Objective: To determine factors contributing to low level of attending the recommended four ANC visits. Design: The study was cross-sectional Setting: The study was quantitative and was conducted in Musanze health center and in its radiation zone. Data was collected using interview-administered questionnaire. Sample: The study enrolled 8 health providers and 67 lactating mothers who visited ANC service in 2018 and did not completed four ANC standard visits. Methods: The study adopted a stratified convenience method. All lactating mothers who did not completed four ANC visits participated in the research. Main outcome measures: The health providers who work in ANC services do not create awareness of importance of completing the four visits, do not support the husband to help a wife and urge her to complete the visits. Results: The study finds that 51% of the interviewed mothers did two ANC visits and 40% who did three ANC visits, 36% of the responded thought that 2 or 3 visits are enough, 21% delivered before the last appointment, 37% of nurses responded that the cause of discontinuance of four ANC is due to the mothers lie ANC service provider on the gestalt age. Conclusion: Factors proved to contribute to the discontinuance of four antenatal care standard visits include lack of awareness on the role of completing four ANC, believe of mothers, ignalence, lack of use of gravidomètre to guess gestalt age, lie on the last date of amenhorea. Findings: Authors’ fees

Objective: To determine the factors contributing to home delivery. Design: The study was cross-sectional. Setting: The study was quantitative and was conducted in all villages of Musanze sector which has home delivery. Data were collected going house to house for mothers who delivered at home. Data were collected using interviewer-administered questionnaire. Sample: All 38 women who delivered at home in 2016-2017 were enrolled in the study. Methods: To know who were delivered at home, researcher takes a copy of monthly reports of CHWs for each village & draw villages which had reported home delivery in the studies period. Before distributing questionnaire, the researcher asked the mother if she had delivered at home for the reported month and if she agrees, the researcher continues with the questionnaire distribution. Main outcome measures: Many factors finds contributing to home delivery. Those include cultural, social and financial factors. Results: The study finds that 23.7% of mothers who delivered at home had a high risk pregnancy, 23.7% had not a health insurance, 63.1% delivered during the night & 23.7% delivered during the rain fall. 29% have not visited by a CHW when they were pregnant, 10.6% have attended any ANC visit & 10.6% were accustomed to home delivery. Conclusion: Mobilization of pregnant mother to come hosting at the health facility one week before the expected delivery date, mobilization on health risk related to home delivery, high risk pregnancy and to avail the means of transport for women who start labor at home. Findings: Authors’ fees