Why do pregnant women in Iringa region in Tanzania start antenatal care late? A qualitative analysis
Loading...
Date
2020-02-24
Journal Title
Journal ISSN
Volume Title
Publisher
Springer Nature
Abstract
Background: When started early in pregnancy and continued up till childbirth, antenatal care (ANC) can be
effective in reducing adverse pregnancy outcomes. While the proportion of women who attend ANC at least once
in low income countries is high, most pregnant women attend their first ANC late. In Tanzania, while over 51% of
pregnant women complete ≥4 visits, only 24% start within the first trimester. This study aimed to understand the
factors that lead to delay in seeking ANC services among pregnant women in Tanzania.
Methods: This qualitative descriptive case study was conducted in two rural districts in Iringa Region in Tanzania. A
total of 40 focus group discussions (FGDs) were conducted involving both male and female participants in 20
villages. In addition, 36 semi-structured interviews were carried out with health care workers, members of health
facility committees and community health workers. Initial findings were further validated during 10 stakeholders’
meetings held at ward level in which 450 people participated. Data were analysed using thematic approach.
Results: Key individual and social factors for late ANC attendance included lack of knowledge of the importance of
early visiting ANC, previous birth with good outcome, traditional gender roles, fear of shame and stigma, and
cultural beliefs about pregnancy. Main factors which inhibit early ANC attendance in Kilolo and Mufindi districts
include spouse accompany policy, rude language of health personnel and shortage of health care providers.
Conclusions: Traditional gender roles and cultural beliefs about pregnancy as well as health system factors
continue to influence the timing of ANC attendance. Improving early ANC attendance, therefore, requires
integrated interventions that address both community and health systems barriers. Health education on the timing
and importance of early antenatal care should also be strengthened in the communities. Additionally, while spouse
accompany policy is important, the implementation of this policy should not infringe women’s rights to access
ANC services.
Description
Keywords
Antenatal Care, Factors for late initiation, health system, Tanzania