Perceived barriers to utilization of antenatal care services in northern Uganda: A qualitative study.

Journal: Sexual & reproductive healthcare : official journal of the Swedish Association of Midwives

Volume: 23

Issue: 

Year of Publication: 2020

Affiliated Institutions:  Centre for Global Health, Department of Clinical Research, University of Southern Denmark, Odense, Denmark. Electronic address: cecilie@uldbjerg.com. Centre for Global Health, Department of Clinical Research, University of Southern Denmark, Odense, Denmark. Electronic address: stis@si-folkesundhed.dk. Department of Public Health, Faculty of Medicine, Gulu University, Uganda. Electronic address: fkaducu@gmail.com. Department of Mental Health, Faculty of Medicine, Gulu University, Uganda. Electronic address: emilio.ovuga@gmail.com. Centre for Global Health, Department of Clinical Research, University of Southern Denmark, Odense, Denmark. Electronic address: msodemann@health.sdu.dk.

Abstract summary 

Antenatal care (ANC) utilization remains a challenge in efforts to reduce maternal mortality and improve maternal health in Uganda. This study aimed to identify perceived barriers to utilization of ANC services in a rural post-conflict area in northern Uganda.A qualitative study using in-depth interviews and focus group discussions of seventeen participants (pregnant women, health workers and a traditional birth attendant). The study was informed through a phenomenological approach to capture perceived barriers to utilization of ANC. The study was carried out in post-conflict Awach sub-county, Gulu District, northern Uganda. Data was analyzed using inductive conventional content analysis.The main perceived barriers to ANC utilization were identified as: poor quality of care, including poor attitude of health workers; socio-cultural practices not being successfully aligned to ANC; and lack of support from the husband, including difficulties in encouraging him to attend ANC. Additionally, institutional structures and procedures at the health centers in terms of compulsory HIV testing and material requirements and transportation were perceived to prevent some pregnant women from attending ANC.Identifying local barriers to ANC utilization are important and should be considered when planning ANC programs. We propose that future efforts should focus on how to ensure a good patient-provider relationship and perceived quality of care, and further how to improve inter-spousal communication and sensitization of husbands for increased involvement in ANC. We recommend more research on how socio-cultural context can meaningfully be aligned to ANC to improve maternal health and reduce maternal mortality.

Authors & Co-authors:  Uldbjerg Cecilie Skaarup CS Schramm Stine S Kaducu Felix Ocaka FO Ovuga Emilio E Sodemann Morten M

Study Outcome 

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Statistics
Citations : 
Authors :  5
Identifiers
Doi : 10.1016/j.srhc.2019.100464
SSN : 1877-5764
Study Population
Women
Mesh Terms
Adult
Other Terms
Antenatal care;Maternal health;Post-conflict;Qualitative;Uganda
Study Design
Phenomenological Study,Cross Sectional Study
Study Approach
Qualitative
Country of Study
Uganda
Publication Country
Netherlands