Perceptions of pregnant women on reasons for late initiation of antenatal care: A qualitative interview study

Warri, Denis; George, Asha

doi:10.21203/rs.2.12406/v4

Cited by 8 publications

(9 citation statements)

References 19 publications

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“…The perception that ANC is only necessary if illness complications arise aligns with previous research suggesting that women often perceive pregnancy as a normal condition and place low value on antenatal care when feeling well. (27,28) It also dovetails with the most common reason cited by women in our study for non-use of ANC services, notably a lack of perceived need. SBC programs may therefore need to reinforce the importance of ANC to women and children even during healthy pregnancies without complications.…”

Section: Discussionsupporting

confidence: 67%

Psychosocial Influences on Pregnancy and Childbirth Behaviors in Northwestern Nigeria: A Cross-Sectional Analysis

Johansson¹,

Anaba²,

Abegunde³

et al. 2020

Preprint

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BackgroundAntenatal care (ANC) and facility delivery are essential maternal health services, but uptake remains low in northwestern Nigeria. To increase service use, social and behavior change (SBC) programs target psychosocial influences across cognitive, emotional and social domains including knowledge, beliefs, self-efficacy, and social norms. Yet there remains limited research that measures and quantitatively examines the role of psychosocial influences on pregnancy and childbirth behaviors in Nigeria or elsewhere. MethodsA cross-sectional population-based survey of randomly sampled women with a child under two years was conducted in Kebbi, Sokoto and Zamfara states of northwestern Nigeria in September 2019. Women were asked about maternal health behaviors during their last pregnancy. New psychosocial metrics were developed using the Ideation Model of Strategic Communication and Behavior Change. Predicted probabilities for visiting ANC four or more times (ANC4+) and giving birth in a facility were derived using mixed-effects logistic regression models adjusted for ideational and sociodemographic variables.ResultsAmong 3,039 women, 23.6% (95% CI: 18.0%-30.3%) attended ANC4+ times and 15.5% (95% CI: 11.8%-20.1%) gave birth in a facility. Among women who did not attend ANC4+ times or have a facility-based delivery during their last pregnancies, the most commonly cited reasons were lack of perceived need (42% and 67%, respectively) and spousal opposition (25% and 27%, respectively). Women who knew any ANC benefit or the recommended number of ANC visits were 3.2- and 2.1-times more likely to attend ANC4+ times. Women who held positive views about health facilities for childbirth had 1.2- and 2.6-times higher likelihood of attending ANC4+ times and facility delivery, while women who believed ANC was only for sickness or pregnancy complications had 17% lower likelihood of attending ANC4+ times. Self-efficacy and supportive spousal influence were also significantly associated with both outcomes.ConclusionsTo improve pregnancy and childbirth practices in northwestern Nigeria, programs should address a range of psychosocial factors – across cognitive, emotional and social domains – that were significantly associated with pregnancy and childbirth behaviors: raising knowledge and dispelling myths, building women’s confidence to access services, engaging spousal support in decision-making, and improving perceived (and actual) maternal health services quality.

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Section: Discussionsupporting

confidence: 67%

Psychosocial Influences on Pregnancy and Childbirth Behaviors in Northwestern Nigeria: A Cross-Sectional Analysis

Johansson¹,

Anaba²,

Abegunde³

et al. 2020

Preprint

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show abstract

“…More so, rate of adequate utilization of antenatal care is higher among women who claimed that they did not experience any problem in respect of distance covered to access health facility compared to women who complained that they experienced difficulty. Problems in terms of distance could imply that the location of health facility is far from the women's residence and the means of getting there is problematic [39,[42][43][44]. For instance, women living in areas where there is poor road network such that vehicles hardly ply the road or areas where transport system is irregular would find it difficult access health facility.…”

Section: Discussionmentioning

confidence: 99%

Correlates of antenatal care utilization among women of reproductive age in sub-Saharan Africa: evidence from multinomial analysis of demographic and health surveys (2010–2018) from 31 countries

Adedokun

Yaya

2020

Arch Public Health

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Background Despite a global reduction of about 38% in maternal mortality rate between 2000 and 2017, sub-Saharan Africa is still experiencing high mortality among women. Access to high quality care before, during and after childbirth has been described as one of the effective means of reducing such mortality. In the sub-region, only 52% of women receive at least four antenatal visits. This study examined the factors influencing antenatal care utilization in sub-Saharan Africa. Methods Data from Demographic and Health Surveys (DHS) of 31 countries involving 235,207 women age 15–49 years who had given birth to children within 5 years of the surveys were used in the study. Multinomial logistic regression model was applied in the analysis. Results About 13% of women in sub-Saharan Africa did not utilize antenatal care while 35 and 53% respectively partially and adequately utilized the service. Adequate utilization of antenatal care was highest among women age 25–34 years (53.9%), with secondary or higher education (71.3%) and from the richest households (54.4%). The odds of adequate antenatal care utilization increased for women who are educated up to secondary or higher education level, from richest households, working, living in urban areas, exposed to media and did not experience problem getting to health facility or obtaining permission to visit health facility. Conclusions This study has revealed information not only on women who did not utilize antenatal care but also on women who partially and adequately utilized the service. The study concluded that the correlates of antenatal care utilization in sub-Saharan Africa include socioeconomic and demographic factors, getting permission to visit health facility, unwillingness to visit health facility alone and problem encountered in reaching the health facility.

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“…In the individual dimension, there is intravenous drug use; in the social dimension, being under 26 years of age, being black or mixed and having up to seven years of study; and in the programmatic dimension, the diagnosis of HIV during prenatal care or at delivery. This last result indicates that women with HIV enter the health service later [42,43].…”

Section: Discussionmentioning

confidence: 81%

Factors Associated with Follow-Up of Children Exposed to Mother-to-Child Transmission of HIV: A Historical Cohort Study Form 2000 to 2017, in Porto Alegre, Brazil.

Calvo

Knauth

Hentges

et al. 2021

Preprint

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Background: There are many inequalities in terms of prevention and treatment for pregnant women with HIV and exposed children in low and middle income countries. The Brazilian protocol for prenatal care includes rapid diagnostic testing for HIV, compulsory notification, and monitoring by the epidemiological surveillance of children exposed to HIV until 18 months after delivery. The case is closed after HIV serology results are obtained. Loss to follow-up is defined as a child who was not located at the end of the case, and, therefore, did not have a laboratory diagnosis. Loss to follow-up is a current problem and has been documented in other countries. This study analyzed the incidence of loss to follow-up of children exposed to HIV and the sociodemographic, behavioral and health variables of associated pregnant women. Methods: This historical cohort study included information on pregnant women living with HIV and the outcome of the child’s exposure to HIV. The association between predictors and the child’s outcome as a loss to follow-up was investigated using the Poisson Regression model. Relative Risk calculations were performed. The significance level of 5% was adopted for variables in the adjusted model. Results: Between 2000 and 2017, of 6,836 children exposed to HIV, 1,763 (25.8%) were classified as loss to follow-up. The factors associated were: maternal age of up to 22 years (aRR 1.25, 95% CI: 1.09-1.43), the mother’s self-declared race/color being black or mixed (aRR 1.13, 95% CI: 1.03-1.25), up to three years of schooling (aRR 1.45, 95% CI: 1.26-1.67), between four and seven years of schooling (aRR 1.14, 95% CI: 1.02-1.28), intravenous drug use (aRR 1.29, 95% CI: 1.12-1.50), and HIV diagnosis during prenatal care or at delivery (aRR 1.37, 95% CI: 1.24-1.52). Conclusion: Variables related to the individual, social and programmatic vulnerability of pregnant women were evidenced.

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Perceptions of pregnant women on reasons for late initiation of antenatal care: A qualitative interview study

Cited by 8 publications

References 19 publications

Psychosocial Influences on Pregnancy and Childbirth Behaviors in Northwestern Nigeria: A Cross-Sectional Analysis

Psychosocial Influences on Pregnancy and Childbirth Behaviors in Northwestern Nigeria: A Cross-Sectional Analysis

Correlates of antenatal care utilization among women of reproductive age in sub-Saharan Africa: evidence from multinomial analysis of demographic and health surveys (2010–2018) from 31 countries

Factors Associated with Follow-Up of Children Exposed to Mother-to-Child Transmission of HIV: A Historical Cohort Study Form 2000 to 2017, in Porto Alegre, Brazil.

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