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Perceptions regarding making household air pollution a routine topic for health education during antenatal care

A qualitative study in Eastern Uganda

Bibliographic Data

ID19592829
AuthorsJoshua Epuitai (0000-0002-7148-5928, Busitema University, corresponding author), Katherine E Woolley (0000-0003-3743-9925, University of Birmingham, corresponding author), Rose Chalo Nabirye (Busitema University, corresponding author), Julius Wandabwa (0000-0002-2826-8530, Busitema University, corresponding author), Julius N Wandabwa, Joseph Odula (Busitema University, corresponding author), Ivan Lyagoba (0009-0002-0530-7127, Busitema University, corresponding author), G Neil Thomas (0000-0002-2777-1847, University of Birmingham, corresponding author)
EditorsJulia Robinson (0000-0003-0719-3995)
Year2025
Volume5
Issue9
Pagese0003973
Publication date2025-09-15
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenuePLOS Global Public Health (JOURNAL)
Journal identifiersISSN: 2767-3375 • E-ISSN: 2767-3375
PublisherPublic Library of Science (PLoS) (PUBLISHER)
DOI10.1371/journal.pgph.0003973
PMID40952980
OpenAlexW4414264109
LanguageEN
References cited28

In Uganda, pregnant women do not routinely receive health education during antenatal care regarding exposure to household air pollution (HAP). The study was conducted to explore perceptions regarding what would be needed to incorporate HAP as a routine topic for health education during antenatal care. The study was based on the capability, motivation, opportunity-behavior (COM-B) model. Qualitative interviews were conducted among healthcare workers and pregnant women attending antenatal care at Mbale Regional Referral Hospital in Uganda. Thematic analysis was used to identify key themes. Capability to provide health education on HAP emanated from health system factors (e.g., lack of capacity, workload, time constraints) and behavioral factors (e.g., HAP not seen as a major risk factor for adverse pregnancy outcomes). Capability to adopt cleaner fuels following health education was thought to be affected by willingness to adopt short-term interventions ahead of cleaner fuels alternatives, cost/affordability constraints, unwillingness to change, and socio-cultural concerns. Socio-economic constraints, weather and safety concerns were thought to affect women’s capability to open doors/windows and cook outdoors following health education. Participants were motivated to provide/receive antenatal health education because of their need to reduce adverse birth outcomes caused by HAP, acceptability of HAP as a topic for education, and the perception of healthcare workers as role models. Training midwives about HAP, using innovative teaching aids, including prompts on HAP in the antenatal card to remind healthcare workers to talk about HAP, giving incentives to healthcare workers and involving them when designing health education about HAP were suggested to enable integration of HAP as routine topic. Our study highlights an opportunity to empower and create demand among pregnant people to adopt behaviors that could reduce exposure to HAP during ANC. Integration of HAP into antenatal care could help transition households from precontemplation and contemplation stage in the uptake of cleaner fuels

Health care · Health education · Incentive · Psychological intervention · Public health · Qualitative research · Referral · Thematic analysis · Air Quality and Health Impacts · Child Nutrition and Water Access · Energy and Environment Impacts

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