نبذة مختصرة : Background: Late initiation of first Antenatal Care (ANC) is said to occur when pregnant women start their first ANC booking at 16 weeks or more gestation. Though ANC coverage has increased to 87.4% recently in Dire Dawa city, majority pregnant women start their first ANC visit late. The objective this study was to assess the first ANC timing and its determinants among pregnant women attending ANC services in public health facilities of Dire Dawa city Administration, Eastern Ethiopia. Subjects and Methods: Facility based cross sectional study design was employed from January to February 2017 that involved a sample size of 413 pregnant women attending antenatal care who were selected by random systematic sampling and a convenience sampling techniques respectively. This study employed descriptive statistics .Bivariate and multivariate logistic regression analysis. The multivariate logistic regression analysis was used to assess associations while simultaneously controlling potential confounding factors. The strength of associations were measured through COR (crude odds ratio) and AOR (adjusted odds ratio). Confidence interval of 95% and p-value <0.05 were applied to determine significance of association. Results: This study revealed prevalence of late first ANC visit 50.6% and the determinants of first ANC timing were; parity AOR=19.6, CI(10.2-41) P-value =0.0001, history of previous abortion AOR=0.39,CI(0.22-0.97) P-value =0.03, history of previous caesarian section AOR=0.3,CI(0.12-0.7) P-value =0.004, history of problems in the last delivery AOR=0.23,CI(0.09-0.56) P-value =0.002, history of died children AOR=0.01,CI(0.001-0.8) P-value =0.02, knowledge of appropriate time of first ANC AOR=1.74,CI(1.1-2.8) P-value =0.01, knowledge on benefits and dangers of staring first ANC early and late respectively AOR=2.82,CI (1.65-4.93) P-value =0.003. Conclusion: Half/significantly high proportion of the pregnant women studied in public health facilities in Dire Dawa city administration. initiate their first ANC late.
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