Journal Article

Understanding barriers preventing pregnant women from starting antenatal clinic in the first trimester of pregnancy in Ntcheu District-Malawi

Muula, Adamson S., Chimatiro, Chancy S., Hajison, Precious, Chipeta, Effie

2018

Overview

Background Exploring barriers contributing to low utilization of Antenatal Care (ANC) during the first trimester of pregnancy is of national programmatic importance. We conducted an exploratory study in 2013 at Bilira Health Centre in Ntcheu district-Malawi with an aim of understanding barriers that prevent pregnant women from attending antenatal clinics in the first trimester of pregnancy. Method This was cross sectional exploratory study using qualitative approach. Data were collected from ANC clients, key informants, health services professionals and women of child bearing age (15–49 years) using an in-depth interviews and Focus Group Discussions (FGDs). Data were analysed manually by reading the transcriptions and memos several times inorder to be familiar with the themes emerged. The emerged themes were coded. Results Most of the women reported that they have a feeling of starting ANC in the early days of their pregnancies, however, they also reported several barriers ranging from cultural beliefs, social economic to service delivery barriers. On cultural barriers many women wait for marriage counselors from husband’s side to give them advice before starting ANC in the process called “ Kuthimba ”. Some women hide the pregnancy in early months to avoid being bewitched. On social-economic barriers, some of the women mentioned that they don’t start ANC early waiting for new clothes. Poor attitude of health workers also has an effect on ANC attendants. Most women pointed out that they started ANC late because some health workers were rude and do not observe confidentiality. Men’s refusal to accompany their spouses to antenatal clinic in fear of HIV test and some by-laws which restrict women who had pregnancy outside marriage to seek an authorisation letter first from Traditional Leaders for them to start ANC at the health facility were also mentioned as contributing barriers. Conclusion Women should be oriented on the national guidelines on Focused ANC (FANC) which advocates for at least 4 visits. There should also be Information, Education and Communication (IEC) on ANC and interventions to deal with social-cultural issues while at the same time improving service delivery at the health facility so that ANC services can be accessible and responsive enough.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Adolescent / Adult / Ambulatory Care Facilities / Antenatal attendance / Attitude of Health Personnel / Clinics / Cross-Sectional Studies / Developing countries / Disease transmission / Education / Female / First trimester / Focus groups / Focused antenatal care / Health aspects / Health care access / Health facilities / Health services / Health Services Accessibility - statistics & numerical data / Humans / LDCs / Malawi / Male / Management / Maternal & child health / Maternal and Child Health / Medicine / Medicine & Public Health / Middle Aged / Patient Acceptance of Health Care - ethnology / Patient Acceptance of Health Care - psychology / Pregnancy / Pregnancy Trimester, First - psychology / Pregnant women / Pregnant Women - ethnology / Pregnant Women - psychology / Prenatal care / Prenatal Care - psychology / Prenatal Care - statistics & numerical data / Prevention / Public Health / Qualitative Research / Reproductive health / Reproductive Health Services / Reproductive Medicine / Surveys and Questionnaires / Womens health / Young Adult