Why do pregnant women in Iringa region in Tanzania start antenatal care late? A qualitative analysis

dc.contributor.authorMaluka, Stephen Oswald
dc.contributor.authorJoseph, Chakupewa
dc.contributor.authorFitzgerald, Sian
dc.contributor.authorSalim, Robert
dc.contributor.authorKamuzora, Peter
dc.date.accessioned2021-01-31T08:44:42Z
dc.date.available2021-01-31T08:44:42Z
dc.date.issued2020-02-24
dc.description.abstractBackground: 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.en_US
dc.description.sponsorshipThe study was funded by a joint initiative of three Canadian government agencies, namely the Canadian Institutes of Health Research (CIHR), Global Affairs Canada (GAC) and Canada’s International Development Research Centre (IDRC) under IMCHA programme Grant No: IDRC 108023–001.en_US
dc.identifier.urihttp://hdl.handle.net/20.500.11810/5534
dc.language.isoenen_US
dc.publisherSpringer Natureen_US
dc.subjectAntenatal Care, Factors for late initiation, health system, Tanzaniaen_US
dc.titleWhy do pregnant women in Iringa region in Tanzania start antenatal care late? A qualitative analysisen_US
dc.typeJournal Article, Peer Revieweden_US
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