Reasons for late presentation for antenatal care, healthcare providers’ perspective

Abstract Background Antenatal care (ANC) provides healthcare services to pregnant women in an attempt to ensure, the best possible pregnancy outcome for women and their babies. Healthcare providers’ understanding of their patient’s behaviour and reasons for engagement in care and their response to t...

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Main Authors: Nelly Jinga, Constance Mongwenyana, Aneesa Moolla, Given Malete, Dorina Onoya
Format: Article
Language:English
Published: BMC 2019-12-01
Series:BMC Health Services Research
Subjects:
Online Access:https://doi.org/10.1186/s12913-019-4855-x
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author Nelly Jinga
Constance Mongwenyana
Aneesa Moolla
Given Malete
Dorina Onoya
author_facet Nelly Jinga
Constance Mongwenyana
Aneesa Moolla
Given Malete
Dorina Onoya
author_sort Nelly Jinga
collection DOAJ
description Abstract Background Antenatal care (ANC) provides healthcare services to pregnant women in an attempt to ensure, the best possible pregnancy outcome for women and their babies. Healthcare providers’ understanding of their patient’s behaviour and reasons for engagement in care and their response to this insight can influence patient-provider interactions and patient demand for ANC early in pregnancy. We examined the insight of healthcare providers into women’s reasons for starting ANC later than the South African National Department of Health’s recommended 20 weeks gestation. We also looked at the impact of late ANC presentation on overall healthcare providers’ work experiences and their response in their interactions with patients. Methods In-depth interviews were conducted with 10 healthcare providers at Maternal Obstetrics Units (MOU) and Primary Healthcare Centres (PHC) in Gauteng, South Africa. Healthcare providers were selected with the assistance of the facility managers. Data analysis was conducted using the qualitative analysis software NVivo 11, using a thematic approach of pinpointing, examining, and recording patterns within the data. Results Healthcare providers were aware of patients need for secrecy in the early stages of pregnancy because of fears of miscarriage and women’s preference for traditional care. Women with prior pregnancies presumed to know about stages of pregnancy and neglected to initiate ANC early. Barriers to early ANC initiation also include, women’s need to balance income generating activities; travel cost to the clinic and refusal of care for coming after the daily patient limit has been reached. Healthcare providers encounter negative attitudes from un-booked patients. This has a reciprocal effect whereby this experience impacts on whether healthcare providers will react with empathy or frustration. Conclusions Timing of ANC is influenced by the complex decisions women make during pregnancy, starting from accepting the pregnancy itself to acknowledging the need for ANC. To positively influence this decision making for the benefit of early ANC, barriers such as lack of knowledge should be addressed prior to pregnancy through awareness programmes. The relationship between healthcare providers and women should be emphasized when training healthcare providers and considered as an important factor that can affect the timing of ANC.
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spelling doaj.art-ce157eb7f464471bbd0a6137226dffba2022-12-21T22:09:16ZengBMCBMC Health Services Research1472-69632019-12-011911910.1186/s12913-019-4855-xReasons for late presentation for antenatal care, healthcare providers’ perspectiveNelly Jinga0Constance Mongwenyana1Aneesa Moolla2Given Malete3Dorina Onoya4Department of Internal Medicine, Health Economics and Epidemiology Research Office, School of Clinical Medicine, Faculty of Health Sciences, University of the WitwatersrandDepartment of Internal Medicine, Health Economics and Epidemiology Research Office, School of Clinical Medicine, Faculty of Health Sciences, University of the WitwatersrandDepartment of Internal Medicine, Health Economics and Epidemiology Research Office, School of Clinical Medicine, Faculty of Health Sciences, University of the WitwatersrandDepartment of Internal Medicine, Health Economics and Epidemiology Research Office, School of Clinical Medicine, Faculty of Health Sciences, University of the WitwatersrandDepartment of Internal Medicine, Health Economics and Epidemiology Research Office, School of Clinical Medicine, Faculty of Health Sciences, University of the WitwatersrandAbstract Background Antenatal care (ANC) provides healthcare services to pregnant women in an attempt to ensure, the best possible pregnancy outcome for women and their babies. Healthcare providers’ understanding of their patient’s behaviour and reasons for engagement in care and their response to this insight can influence patient-provider interactions and patient demand for ANC early in pregnancy. We examined the insight of healthcare providers into women’s reasons for starting ANC later than the South African National Department of Health’s recommended 20 weeks gestation. We also looked at the impact of late ANC presentation on overall healthcare providers’ work experiences and their response in their interactions with patients. Methods In-depth interviews were conducted with 10 healthcare providers at Maternal Obstetrics Units (MOU) and Primary Healthcare Centres (PHC) in Gauteng, South Africa. Healthcare providers were selected with the assistance of the facility managers. Data analysis was conducted using the qualitative analysis software NVivo 11, using a thematic approach of pinpointing, examining, and recording patterns within the data. Results Healthcare providers were aware of patients need for secrecy in the early stages of pregnancy because of fears of miscarriage and women’s preference for traditional care. Women with prior pregnancies presumed to know about stages of pregnancy and neglected to initiate ANC early. Barriers to early ANC initiation also include, women’s need to balance income generating activities; travel cost to the clinic and refusal of care for coming after the daily patient limit has been reached. Healthcare providers encounter negative attitudes from un-booked patients. This has a reciprocal effect whereby this experience impacts on whether healthcare providers will react with empathy or frustration. Conclusions Timing of ANC is influenced by the complex decisions women make during pregnancy, starting from accepting the pregnancy itself to acknowledging the need for ANC. To positively influence this decision making for the benefit of early ANC, barriers such as lack of knowledge should be addressed prior to pregnancy through awareness programmes. The relationship between healthcare providers and women should be emphasized when training healthcare providers and considered as an important factor that can affect the timing of ANC.https://doi.org/10.1186/s12913-019-4855-xAntenatal careHealthcare providersLate presentationMidwifePregnancy
spellingShingle Nelly Jinga
Constance Mongwenyana
Aneesa Moolla
Given Malete
Dorina Onoya
Reasons for late presentation for antenatal care, healthcare providers’ perspective
BMC Health Services Research
Antenatal care
Healthcare providers
Late presentation
Midwife
Pregnancy
title Reasons for late presentation for antenatal care, healthcare providers’ perspective
title_full Reasons for late presentation for antenatal care, healthcare providers’ perspective
title_fullStr Reasons for late presentation for antenatal care, healthcare providers’ perspective
title_full_unstemmed Reasons for late presentation for antenatal care, healthcare providers’ perspective
title_short Reasons for late presentation for antenatal care, healthcare providers’ perspective
title_sort reasons for late presentation for antenatal care healthcare providers perspective
topic Antenatal care
Healthcare providers
Late presentation
Midwife
Pregnancy
url https://doi.org/10.1186/s12913-019-4855-x
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