evidence: Conclusion The number of ANC visits was considered to be inadequate with substantial variation among the studied countries. Comprehensive interventions on scaling uptake of ANC are needed among the low-performing countries. Particular attention should be given to women of low economic status and from rural areas. [...] The WHO advises every pregnant woman with a normal pregnancy in middle/low-income countries to attend at least four ANC visits.1 However, many women in low-income countries particularly in SSA have limited access to health providers.10 Several studies have attempted to identify the factors associated with the underutilisation of ANC.11 12 Age,12–16 women’s education,8 12–24 husbands’ education,18 22 23 socioeconomic status,14–23 25 women’s employment,18 birth order,11 12 18 frequency of listening to the radio/watching TV/reading newspaper/magazines,8 11 18 23 24 and place of residence12 13 16–19 22 24 25 are among the factors associated with underutilisation of ANC. The factors attributed to inadequate ANC follow-ups are quite substantial across regions and countries.11 16 23 26 27 [...] Therefore, regional and country-specific maternal health programme interventions are required to address the barriers of adequate ANC visits. Moreover, health programmes should target women from rural areas, without schooling, no outside home occupation, from low household economic status, non-first-time pregnancy and had no access to media.