Perceptions of pregnancy, labour, and post-partum difficulties related with the adoption of focused antenatal care services among women of reproductive age in Sirisia Sub-County, Bungoma County, Kenya
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20243632Keywords:
Pregnancy, Safe child birth, Focused antenatal care, Postnatal care, Skilled birth attendantAbstract
Background: Focused antenatal care (FANC) adoption is significantly influenced by women's perceptions of pregnancy, labour, and post-partum difficulties. Cultural beliefs, personal experiences, and social norms shape these perceptions, affecting whether women seek FANC services. Fear of medical procedures and privacy concerns also deter FANC adoption. These perceptions contribute to FANC underutilization, potentially compromising maternal and neonatal health outcomes.
Methods: Analytical cross-sectional study design was used and 323 participants in the selected wards in Sirisia subcounty, Bungoma County, Kenya. Data was collected using interviewer administered structured questionnaire, and focus group discussion. Quantitative data analysis was conducted using statistical package for the social sciences (SPSS) version 29.0 and involved univariate and bivariate analysis. Bivariate analysis was done through logistic regression was used to test the significance of the association between the dependent and independent variables (p<0.05). Qualitative data was analyzed by thematic content analysis.
Results: More than half 183 (56.7%) had initial prenatal care attendance between 4-6 months and 17 (5.3%) between 7-9 months. Further, 202 (62.5%) had four or more ANC visits with 5 (1.5%) and 85 (26.3%) had one and three visits respectively. Significant relationships were found between FANC uptake and positive perceptions of well-being (OR=5.810), worry alleviation (OR=2.425), complication reduction (OR=5.011), birth preparedness (OR=4.551), service access (OR=3.005), and risk detection (OR=5.847). Barriers included fatigue (66%), permission requirements (67%), and transportation issues (65%). Factors like clinic distance, terrain, waiting times, and staffing shortages significantly influenced FANC uptake (p=0.0001).
Conclusions: FANC uptake influenced by perceived benefits and demographics. Logistical challenges remain. Recommendations include mobile clinics and community health worker education to improve access and awareness.
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References
McHenga M, Burger R, Von Fintel D. Examining the impact of WHO’s Focused Antenatal Care policy on early access, underutilisation and quality of antenatal care services in Malawi: A retrospective study. BMC Health Serv Res. 2019;19(1):1-15.
Heri R, Mselle LT, Malqvist M. Qualitative Exploration Study of Perceptions of Women and Nurse-Midwives on Antenatal Care Information and Communication in Tanzania. Int J Womens Health. 2023;15(06):927-41.
Owusu SS, Sibaii F, Lee K, Gill M, Hatch J. Factors associated with antenatal care service utilization among women with children under five years in Sunyani Municipality, Ghana. medRxiv. 2021;115(16):1-13.
World Health Organization. WHO recommendations on antenatal care for a positive pregnancy experience: summary: highlights and key messages from the World Health Organization’s 2016 global recommendations for routine antenatal care. Lancet. 2018;387(100):110-98.
Konlan KD, Kombat JM, Japiong M, Konlan KD. Perception of pregnant women on maternity care services at the Volta Regional Hospital, Ghana. Int J Community Med Public Heal. 2018;5(7):2699.
KDHS. Kenya Demographic and Health Survey Key Findings. Kenya Bur Stat. 2023;6(2):24-59.
Muthingu MC, Osero J, Chomi E. The Perceptions of Women of Reproductive Age towards the Uptake of Focused Antenatal Care Services in Nakuru County. J Med Nurs Public Heal. 2018;1(2):50-67.
Ahmed I, Mwanzo I, Agina O. A Qualitative Exploration of Access and Utilization of Focused Antenatal Care among Pastoral Community in North Eastern Kenya. Asian J Med Heal. 2020;18(6):1-10.
Mutai KT, Otieno GO. Utilization of focused antenatal care among expectant women in Murang’a county, Kenya. Pan Afr Med J. 2021;39.
Funsani P, Jiang H, Yang X, Zimba A, Bvumbwe T, Qian X. Why pregnant women delay to initiate and utilize free antenatal care service: a qualitative study in theSouthern District of Mzimba, Malawi. Glob Heal J. 2021;5(2):74-8.
Ngowi AF, Mkuwa S, Shirima L, Ngalesoni F, Frumence G. Determinants of Focused Antenatal Care Utilization Among Women in Simiyu Region Tanzania. SAGE Open Nurs. 2023;9.
Nwabueze CO, Okeke CC, Nwevo CO, Nwodo LA, Nwekpa WC, Nwaiwu PI. Assessing Focused Antenatal Care Awareness and Utilization Among Pregnant Women in Enugu State, Nigeria: A Cross-Sectional Survey. Cureus. 2023;15(5):1-15.
Konje ET, Magoma MTN, Hatfield J, Kuhn S, Sauve RS, Dewey DM. Missed opportunities in antenatal care for improving the health of pregnant women and newborns in Geita district, Northwest Tanzania. BMC Pregnancy Childbirth. 2018;18(1):394.