scholarly journals Factors for Late Initiation of Antenatal Care in Kahama Municipal, Tanzania

2022 ◽  
Vol 3 (1) ◽  
pp. 1-10
Author(s):  
Hamis Bakari ◽  
Gladys Reuben Mahiti

Background: Maternal mortality is a major public health issue in developing countries due to its shocking magnitude and lower declining pattern, 295 000 women died of pregnancy or childbirth related complications in 2017. Late initiation of Antenatal Care (ANC) services in most low-income countries like Tanzania has been reported as a major problem which increase maternal mortality rate (MMR). However, different factors for late initiation of antenatal care are not well identified. Therefore, this study aimed to identify factors for late initiation of antenatal care both individual factors and health policy factors as per pregnant women and health care providers opinions in Kahama Municipal, Tanzania. Broad Objective: The study focused on assessment of factors for late initiation of Antenatal Care (ANC) in Kahama Municipal, Tanzania. Materials and Methods: This study was conducted using a qualitative method with exploratory approach which was carried out to explore factors for late initiation of antenatal care in Kahama Municipal. An in-depth interview (IDI) and Focus Group Discussion (FGD) were methods used to collect data. The study comprised of 14 in-depth interviews (IDIs) with pregnant women with age range of 18 years to 49 years attending antenatal care clinics in two health facilities and 4 in-depth interviews (IDIs) with health care providers attending pregnant women during antenatal care clinic visit. Furthermore, two Focus Group Discussions (FGDs), one from each health facility with pregnant women were conducted. Data Analysis: Thematic analysis was conducted through use of inductive approach. The audio recordings were conducted using the Swahili language then transcribed and translated into the English language where themes were obtained after translation. Results: Findings obtained from this study were factors for late initiation of antenatal care as reported by both pregnant women and health care providers. Factors for late initiation of antenatal care were under guidance of Health Behavioral Modal (HBM): Factors mentioned by pregnant women included pregnant women education level, negligence of pregnant women to attend clinic, unplanned pregnancy among couples, distance from pregnant women settlement to the facility, pregnant women misconceptions related to antenatal care services, use of local herbs, pregnancy complications, , unfriendly services and unequal gender power relation within a family. Factors mentioned by health care providers based on health policy and managerial factors such as Partner accompanying policy, distant allocation of health facility from people’s settlement and unfriendly services provided by health care providers. Conclusion: This study focused on assessing factors for late initiation of antenatal care in Kahama municipal council in Shinyanga, Tanzania. Different factors for late initiation of antenatal care were reported which included pregnant women and health care providers. Pregnant women education level, negligence of pregnant women to attend clinic, unplanned pregnancy among couples, and distance from pregnant women settlement to the facility, pregnant women misconceptions related to antenatal care services, use of local herbs, pregnancy complications. Health policy and managerial related factors were partner accompanying policy, unfriendly services, and allocation of health facility. Recommendation: However different improvement made on maternal health services in Tanzania but still some of pregnant women are not utilizing it efficiently because of different obstacles like distance from people’s settlement to the health facility, Partner accompanying policy and unfriendly services provided by health care providers. Through such obstacles as a policy maker, I would like to advice Government through Ministry of Health to allocate health facility nearby people’s settlement, providing outreach program to educate the community about antenatal care rather than relying on partner accompanying policy and lastly is provision of refresher training related to client’s rights during health care services provision to all staff.

2018 ◽  
Vol 18 (1) ◽  
Author(s):  
Akashi Andrew Rurangirwa ◽  
Ingrid Mogren ◽  
Joseph Ntaganira ◽  
Kaymarlin Govender ◽  
Gunilla Krantz

2020 ◽  
Author(s):  
Carlos E. Erazo ◽  
Carlos V. Erazo ◽  
Mario J. Grijalva ◽  
Ana L. Moncayo

Abstract Background: Vaccination is the most effective way to prevent infection and severe outcomes caused by influenza viruses in pregnant women and their children. In Ecuador, the coverage of seasonal influenza vaccination in pregnant women is low. The aim of this study was to assess the knowledge, attitudes, and practices (KAP) of pregnant women toward influenza vaccination in Quito-Ecuador.Methods: A cross-sectional study enrolled 842 women who delivered at three main public gynecological-obstetric units of the Metropolitan District of Quito. A questionnaire regarding demographics, antenatal care, risk conditions and knowledge, attitudes and practices related to influenza vaccination was administered. We examined factors associated with vaccination using log-binomial regression models.Results: A low vaccination rate (36.6%) against influenza was observed among pregnant women. The factors associated with vaccination included the recommendations from health providers (adjusted PR: 15.84; CI 95% 9.62-26.10), belief in the safety of the influenza vaccine (adjusted PR: 1.53; CI 95% 1.03-2.37) and antenatal care (adjusted PR: 1.21; CI 95% 1.01-1.47). The most common reasons for not vaccinating included the lack of recommendation from health care providers (73.9%) and lack of access to vaccine (9.0%).Conclusions: Health educational programs aimed at pregnant women and antenatal care providers have the most potential to increase influenza vaccination rates. Further studies are needed to understand the barriers of health care providers regarding influenza vaccination in Ecuador.


2020 ◽  
Author(s):  
Bettina Utz ◽  
Bouchra Assarag ◽  
Touria Lekhal ◽  
Wim Van Damme ◽  
Vincent De Brouwere

Abstract Background: Gestational diabetes mellitus (GDM) is associated with an increased risk for a future type 2 diabetes mellitus in women and their children. As linkage between maternal health and non-communicable diseases, antenatal care plays a key role in the primary and secondary prevention of GDM associated adverse outcomes. While implementing a locally adapted GDM screening and management approach through antenatal care services at the primary level of care, we assessed its acceptability by the implementing health care providers. Methods : As part of a larger implementation effectiveness study assessing a decentralized gestational diabetes screening and management approach in the prefecture of Marrakech and the rural district of Al Haouz in Morocco, we conducted four focus group discussions with 29 primary health care providers and seven in-depth interviews with national and regional key informants. After transcription of data, we thematically analysed the data using a combined deductive and inductive approach. Results: The intervention of screening and managing women with gestational diabetes added value to existing antenatal care services but presented an additional workload for first line health care providers. An existing lack of knowledge about gestational diabetes in the community and among private health care physicians required of public providers to spend more time on counselling women. Nurses had to adapt recommendation on diet to the socio-economic context of patients. Despite the additional task, especially nurses and midwives felt motivated by their gained capacity to detect and manage gestational diabetes, and to take decisions on treatment and follow-up. Conclusions : Detection and initial management of gestational diabetes is an acceptable strategy to extend the antenatal care service offer in Morocco and to facilitate service access for affected pregnant women. Despite its additional workload, gestational diabetes management can contribute to the professional motivation of primary level health care providers.


2019 ◽  
Author(s):  
Bettina Utz ◽  
Bouchra Assarag ◽  
Touria Lekhal ◽  
Wim Van Damme ◽  
Vincent De Brouwere

Abstract Background Gestational diabetes mellitus (GDM) is associated with an increased risk for a future diabetes mellitus in women and their children. As linkage between maternal health and non-communicable diseases, antenatal care plays a key role in the primary and secondary prevention of GDM associated adverse outcomes. While implementing a locally adapted GDM screening and management approach through antenatal care services at the primary level of care, we assessed its acceptability by the implementing health care providers. Methods As part of a larger implementation effectiveness study assessing a decentralized gestational diabetes screening and management approach in the prefecture of Marrakech and the rural district of Al Haouz in Morocco, we conducted four focus group discussions with 29 primary health care providers and seven in-depth interviews with national and regional key informants. Looking at the main themes screening, diagnosis, treatment and service organization, we thematically analyzed the data using a combined de- and inductive approach. Results The intervention of screening and managing women with gestational diabetes added value to existing antenatal care services but presented an additional workload for first line health care providers. Lack of knowledge about gestational diabetes in the community but also by private health care providers demanded more time for counseling. Nurses had to adapt recommendation on diet to the socio-economic context of patients. Despite the additional task, especially nurses and midwives felt motivated by their gained capacity to detect and manage gestational diabetes and the ability to take decisions on follow-up. Conclusions Detection and initial management of gestational diabetes is an acceptable strategy to extend the antenatal care service offer in Morocco and to facilitate service access for affected pregnant women. Despite its additional workload, gestational diabetes management can contribute to the professional motivation of primary level health care providers.


2020 ◽  
Author(s):  
Bettina Utz ◽  
Bouchra Assarag ◽  
Touria Lekhal ◽  
Wim Van Damme ◽  
Vincent De Brouwere

Abstract Background: Gestational diabetes mellitus (GDM) is associated with an increased risk for a future type 2 diabetes mellitus in women and their children. As linkage between maternal health and non-communicable diseases, antenatal care plays a key role in the primary and secondary prevention of GDM associated adverse outcomes. While implementing a locally adapted GDM screening and management approach through antenatal care services at the primary level of care, we assessed its acceptability by the implementing health care providers. Methods : As part of a larger implementation effectiveness study assessing a decentralized gestational diabetes screening and management approach in the prefecture of Marrakech and the rural district of Al Haouz in Morocco, we conducted four focus group discussions with 29 primary health care providers and seven in-depth interviews with national and regional key informants. After transcription of data, we thematically analysed the data using a combined deductive and inductive approach. Results: The intervention of screening and managing women with gestational diabetes added value to existing antenatal care services but presented an additional workload for first line health care providers. An existing lack of knowledge about gestational diabetes in the community and among private health care physicians required of public providers to spend more time on counselling women. Nurses had to adapt recommendation on diet to the socio-economic context of patients. Despite the additional task, especially nurses and midwives felt motivated by their gained capacity to detect and manage gestational diabetes, and to take decisions on treatment and follow-up. Conclusions : Detection and initial management of gestational diabetes is an acceptable strategy to extend the antenatal care service offer in Morocco and to facilitate service access for affected pregnant women. Despite its additional workload, gestational diabetes management can contribute to the professional motivation of primary level health care providers.


Author(s):  
Kirui N. Jelagat ◽  
Keraka M. Nyanchoka ◽  
Musili F.

Background: Male participation in utilization of reproductive health is likely to promote timely and proper antenatal care, encourage women to deliver under the care of a skilled attendant, and also help identify and seek heath care in cases of post-partum complications. However, in most African societies, pregnancy, delivery and postnatal services has been erroneously classified as purely feminine issue by the society.Methods: A cross-sectional descriptive study design was adopted for the study. The target population of the study comprised of males above 18 years working in selected manufacturing industries in the area of Babadogo located in Nairobi County, Kenya. The sample size for the study was 266 respondents. Structured questionnaires were used for data collection. Data collected was quantitatively analysed using Statistical Package for Social Sciences (SPSS).Results: 56.0% (145) of the respondents had accompanied their partner to antenatal care facilities; 34.0% (88) of the respondents had ever participated in ANC services. Chi-square test statistics showed that distance to the nearest health facility (χ2=7.472 df=3, p=0.024), cost of accessing ANC services (χ2=26.253 df=4, p=0.001), attitude of healthcare providers (χ2=31.705 df=3, p=0.001) and friendliness of the waiting bay (χ2=9.718 df=2, p=0.008) significantly influenced male participation in antenatal care services’ utilization among spouses.Conclusions: Despite majority of men accompanying their wives to antenatal care facilities, most of them did not participate in the antenatal care services. Another conclusion is that facility factors such as distance, cost, health care providers’ attitude, and waiting bay friendliness influence male participation in utilization of antenatal care services.


2020 ◽  
Author(s):  
Carlos E. Erazo ◽  
Carlos V. Erazo ◽  
Mario J. Grijalva ◽  
Ana L. Moncayo

Abstract Background: Vaccination is the most effective way to prevent infection and severe outcomes caused by influenza viruses in pregnant women and their children. In Ecuador, the coverage of seasonal influenza vaccination in pregnant women is low. The aim of this study was to assess the knowledge, attitudes and practices of pregnant women toward influenza vaccination in Quito-Ecuador.Methods: A cross-sectional study enrolled 842 women who delivered at three main public gynecological-obstetric units of the Metropolitan District of Quito. A questionnaire regarding demographics, antenatal care, risk conditions and knowledge, attitudes and practices related to influenza vaccination was administered. We examined factors associated with vaccination using log-binomial regression models.Results: A low vaccination rate (36.6%) against influenza was observed among pregnant women. The factors associated with vaccination included the recommendations from health providers (adjusted PR: 15.84; CI 95% 9.62-26.10), belief in the safety of the influenza vaccine (adjusted PR: 1.53; CI 95% 1.03-2.37) and antenatal care (adjusted PR: 1.21; CI 95% 1.01-1.47). The most common reasons for not vaccinating included the lack of recommendation from health care providers (73.9%) and lack of access to vaccine (9.0%).Conclusions: Health educational programs aimed to pregnant women and antenatal care providers have the most potential to increase influenza vaccination rates. Further studies are needed to understand the barriers of health care providers regarding influenza vaccination in Ecuador.


2020 ◽  
Author(s):  
Bettina Utz ◽  
Bouchra Assarag ◽  
Touria Lekhal ◽  
Wim Van Damme ◽  
Vincent De Brouwere

Abstract Background: Gestational diabetes mellitus (GDM) is associated with an increased risk for a future type 2 diabetes mellitus in women and their children. As linkage between maternal health and non-communicable diseases, antenatal care plays a key role in the primary and secondary prevention of GDM associated adverse outcomes. While implementing a locally adapted GDM screening and management approach through antenatal care services at the primary level of care, we assessed its acceptability by the implementing health care providers. Methods : As part of a larger implementation effectiveness study assessing a decentralized gestational diabetes screening and management approach in the prefecture of Marrakech and the rural district of Al Haouz in Morocco, we conducted four focus group discussions with 29 primary health care providers and seven in-depth interviews with national and regional key informants. After transcription of data, we thematically analysed the data using a combined deductive and inductive approach. Results: The intervention of screening and managing women with gestational diabetes added value to existing antenatal care services but presented an additional workload for first line health care providers. An existing lack of knowledge about gestational diabetes in the community and among private health care physicians required of public providers to spend more time on counselling women. Nurses had to adapt recommendation on diet to the socio-economic context of patients. Despite the additional task, especially nurses and midwives felt motivated by their gained capacity to detect and manage gestational diabetes, and to take decisions on treatment and follow-up. Conclusions : Detection and initial management of gestational diabetes is an acceptable strategy to extend the antenatal care service offer in Morocco and to facilitate service access for affected pregnant women. Despite its additional workload, gestational diabetes management can contribute to the professional motivation of primary level health care providers.


Author(s):  
Kennedy Diema Konlan ◽  
Joseph M. Kombat ◽  
Milipaak Japiong ◽  
Kennedy Dodam Konlan

Background: Maternity period is crucial and sensitive in the life of women due to various physiological changes that take place in the body during pregnancy and after. These changes need close monitoring to help optimize maternal and foetal health. This study explored pregnant women’s perceptions of maternity care services in the Volta Regional Hospital.Methods: Multiparous women (170) in the Ante Natal Clinic responded to a pretested questionnaire. The sample size was determined using Fischer’s formula for sample size calculation. Respondents were chosen using the convenient sampling method. The data was analysed using Statistical Package for Social Sciences version 20 in to descriptive statistics.Results: This study identified that women (42.5%) were never encouraged by health care providers to bring their partners during antenatal visits. Pregnant women (62.9%) reported that health care professionals did not allow their support persons including their husbands to be with them during labour. Women (34.1%) during labour were sometimes assaulted while 2.9% were always assaulted. Majority (74.2%) of the women received this five cardinal services that included vitamin K, eye care, cord care, bathing and immunization during the post natal period as 60.7% were introduced to family planning by midwives.Conclusions: Partner involvement in maternal health care needs to be encouraged by midwives to improve support from partners during pregnancy, labour and the post natal period. Support persons should be allowed to stay with women during labour to give the necessary support and encouragement and also take part in decision making concerning women’s care.


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