BACKGROUND:
Maternal healthcare is a critical public health issue worldwide. Access to and use of antenatal care (ANC) services is essential for maternal and neonatal health outcomes. Despite World Health roll out on recommended antenatal visits, various sociocultural and economic factors significantly hinder access, especially in resource-constrained settings.

OBJECTIVES:
This study aimed to explore the sociocultural and economic factors influencing ANC access and attendance in Kilifi County, Kenya.

METHODS:
A qualitative descriptive approach was used to explore the experiences and perceptions of pregnant women and healthcare providers regarding ANC access and attendance. Data were collected through in-depth interviews with pregnant women and midwives. Thematic analysis was conducted to identify recurring patterns related to cultural, gender, and economic barriers affecting ANC access and attendance.

RESULTS:
The study identified cultural norms, family and community influence, male involvement, financial constraints, pregnancy health promotion, and sources of ANC information as key factors affecting ANC access. Patriarchal decision-making and cultural preferences for traditional birth attendants discouraged facility-based care, while financial dependency and transportation costs further limited attendance. Male family members often controlled healthcare decisions, leading to delays in seeking ANC. Despite midwives promoting early clinic visits and pregnancy risk awareness, entrenched sociocultural beliefs and economic barriers continued to hinder effective health promotion and ANC utilization.

CONCLUSIONS:
Sociocultural norms, financial constraints, and male-dominated decision-making hinder ANC access. Addressing these barriers requires comprehensive interventions, including community engagement, male involvement, and economic support. Culturally sensitive health promotion that respects community beliefs while emphasizing modern healthcare benefits is essential for improving ANC utilization and maternal health outcomes.

KEY MESSAGE:
Addressing sociocultural and economic barriers is crucial for improving ANC access. Community engagement, male involvement, financial support, and culturally sensitive health promotion can enhance maternal health outcomes and align with Sustainable Development Goal 3 on good health and well-being. Pregnancy - access