Midwives’ Voices on Early Initiation of Antenatal Care Following a Positive Gravindex Test: A Qualitative Study
Abstract
Abstract
Background: Early Antenatal Care (ANC) initiation is aimed at improving maternal and perinatal health outcomes through the identification of complications and determining the level of care needed. This study aimed to determine the voices of midwives on the provision of early initiation of ANC following positive gravindex.
Materials and Methods: The phenomenology approach underpinned the study. The participants included midwives providing ANC at health facilities under Tshino–Mutsha local area in May–December 2020. Nonprobability, purposive sampling was used to select four clinics and to sample 20 midwives. Semistructured face‑to‑face, in‑depth interviews were conducted using an interview guide. Data saturation was reached at Participant 15; however, the researcher continued until Participant 20. Trustworthiness was ensured and ethical principles were adhered to. Data analysis was done using Tesch’s open coding approach.
Results: Two themes and seven subthemes emerged, as challenges related to the provision of midwifery practice and to pregnant women. The seven subthemes were the shortage of resources, poor support of midwives, poor adherence to the available protocol for the provision of ANC, blaming of midwives by management and community, late ANC booking by pregnant women, denial of pregnancy by young women ignorance leading to a general resistance to ANC instructions, hence late booking
Conclusions: It was concluded that shortage of human and material resources hindered the initiation of early ANC to detect, prevent, and manage the existing and potential causes of maternal and newborn mortality and morbidity.
Keywords
Full Text:
PDFReferences
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. Geneva Switzerland. World Health Organization; 2018.
World Health Organization. Trends in Maternal Mortality: 1990 2015: Estimates from WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division. United Kingdom. World Health Organization; 2015.
Guidelines for Maternity Care in South Africa: A Manual for Clinics, Community Health Centres and District Hospitals. 2015. Pretoria: National Department of Health; 2016.
Dantas JA, Singh D, Lample M. Factors affecting utilization of health facilities for labour and childbirth: A case study from rural Uganda. BMC Pregnancy Childbirth 2020;20:39.
Ragolane VJ. Factors contributing to late antenatal care booking in Mopani District of Limpopo Province. Published MPH dissertation. Pretoria: University of South Africa; 2017.
Geta MB, Yallew WW. Early initiation of antenatal care and factors associated with early antenatal care initiation at health facilities in southern Ethiopia. Advances in Public Health 2017;2017:1624245.
Paudel YR, Jha T, Mehata S. Timing of first antenatal care (ANC) and inequalities in early initiation of ANC in Nepal. Front Public Health 2017;5:242.
Weldemariam S, Damte A, Endris K, Palcon MC, Tesfay K, Berhe A, et al. Late antenatal care initiation: The case of public health centers in Ethiopia. BMC Res Notes 2018;11:1 6.
Kumar R. Research Methodology: A Step by Step Guide for Beginners. Sage; Oliver’s Yard 55 City Road London. 2018.
Neuendorf KA. Content analysis and thematic analysis. In: Advanced Research Methods for Applied Psychology. Los Angeles, CA. Routledge; 2018. p. 211 23.
Alderson P, Morrow V. The Ethics of Research with Children and Young People: A Practical Handbook. Sage; Oliver's Yard 55 City road London. 2020.
Tesfaye G, Loxton D, Chojenta C, Semahegn A, Smith R. Delayed initiation of antenatal care and associated factors in Ethiopia: A systematic review and meta analysis. Reprod Health 2017;14:1 7.
Ewunetie AA, Munea AM, Meselu BT, Simeneh MM, Meteku BT. DELAY on first antenatal care visit and its associated factors among pregnant women in public health facilities of Debre Markos town, North West Ethiopia. BMC Pregnancy Childbirth 2018;18:1 8.
Warri D, George A. Perceptions of pregnant women of reasons for late initiation of antenatal care: A qualitative interview study. BMC Pregnancy Childbirth 2020;20:1 2.
Ebonwu J, Mumbauer A, Uys M, Wainberg ML, Medina Marino A. Determinants of late antenatal care presentation in rural and peri urban communities in South Africa: A cross sectional study. PLoS One 2018;13:e0191903.
Tibandebage P, Kida T, Mackintosh M, Ikingura J. Can managers empower nurse-midwives to improve maternal health care? A comparison of two resource-poor hospitals in Tanzania. Int J Health Plann Manag 2016;31:379 95.
Bogren M, Grahn M, Kaboru BB, Berg M. Midwives’ challenges and factors that motivate them to remain in their workplace in the Democratic Republic of Congo—An interview study. Hum Resour Health 2020;18:65.
Lumadi TG, Matlala MS. Perceptions of midwives on shortage and retention of staff at a public hospital in Tshwane District. Curationis 2019;42:e1 10.
Goshu M, Godefay H, Bihonegn F, Ayalew F, Haileselassie D, Kebede A, et al. Assessing the competence of midwives to provide care during labor, childbirth and the immediate postpartum period–A cross sectional study in Tigray region, Ethiopia. PLoS One 2018;13:e0206414.
Wagnew F, Dessie G, Alebel A, Mulugeta H, Belay YA, Abajobir AA. Does short message service improve focused antenatal care visit and skilled birth attendance? A systematic review and meta analysis of randomized clinical trials. Reprod Health 2018;15:191.
Grissinger M. Disrespectful behaviour in health care: Its impact, why it arises and persists, and how to address it part 2. Pharm Ther 2017;42:74.
Mills TA, Ricklesford C, Cooke A, Heazell AE, Whitworth M, Lavender T. Parents’ experiences and expectations of care in pregnancy after stillbirth or neonatal death: A meta synthesis. BJOG 2014;121:943 50.
Konje ET, Hatfield J, Sauve R, Kuhn S, Magoma M, Dewey D. Late initiation and low utilization of postnatal care services among women in the rural setting in Northwest Tanzania: A community based study using a mixed method approach. BMC Health Serv Res 2021;21:635.
Mulondo SA. Factors associated with underutilization of antenatal care services in Limpopo, South Africa. Br J Midwifery 2020;28:788 95.
Adewuyi EO, Auta A, Khanal V, Bamidele OD, Akuoko CP, Adefemi K, et al. Prevalence and factors associated with underutilization of antenatal care services in Nigeria: A comparative study of rural and urban residences based on the 2013 Nigeria demographic and health survey. PLoS One 2018;13:e0197324.
Refbacks
- There are currently no refbacks.