Individual Motivation for Completion of Antenatal Care Consultations In The Community Health Center: A Mixed Methods Study

Background: Antenatal care is an intensive program for mother and child, predominantly received from healthcare professionals during pregnancy. Recent studies have shown a high rate of incomplete consultations, while several qualitative and quantitative assessments highlighted the influencing risks and motivational factors. These were performed in an attempt to gain a more comprehensive understanding hence data were collected and consequently evaluated on the basis of competition, using a convergent mixed-methods design.Methods: The data were collected in Makassar, Indonesia, using a sequential explanatory designed that was initially conducted as a quantitative study in the form of a questionnaire for pregnant/reproductive women (n=326), followed by a focus group discussion (FGD), as a qualitative study targeted at people, which includes pregnant/reproductive women and health workers (n=60). To quantitatively evaluate the relationship between each factor and the completion of antenatal care consultations, odds ratios (ORs) were calculated using the logistic regression model. Similarly, in order to validate the results from the quantitative study and explore the real background in each motivation factor, qualitative analysis was conducted by FGD.Results: In the qualitative analysis, the level of education of the husband and the time allocated to examination were linked with the completion status of antenatal care consultations. Particularly, the women that received accurate and prompt services were more likely to complete the antenatal care consultations [Adjusted OR for additional physical examination:1.90 (95% CI: 1.03–3.48); and OR for additional obstetric physical examination: 9.10 (95% CI: 3.42–24.23)] compared to the women that did not receive. According to the FGD, the quality of health care centers was an important factor for the completion of antenatal care performance, and pregnant women frequently visited Posyandu which is a health post in the community instead of going to the community health center.Conclusions: The main challenges for individual motivation to complete their consultations remain the socio-economic status, lack of knowledge on pregnancy experiences, and the quality of health care centers. These factors need to be considered in order to improve the health policy for adequate services for pregnant women.