Women's experiences and views about costs of seeking malaria chemoprevention and other antenatal services: a qualitative study from two districts in rural Tanzania

Mubyazi, Godfrey M.; Bloch, Paul; Magnussen, Pascal; Olsen, Øystein Evjen; Byskov, Jens; Hansen, Kristian Schultz; Bygbjerg, Ib Christian

doi:10.1186/1475-2875-9-54

Cited by 71 publications

(128 citation statements)

References 23 publications

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“…16 In Gambia and Tanzania as well, the intake of two SP doses was quite uncommon. 17,18 In Tori Bossito, women are well-followed during their pregnancy, with an average of four ANVs; however, it seems, regarding to anterior studies, that even high rates of attendance to ANVs are not sufficient for a good IPTp coverage and uptake, 14 because the quality of service delivery and the community perceptions and behavior have a great importance as well. 14 Among the factors that need to be improved, one of the main ones is the poor adherence to the official recommendations.…”

Section: Discussionmentioning

confidence: 99%

Prevention of Malaria during Pregnancy: Assessing the Effect of the Distribution of IPTp Through the National Policy in Benin

Port

Cottrell²,

Dechavanne³

et al. 2011

The American Society of Tropical Medicine and Hygiene

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The efficiency of malaria prevention during pregnancy was compared between three studies in Benin for malaria infection of the placenta (MIP) and low birth weight (LBW). The first was carried out when chloroquine prophylaxis was still recommended, the second was an intermittent preventive treatment in pregnancy (IPTp) clinical trial comparing sulfadoxine pyrimetamine (SP) versus mefloquine, and the third was an observational study after SP-IPTp national implementation. We showed an association between the use of IPTp and the reduction of LBW (10% with national IPTp and 8.7% in IPTp trial versus 15.7% in pre-trial study). The effect on MIP was better in the trial (2.9% versus 11.2% and 16.7% for national IPTp and pre-trial studies, respectively). In spite of a good overall compliance with the national IPTp (with 84% of women taking at least one dose of SP), there are still failures in adherence to the directly observed therapy (DOT) scheme and needs for better training of health staff.

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Section: Discussionmentioning

confidence: 99%

Prevention of Malaria during Pregnancy: Assessing the Effect of the Distribution of IPTp Through the National Policy in Benin

Port

Cottrell²,

Dechavanne³

et al. 2011

The American Society of Tropical Medicine and Hygiene

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“…Previous reports from throughout sub-Saharan Africa have recognized some of these barriers, but a number of these studies have been quantitative surveys. It is interesting to note that when a structured questionnaire 4,11,12,14,15 is used there is more emphasis on the practical barriers to attendance whereas the more open-ended, lessconstrained approach with a qualitative study 5,[6][7][8]10 enables the identification of additional and more complex barriers. During the first three months the barriers are almost entirely identified by qualitative studies.…”

Section: Discussionmentioning

confidence: 99%

“…Although government supported health centres in the Gambia do not charge, the costs of care in other countries was regularly cited as a difficulty 7,10,11,14 . Also cited were conflicting domestic demands, journey time and distance to the HC 10,4,12 .…”

Section: Discussionmentioning

confidence: 99%

“…Also cited were conflicting domestic demands, journey time and distance to the HC 10,4,12 . In addition the qualitative studies reported many more instances of poor relationships with the health staff, shame or humiliation if the documentation was not in place 7 , and an overriding suspicion that they were perceived as poor and uneducated 5 .…”

Section: Discussionmentioning

confidence: 99%

“…Throughout sub-Saharan Africa, in addition to social taboos, there is evidence that women are unsure of the purpose behind antenatal care 7 , probably due to a belief that childbearing represents a normal ‗bodily experience' rather than an illness 8 . Practical barriers to using antenatal care include remoteness from treatment facilities and costs [9][10][11] , a belief that attendance is necessary to obtain a document that permits delivery within the hospital 8 , and the attitude of health professionals [12][13][14][15] . The barriers to antenatal care remain unstudied in an urban context.…”

Section: Introductionmentioning

confidence: 99%

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Barriers to Antenatal Care in an Urban Community in the Gambia: An In-depth Qualitative Interview Study

Laing

Sinmyee

Rafique

et al. 2017

Afr J Reprod Health

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This qualitative study investigated the barriers to obtaining access to antenatal care in a small, urban government-supported health centre in the Gambia. It thus addresses an important issue related to maternal health and the prevention of maternal deaths. In-depth interviews were conducted with 25 pregnant women, 13 healthcare workers and 9 male partners. Three areas were identified for study: recognition and acknowledgment of pregnancy, recognition of the need for care and practical barriers to attendance. Intentional concealment of early pregnancy was common to avoid adverse social consequences or for fear that malign interventions would cause a miscarriage. In the absence of symptoms many women considered it unnecessary to attend the antenatal clinic until well into the second trimester. Practical barriers to attendance included conflicting domestic demands and the attitude of some healthcare workers. Access to antenatal care in the Gambia throughout pregnancy should be considered in a stepwise fashion and barriers to care were identified at each stage. Interviews with male partners and health workers highlighted their key role. (Afr J Reprod Health 2017; 21[3]:62-69).Keywords: Access, antenatal care, health services, qualitative, Gambia, Africa RésuméCette étude qualitative a étudié les obstacles à l'accès aux soins prénatals dans un petit centre de santé soutenu par le gouvernement urbain en Gambie. Il aborde ainsi une question importante liée à la santé maternelle et à la prévention des décès maternels. Des entretiens approfondis ont été réalisés avec 25 femmes enceintes, 13 agents de santé et 9 partenaires masculins. Trois domaines ont été identifiés pour l'étude: l'identification et la reconnaissance de la grossesse, la reconnaissance du besoin de soins et des obstacles pratiques à la fréquentation. La dissimulation intentionnelle de la grossesse précoce était fréquente pour éviter les conséquences sociales négatives ou pour craindre que des interventions malignes ne causent une fausse couche. En l'absence de symptômes, de nombreuses femmes ont jugé inutile de fréquenter la clinique prénatale jusqu'à bien au deuxième trimestre. Les obstacles pratiques à la participation comprenaient des demandes intérieures contradictoires et l'attitude de certains agents de santé. L'accès aux soins prénatals en Gambie tout au long de la grossesse doit être pris en compte par étapes et les barrières aux soins ont été identifiées à chaque étape. Les entretiens avec des partenaires masculins et des agents de santé ont souligné leur rôle clé. (Afr J Reprod Health 2017; 21[3]:62-69).

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Perception of Pregnant Women About Antenatal Care in a Cottage Hospital in Port Harcourt, Nigeria

Ekott

Ovwigho²,

Ehigiegba

et al. 2012

J Community Health

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Antenatal care gives opportunity for care of women during pregnancy, prevention and treatment of diseases as well as behavioral change interventions. The perception of users about services influences service utilization. This study was performed to assess user satisfaction with antenatal care services at the centre and to identify constraints at service points. Women attending antenatal care at a cottage hospital In Nigeria were administered questionnaires to evaluate their satisfaction with services and their views about services at various points of care. Data analysis was made using Statistical Package for Social Science version 15.0. Statistical significance was set at P < 0.5. Four hundred correctly completed questionnaires were analysed. The mean age of the respondents was 29 years (SD of 4) and their parity ranged from 0 to 5 (mean 2.5 ± 1.9). The overall satisfaction with care was 94 % and it was highest (95.8 %) with health talks and least with medical consultations (64 %). Attributes valued at service points were educating nature of health talks, prompt attention, and friendly and polite staff. Reasons for dissatisfaction were unfriendly attitudes of staff and delay at service points. Additional care packages women would want were: more staff employed 61 (15.3 %), better organized services 34 (8.5 %) and routine ultrasound scans 25 (6.3 %). Women valued antenatal care and were highly satisfied with services received at the centre. Health education forums should be used to address issues with service delivery. Constraints at service points should be addressed to enhance better service delivery.

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Women's experiences and views about costs of seeking malaria chemoprevention and other antenatal services: a qualitative study from two districts in rural Tanzania

Cited by 71 publications

References 23 publications

Prevention of Malaria during Pregnancy: Assessing the Effect of the Distribution of IPTp Through the National Policy in Benin

Prevention of Malaria during Pregnancy: Assessing the Effect of the Distribution of IPTp Through the National Policy in Benin

Barriers to Antenatal Care in an Urban Community in the Gambia: An In-depth Qualitative Interview Study

Perception of Pregnant Women About Antenatal Care in a Cottage Hospital in Port Harcourt, Nigeria

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