Omona, Kizito2022-05-162022-05-162022-05-112424-9653http://hdl.handle.net/20.500.12280/2993Globally, the World Health Organization recommends all women with uncomplicated pregnancies to attend up to four ANC visits during the course of the pregnancy. However, it has been reported elsewhere that the ANC 4th visit tends to be under-utilized in low-income settings. Among the 69 countries tracked by the countdown to 2015, the coverage rate of the 4th ANC visit is less than 50%. On average, only 16% of women in Uganda attend the 4th antenatal care visit, suggesting low utilization of the 4th antenatal care visit. The low attendances have persisted despite the efforts and awareness from government, policymakers and stakeholders. The purpose of this study was to determine the level of utilization ANC 4th visit and ascertain the factors affecting the utilization. An analytical cross-sectional design was used. Samples of 283 mothers were interviewed using questionnaires. Data were analyzed using SPSS. Quality controls and ethical considerations were taken care of. Only 59(20.8%) of the mothers utilized ANC 4th visit. Monthly income (p=0.003), knowledge about ANC 4th visit (p = 0.044), discussing ANC with Husband freely (p = 0.020) and husband providing financial support towards ANC visits (p=0.010) significantly influenced utilization of ANC 4th visit among mothers. Findings additionally showed cultural practices about ANC (p=0.000), mode of transport used during ANC visit (p =0.000) and instances of stockouts at health units (p=0.023) as having a significant bearing on utilization of ANC 4th visit among mothers (p values ≤ 0.05). The odds of attending 4th ANC visit were 3.44 times among mothers who discuss with their husbands freely about ANC compared to those who did not discuss it. Conclusively, the level of utilization 4th ANC visit in Rubirizi district health facilities is still unacceptably very low. Concerted efforts may be required by all stakeholders.enAntenatal CareANC 4th VisitMothersRubirizi DistrictUgandaArticle