A qualitative exploration of health workers’ and clients’ perceptions of barriers to completing four antenatal care visits in Morogoro Region, Tanzania
Dados Bibliográficos
| ID | 11491002 |
|---|---|
| Autores | Jennifer A Callaghan-Koru (0000-0002-3007-1702, Johns Hopkins University, autor correspondente), Shannon A Mcmahon (0000-0002-8634-9283, Johns Hopkins University), Joy J Chebet (0000-0001-8810-2105, Johns Hopkins University), Charles Kilewo (Muhimbili University of Health and Allied Sciences), Gasto Frumence (0000-0003-4605-9457, Muhimbili University of Health and Allied Sciences), Shivam Gupta (0000-0003-0633-3917, Johns Hopkins University), Raz Stevenson (United States Agency for International Development), Chrisostom Lipingu, Abdulla H Baqui (0000-0001-8350-1983, Johns Hopkins University), Abdullah H Baqui, Peter J Winch (0000-0001-8569-5507, Johns Hopkins University) |
| Ano | 2016 |
| Volume | 31 |
| Fascículo | 8 |
| Páginas | 1039-1049 |
| Data de publicação | 2016-10-01 |
| Peer Reviewed | Sim |
| Open Access | Sim |
| Tipo | ARTICLE |
| Periódico | Health Policy and Planning (JOURNAL) |
| Identificadores do periódico | ISSN: 0268-1080 • E-ISSN: 1460-2237 |
| Editora | Oxford University Press (PUBLISHER • GB) |
| DOI | 10.1093/heapol/czw034 |
| PMID | 27117481 |
| OpenAlex | W2344264068 |
| Idioma | EN |
| Citações recebidas | 5 |
| Referências citadas | 39 |
Antenatal care (ANC) remains an important contact point on the continuum of care for mothers and children in low- and middle-income countries. In Tanzania, the proportion of pregnant women completing at least four ANC visits (ANC-4) dropped from 70% to 43% between 1999 and 2010. To identify potential causes of the decline in the number of ANC visits, we conducted qualitative research at 18 health centres in Morogoro Region, exploring providers' communication about ANC visits and clients' and providers' perceptions of changes in ANC services and barriers to completing four visits. We also observed counselling messages delivered during 203 ANC consultations. Our results indicate that provider communication about ANC visit recommendations is inadequate, and confusion exists among clients about when and how often they should attend. Participants highlighted how the scale up of Prevention of Mother-to-Child Transmission, with routine human immunodeficiency virus testing for women and their male partners, presents additional barriers for some women. Changes to the timing and content of ANC services following the adoption of the Focused ANC model was described by participants as changing women's perceptions and decisions in how they utilize ANC services. In particular, condensed delivery of technical interventions fostered a sense among clients that multiple visits are unnecessary. Other barriers that may contribute to declining ANC-4 include changing norms about family planning and birth spacing, out-of-pocket costs for clients and informal practices adopted by health facilities and providers such as turning women away who attend early in pregnancy or are not accompanied by male partners. Further research is needed to determine the role and extent that these barriers may be contributing to declining ANC-4. Issues of poor communication, supply inadequacies and informal practices, deserve immediate attention from the health system.
Behavior change communication · Developing country · Economic growth · Environmental health · Family medicine · Health care · Health services · Population · Psychological intervention · Qualitative research · Socioeconomics · Tanzania · Child Nutrition and Water Access · Global Maternal and Child Health · Medicine · Nursing · Poverty, Education, and Child Welfare
Analysis of dropout across the continuum of maternal health care in Tanzania
The Development of an Electronic Clinical Decision and Support System to Improve the Quality of Antenatal Care in Rural Tanzania
Family health strategy and equity in prenatal care
Effective coverage for maternal health
The impact of a community health worker intervention on uptake of antenatal care
Street-Level Bureaucracy
Determinants of use of maternal health services in Nigeria - looking beyond individual and household factors
Continuum of care for maternal, newborn, and child health
Evidence-based, cost-effective interventions
WHO antenatal care randomised trial for the evaluation of a new model of routine antenatal care
Why Do Women Not Use Antenatal Services in Low- and Middle-Income Countries? A Meta-Synthesis of Qualitative Studies
Strategies for reducing maternal mortality
Low male partner participation in antenatal HIV counselling and testing in northern Tanzania
Program synergies and social relations
What does Access to Maternal Care Mean Among the Urban Poor? Factors Associated with Use of Appropriate Maternal Health Services in the Slum Settlements of Nairobi, Kenya
Male Involvement in PMTCT Services in Mbeya Region, Tanzania
Women's perception as a barrier to focused antenatal care in Nigeria
Determinants of prenatal care use
Dilemmas and paradoxes in providing and changing antenatal care
Understanding pathways for scaling up health services through the lens of complex adaptive systems
Effectiveness and strategies of iron supplementation during pregnancy
Frequency and timing of antenatal care in Kenya
Outpatient process quality evaluation and the Hawthorne Effect
What impact does contact with the prenatal care system have on women's use of facility delivery? Evidence from low-income countries
| Obras citantes distintas | 5 |
|---|---|
| Citações por ano | 0,56 |
| Intervalo de citações | 2017 - 2025 (9) |
| Velocidade de citação | recent |
| Altamente citado | Não |
| Tipos de citação | Neutras: 5 |