A qualitative study to explore women’s perceptions of pregnancy and antenatal care in Chizenga village, Chikwawa, Malawi

Bibliographic Data

ID24219178
AuthorsHelen Layton (0009-0003-1499-9900, Liverpool School of Tropical Medicine), Deborah Nyirenda (0000-0002-5867-4687, Community Engagement and Bioethics Research Group, Malawi Liverpool Wellcome Research Programme), Terry Kana (0000-0002-1501-6860, Liverpool School of Tropical Medicine)
EditorsNicola L Hawley (0000-0002-2601-3454, Yale University)
Year2026
Volume6
Issue9
Pagese0005515
Publication date2026-09-25
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.0005515
PMID42789677
OpenAlexW7214335538
LanguageEN
References cited37

National survey data indicate that only around one quarter of women in Malawi attend their first antenatal care (ANC) visit during the first trimester. This study explores women’s perceptions of ANC in Chizenga village, Chikwawa, a rural setting with high maternal mortality and low ANC uptake. Using an interpretivist qualitative design, 14 pregnant women aged 18–44 years were recruited through purposive sampling. Semi-structured interviews were conducted in Chichewa, translated into English, and analysed using thematic analysis to identify patterns across the dataset and develop themes grounded in participants’ accounts. Findings indicate that while women valued ANC and recognised its role in reducing maternal and neonatal mortality, most initiated care after the first trimester. Key themes included understanding of pregnancy health and ANC, nutritional constraints despite awareness, gendered dynamics in ANC attendance, the perceived influence of witchcraft, experiences of respectful and disrespectful care, and structural barriers related to distance and transport. Socioeconomic constraints, particularly distance, transport costs, and limited health literacy, contributed to delayed ANC attendance. Nevertheless, women demonstrated resilience and a strong commitment to maternal health, with some walking over 22 kilometres to access services. Participants voiced a need for increased ANC education and proposed community-based solutions such as health worker outreach and improved access to services. The study calls for context-sensitive policy interventions, including community-based health education, outreach antenatal services, and improved transport support, to ensure equitable access to respectful antenatal care.

antenatal care uptake · community health education · delayed antenatal care · Health literacy · maternal mortality · Pregnant women · respectful maternity care · rural maternal health · transport barriers · witchcraft beliefs · Global Maternal and Child Health · Maternal and Neonatal Healthcare · Maternal and Perinatal Health Interventions

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