Rural residence (AOR=4.17, 95% CI: 1.19, 14.52), short birth intervals (AOR=5.3, 95% CI: 1.73, 16.17), ANC attendance <4 visits (AOR=5.28, 95% CI: 1.68, 16.53), maternal anemia (AOR=9.31, 95% CI: 2.59, 33.42) and preterm birth (AOR=4.39, 95% CI: 1.38,13.97) significantly associated with LBW. Conclusion and recommendation: Maternal age, rural residence, short birth interval, inadequate ANC follow-up and maternal anemia were significantly associated with low birth weight. Efforts should be made to identify women with high odds of low birth weight.
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    UNMET NEED FOR MODERN CONTRACEPTION AND ASSOCIATED FACTORS AMONG REPRODUCTIVE AGE WOMEN IN LAELAY MAICHEW DISTRICT, CENTERAL TIGRAY, ETHIOPIA 2024/2025 (CROSS-SECTIONAL STUDY)
    (Mekelle University, 2025-01-28) DEBESOM G/KIDAN
    Background: - Unmet need for family planning is considered as one of the major public health concern, worldwide. Globally one in twelve and one in five married women in Africa faces unmet need for family planning. Despite some studies highlight on some parts of Ethiopia, however, there is lack of study on the post war and covid 19 in Tigray more specifically in the district areas. Moreover, there is a paucity of research on unmet need for family planning among reproductive age women in study area The results of this study was provided information on the current status of unmet need for family planning and factors that affect the need for family planning among reproductive age women in Laelay Maichew district. Objective; To assess the prevalence and factors associated with unmet need for modern contraception among reproductive age women in Laelay Maichew district, Tigray, Northern Ethiopia, 2024/2025. Methods and materials: - Community based cross-sectional study was conducted from September to October 2024 among reproductive age woman in Laelay Maichew district central zone of Tigray. A total of 575 study participants selected using a systematic random sampling technique were interviewed. Data was collected through structured and pretested intervieweradministered questionnaires. It was entered into Epi data version 4.6 and analyzed by Statistical Package for Social Science version 25. Hosmer- Lemeshow was used to test for model fitness which was (p-value=0.184) then result was summarized using tables, texts and figures. Result: The study found that 24.7% (95% CI: 21%, 28%) and of which 19.96% was unmet need for spacing and 4.74% was unmet need for limiting. Mother's educational status (AOR = 3.219, 95% CI = 1.417-7.311),), never having used modern contraceptive methods (AOR = 2.747, 95% CI = 1.634-4.616), having a partner who was unsupportive of family planning (AOR = 1.733, 95% CI = 1.023-2.934) and availability of radio or TV (AOR = 2.009, 95% CI = 1.201- 3.360 were independent predictors of unmet need for modern contraception among the study participants. Conclusions and Recommendations; In Laelay Maichew district, the unmet need for modern contraceptives was notably high. Significant factors linked to this unmet need included the educational status of women, prior use of family planning, partner support to use family planning, and the availability of radio and/or TV in respondents' homes. Addressing these areas may help improve family planning services and reduce unmet needs.
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    DETERMINANTS OF EXTERNALLY VISIBLE BIRTH DEFECTS AMONG NEWBORNS DELIVERED IN PUBLIC GENERAL HOSPITALS OF TIGRAY, ETHIOPIA, 2025 G.C
    (Mekelle University, 2025-06-28) BIREY YEMAR
    Background: Birth defects are a series of functional and structural abnormalities resulted from disruption of the normal human embryonic development. Regardless of the interventions and targets to reduce neonatal mortality, the burden of birth defects remains high especially in low and middle income countries such as Ethiopia. In Tigray the neonatal mortality showed significant increment during the war crisis and birth defects takes a significant role with limited studies before the war and no studies conducted after the war. Studies on determinants of birth defects are timely essential to manage their burden and will be a guide on the postwar health care reform. Objective: To asses determinants of externally birth defects among newborns delivered in public general hospitals of Tigray, Ethiopia, 2024/25 Methodology: Institutional based unmatched case control study design was conducted from December 1 to December 30, 2024 among 388 subjects (97 cases and 291controls) in public general hospitals of Tigray. Subjects were selected using systematic random sampling method after proportional allocation to each randomly selected five hospitals. Cases and controls were newborns that had at least one visible minor or major birth defect and without externally visible birth defect, respectively delivered from November 1, 2023-Octeber 30, 2024 in the selected public general hospitals. A structured checklist was used to extract data from maternal medical charts. Data was entered through Epi data and transported to SSPS version 25 for analysis. Multivariate Logistic regression model was used to identify factors associated with birth defects at p value less than 0.05. Results; more than half the mothers (51.5% and 58.4% of cases and controls respectively) fall in between 25 and 35 age category). Rural residence [AOR=1.95; 95% CI:(1.04, 3.667);p-value=0.037], lack of folic acid intake [AOR=2.77;95%CI: (1.464,5.24); pvalue=0.002], history of acute illnesses[AOR=5.118;95%CI:(1.389,18.865);p-value=0.014],male sex [AOR=2.4;95%CI:(1.322,4.364);p-value=0.004],and Prematurity [AOR=11.74; 95%CI :( 2.598, 53.05); p-value=0.001] were significant predictors of birth defects. Conclusion and recommendations; Rural residence, lack of folic acid intake, acute illnesses, newborn sex and prematurity, were significant predictors of birth defects. So that it’s vital to address the modifiable factors such as folic acid intake, acute illnesses, awareness creation and service delivery in rural setting.
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    UTILIZATION OF CERVICAL CANCER SCREENING SERVICE AND ITS ASSOCIATED FACTORS AMONG HIV POSITIVE WOMEN ATTENDING ART CLINIC IN SOUTHERN TIGRAY-ETHIOPIA, 2024
    (Mekelle University, 2025-04-28) Asmelash Dargie
    Background: Cervical cancer is the second most cause of cancer deaths among reproductive age women in Ethiopia. It is six times more likely to occur in HIV positive than in the general population. Cervical cancer is both treatable and preventable if diagnosed and treated early. However, in Ethiopian among women who test positive for HIV, the utilization of cervical cancer screening is low. Its determinant factors were not well studied in the study area. This study aimed to assess utilization of CCS and the factors that influence its use among HIV-positive women receiving antiretroviral therapy at public health facilities. Objective: To assess cervical cancer screening service utilization and its associated factors among HIV positive women attending ART clinic in public health facilities Southern Tigray-Ethiopia, 2024. Methods and Material: Facility based cross sectional study design was conducted from May 30/2024 – July 30/2024. A total of 334 HIV positive women who come to the selected health facility in southern Tigray for HIV service were selected by systematic random sampling method. A pretested interviewer administer questionnaire was administered on 5% of the study participant. Data were collected by interviewer administer questionnaire; Collected were entered to Epi data version 7.2 and exported to SPSS version 27 for analysis. Bivariate and multivariable binary logistic regressions was used to identify factors associated with outcome variable. Moreover, the final result was organized and presented in chart, diagram, graphic, textual and tabular form. Result: Among the 334 study participants, all of them involved in the study with the response rate of 100%. The magnitude of cervical cancer screening service among HIV positive women was 11.4% (95% CI: 8.1% - 15%). formal educational (AOR = 3.3, 95% CI: 1.2, 8.9), history of STI (AOR = 8.4; 95% CI: 2.2–32.32.), family history of cervical cancer (AOR = 7.73, 95% CI: 1.13– 52.65) and good knowledge (AOR = 15.07, 95%CI: 3.32–68.34) were found to be statistically significant. Conclusion and recommendation: the magnitude of cervical cancer screening service utilization among HIV positive women was very low. So, we suggest all health professional, world health organization and pathfinder international to work on community awareness creation and sensitization on cervical cancer and cervical cancer screening service
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    UTILIZATION AND FACTORS ASSOCIATED WITH MINIMUM EIGHT CONTACT ANTENATAL CARE AMONG MOTHERS WHO DELIVERED IN PUBLIC HOSPITALS OF CENTRAL ZONE, TIGRAY, NORTH ETHIOPIA, 2024.
    (Mekelle University, 2025-03-28) ADISU TESFU
    Background: Maternal mortality, a largely preventable global health concern, remains high, particularly in sub-Saharan Africa. The WHO recommends eight or more antenatal care (ANC) contacts, yet only 65% of women globally achieve this, with lower rates in high-mortality regions. In Ethiopia, only 43% receive four or more ANC visits, and 32% receive none. Data on eight+ ANC utilization in central Tigray, Ethiopia, was previously lacking. Objective: To assess utilization and factors associated with eight+ ANC contacts among mothers who delivered in public hospitals in central Tigray, Ethiopia, in 2024. Methods: A hospital-based cross-sectional study was conducted among 614 mothers from November 15 to December 15, 2024. A systematic sampling method was used, with proportional allocation to each hospital. Ethical clearance was obtained from Mekelle University, and permissions were secured from the Tigray Regional Health Bureau and hospitals. Data were entered into Epi Data and analyzed using SPSS version 27, with statistical significance set at p < 0.05. Results: The magnitude of eight+ ANC utilization was 36.2%. Factors significantly associated with eight+ ANC utilization included having a trader partner [AOR = 1.755, 95% CI: 1.097– 2.807], presence of danger signs [AOR = 2.131, 95% CI: 1.362–3.333], planned pregnancy [AOR = 2.287, 95% CI: 1.394–3.751], ANC initiation within 12 weeks [AOR = 3.275, 95% CI: 2.204–4.868], living <30 minutes [AOR = 3.683, 95% CI: 1.777–7.632] or 30–60 minutes [AOR = 2.099, 95% CI: 1.055–4.174] from a health facility, and positive attitude toward ANC [AOR = 2.364, 95% CI: 1.039–5.379]. Conclusion and Recommendation: Utilization of eight+ ANC contacts in central Tigray remains low. Key factors include partner occupation, presence of danger signs, pregnancy planning, ANC initiation timing, distance to health facilities, and maternal attitudes. Targeted interventions, such as community education, improved accessibility, and strengthened healthcare systems, are needed to increase ANC8+ utilization.