Timing and reasons for antenatal care booking among women in a tertiary health care center in Southern Nigeria

BMC Pregnancy Childbirth

2020

Background: Antenatal care serves as a key entry point for a pregnant woman to receive a broad range of services and should be initiated at the onset of pregnancy. The aim of the study was to understand the reasons for the late initiation of antenatal care by pregnant women in Nkwen Baptist Health Centre, Bamenda, Cameroon. Methods: The study applied purposive sampling to recruit eighteen pregnant women and three key informants for data collection through individual interviews. Pregnant women who initiated antenatal care after the first trimester were recruited during antenatal care clinics and were interviewed in a room at the Antenatal Care Unit. Key informants were midwives working at the Antenatal Care Unit. Participation in the study was voluntary. The purpose of the study was explained to participants, and they signed a consent form if they were willing to participate in the research. Data were audio-recorded and analyzed using thematic coding analysis. Results: Pregnant women placed a low value on early antenatal care because they perceived pregnancy to be a normal health condition or to not be a serious issue that required seeking health care. Furthermore, previous positive pregnancy outcomes for which women did not access care made them less motivated to initiate antenatal care early. Participants perceived the booking system to be user-unfriendly and complained of overcrowded conditions, long waiting times and some rude service providers. The cost of services and distance to health facilities that required travel via uncomfortable transport on poor road networks were identified as perceived barriers. The absence of effective community health programmes, perceived lack of support from parents and spouses, fear of bewitchment and stigma due to cultural beliefs about the early initiation of antenatal care were also identified as variables influencing late initiation. Conclusion: Pregnant women lack information on the purpose of early antenatal care. Health facility barriers as well as socio-cultural beliefs have significant influences on the timing of antenatal care initiation. The government of Cameroon should strengthen the health system and implement activities to engage communities in improving care seeking for antenatal care and thereby improving maternal health status of women.

Section: Discussionsupporting

confidence: 84%

Section: Discussionsupporting

confidence: 83%

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

BMC Pregnancy Childbirth

2020

“…Previous positive pregnancy experiences made pregnant women develop confidence and thus were less motivated to initiate antenatal care early. This is in line with another study that found that multiparous women are usually confident, believing that having delivered many times previously, they are well versed with the art and need not book for antenatal care early [31]. On the other hand, previous negative pregnancy outcomes influenced some of the participants to delay initiating antenatal care because initially they planned to terminate the pregnancy.…”

Section: Perceived Susceptibility/ Perceived Severity Due To Late Antsupporting

confidence: 85%

“…In this study, some participants believed that there was no ideal booking time for antenatal care. This is similar to a study in Southern Nigeria in which the majority of pregnant women claimed that it was safe to book antenatal care at any time during pregnancy [31]. There were diverse reasons for lack of information on ideal booking time.…”

Section: Perceived Susceptibility/ Perceived Severity Due To Late Antsupporting

confidence: 84%

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

2019

Preprint

Background: Antenatal care serves as a key entry point for a pregnant woman to receive a broad range of services and should be initiated at the onset of pregnancy. The aim of the study was to understand the reasons for late initiation of antenatal by pregnant women in Nkwen Baptist Health Center, Cameroon. Methods: The study applied purposive sampling to recruit eighteen pregnant women and three key informants for data collection through individual interviews. Pregnant women who initiated antenatal care after the first trimester were recruited during antenatal care clinics and interviewed in a room at the antenatal care unit. Key informants were midwives working at the antenatal care unit. Participation in the study was voluntary. Participants were explained the purpose of the study and signed a consent form if they were willing to participate in the research. Data was collected using an audio tape and analyzed using Thematic Coding Analysis. Results: Pregnant women place low value on early antenatal care due to the fact that they perceive pregnancy as a normal health condition or not a serious issue that requires seeking health care. Furthermore previous pregnancy outcomes that were positive regardless of accessing care made them less motivated to initiate antenatal care early. The booking system is perceived as user-unfriendly with overcrowded conditions, long waiting times and rudeness of some service providers. Cost of services and distance to health facilities with uncomfortable transport and poor road network were identified as perceived barriers. The absence of effective community health programmes, perceived lack of support from parents and spouses, fear of bewitchment and stigma due to cultural beliefs about early initiation of antenatal care were also identified as variables influencing late initiation. Conclusion: Pregnant women lack information on the purpose of early antenatal care. Health facility barriers as well as socio cultural beliefs also have significant influence on timing of antenatal care initiation. The government of Cameroon should strengthen the health system and implement activities that engage communities to improve timing of care seeking for antenatal care and thereby improve the maternal health status of women. BackgroundIn 2015, about 303,000 women died from pregnancy related causes globally, with 99% of all maternal deaths occurring in low and middle income countries [36]. Within low and middle income countries, the highest maternal mortality rates are found in sub-Saharan Africa [28]. Within sub-Saharan Africa, the West African region has the highest maternal mortality in Africa, approximately accounting for 20% of global maternal deaths [27]. In West Africa, Cameroon has one of the highest maternal mortality rates with 596 deaths / 100,000 live births [34]. Additionally, in Cameroon, approximately 80,000 women and girls suffer from injuries or disabilities caused by complications during pregnancy and childbirth each year [30]. The major causes of maternal mortality in Cameroon a...

“…In this study, some participants believed that there was no ideal booking time for antenatal care similar to a study in Southern Nigeria in which the majority of pregnant women claimed that it was safe to book antenatal care at any time during pregnancy [40]. There were diverse reasons for lack of 20 information on ideal booking time.…”

Section: Perceived Susceptibility/ Perceived Severity Due To Late Antmentioning

confidence: 52%

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

2019

Preprint

Background: Antenatal care serves as a key entry point for a pregnant woman to receive a broad range of services and should be initiated at the onset of pregnancy. The aim of the study was to understand the reasons for late initiation of antenatal by pregnant women in Nkwen Baptist Health Center, Cameroon. Methods: The study applied purposive sampling to recruit eighteen pregnant women and three key informants for data collection through individual interviews. Pregnant women who initiated antenatal care after the first trimester were recruited during antenatal care clinics and interviewed in a room at the antenatal care unit. Key informants were midwives working at the antenatal care unit. Participation in the study was voluntary. Participants were explained the purpose of the study and signed a consent form if they were willing to participate in the research. Data was collected using an audio tape and analyzed using Thematic Coding Analysis. Results: Pregnant women place low value on early antenatal care due to the fact that they perceive pregnancy as a normal health condition or not a serious issue that requires seeking health care. Furthermore previous pregnancy outcomes that were positive regardless of accessing care made them less motivated to initiate antenatal care early. The booking system is perceived as user-unfriendly with overcrowded conditions, long waiting times and rudeness of some service providers. Cost of services and distance to health facilities with uncomfortable transport and poor road network were identified as perceived barriers. The absence of effective community health programmes, perceived lack of support from parents and spouses, fear of bewitchment and stigma due to cultural beliefs about early initiation of antenatal care were also identified as variables influencing late initiation. Conclusion: Pregnant women lack information on the purpose of early antenatal care. Health facility barriers as well as socio cultural beliefs also have significant influence on timing of antenatal care initiation. The government of Cameroon should strengthen the health system and implement activities that engage communities to improve timing of care seeking for antenatal care and thereby improve the maternal health status of women.