Women’s views and experiences of antenatal care in Iraq: a Q methodology study

Abstract

BackgroundUnderstanding women’s experiences and perspectives of antenatal care services is particularly critical for enhancing effectiveness of services delivery and addressing women’s needs and expectations. As part of a comprehensive assessment of the maternity care services in Iraq, this study aimed to explore the views and experiences of antenatal care in a sample of women.MethodsThis explorative study was conducted in Erbil governorate, Iraq. Data were collected using Q methodology, a technique for eliciting subjective views and identifying shared patterns among individuals. A sample of 38 women of different educational and socioeconomic statuses were invited to sort a set of 39 statements reflecting different aspects of the available antenatal care services and issues related to their last pregnancies into a distribution on a scale of nine from “disagree most” to “agree most”. By-person factor analysis was used to derive latent views through centroid factor extraction and varimax rotation of factors.ResultsAnalysis of the participants’ Q sorts resulted in identifying four distinct views and experiences of pregnancy and antenatal care services: (i) public maternity services second best: preference for, and ability to afford, private care, (ii) dissatisfaction with public maternity services: poor information sharing and lack of health promotion, (iii) satisfaction with public maternity service but information gaps perceived and (iv) public maternity services second best: preference for private care but unaffordable. The typical characterizations that were associated with each view were highlighted.ConclusionsThis study revealed different patterns of views and experiences of women of pregnancy and antenatal care services and recognized the particular issues related to each pattern. Different patterns and types of problems and concerns related mainly to inadequate provision of information and poor interpersonal communication, poor utilization of public services and a general preference to use private services were identified in the different groups of women.

Undergraduate nursing students' subjective attitudes to curriculum for Simulation-based objective structured clinical examination

“…This method offers a scientific approach to clearly understand an individual's subjective viewpoints toward a certain phenomenon, interest, or concern, and it results in a systematic examination through a rigorous method (Dziopa and Ahern, 2011;Simons, 2013). The Q-methodology is useful to clearly determine whether a subject's point of view is similar or is an alternative to that of others, and the similarities and differences are verified among the emerging factors (Shabila et al, 2014). In particular, the method can be applied to study of a wide range of health topics, and it is appropriate to explore the attitudes of nurses or students toward specific issues or topics related to nursing, including nursing education itself and its related aspects (Cross, 2005;Simons, 2013).…”

Assessment of women’s perspectives and experiences of childbirth and postnatal care using Q-methodology

“…This is particularly true when the respondents receive maternity services at different service delivery points with different quality of care and health professional with different skills. Q-methodology can help in uniquely identifying and highlighting such differences in a new and insightful way (7,10). There can be many possible reasons for differences between the respondents in their experience of care.…”

“…A review of the literature about Iraqi women's perspectives of maternity care services and the views of women of similar cultural background helped in compiling additional statements (21,22). The details of these activities are provided elsewhere as they were also used to determine the statements for another study to assess women's perspectives of antenatal care (10).…”

“…The Iraqi health-care system has been seriously affected during the last few decades as a result of different wars, internal conflicts, international sanctions and political instability (5-7). These damaging effects have had a particular negative impact on the availability and quality of maternity care services, which continue to suffer from serious problems (5,(8)(9)(10). These events caused a significant drop in the important health indices, with the maternal mortality ratio and neonatal mortality rate remaining as high as 84 per 100 000 live births and 23 per 1000 live births respectively in 2010 (11).…”

A Study on Setting up a Database for Maternal Health Care Program in Darbandikhan-Kurdistan

“…Regarding to preserving data, a study has reported that many mistakes data in the hospitals have been recorded about maternal mortality and as well as system of clear data entry has recommended in the same study [9]. From another side, another study on view of women toward maternal and antenatal care has reported that the poor utilization of public services has determined as main challenge to women to not prefer public sector instead of using of private sector [14]. Due to all above challenges remain in Iraqi health system could not monitor the vertical national health programs such as maternal health.…”