Malaria transmission is influenced by climate, land use and deliberate intervention. The study provides quantitative data coThe study shows disparities in the utilization of ANC at sub-county and county level. Sub-counties in the Northern and North-Eastern regions had the lowest utilisation of ANC4. Only twenty sub-counties had ANC4 attendance of over 70% while 18 had a coverage of less than 35%. Maternal education was a significant determinant for ANC coverage; Women with tertiary education were three times more likely to utilize ANC4 compared to those without any education. ANC utilization rates were less than 50% in regions with lower coverage of health facility deliveries. Similar relationships and observations were made for all the other determinants (age at first marriage, birth order and household wealth) except for marital status.