Abstract
Since the implementation of free maternity services in South Africa from 1994, more maternity services were provided (SA, 1994: 73). These services are however inaccessible to many pregnant women in the rural areas, leading to sub-optimal antenatal health service utilization. Another problem that emerged, is deterioration in antenatal health service rendering throughout the country, as well as a lack of guidelines for the mobilization of pregnant women in order to promote optimal antenatal health service utilization (ANHSU) in the North West Province. The mentioned problems were the reasons for undertaking this research. The aims formulated for this research were: To determine the composition of the infrastructure of the antenatal health services and the efficacy of the antenatal health-service rendering in the greater Mafikeng-Mmabatho District; To undertake a survey of the ANHSU by pregnant women attending the mentioned services; To explore and describe the perceptions of these pregnant women regarding ANHSU; To formulate recommendations for antenatal health service providers working in the greater Mafikeng-Mmabatho District for the mobilization of pregnant women to promote optimal ANHSU. A qualitative survey design was followed within the context of the greater Mafikeng-Mmabatho District in the North West Province. Data-collection was managed through completion of structured questionnaires by chief professional nurses and puerperal women and by holding semi-structured interviews with puerperal women who were selected using non-probable, voluntary and purposive sampling. The findings that emerged were, that the composition of the infrastructure of the majority antenatal health services in the greater Mafikeng-Mmabatho District were insufficiently equipped indicating the provision of ineffective antenatal health service rendering. Pregnant women were utilizing the antenatal health services sub-optimally and the exploration and description of their ANHSU, revealed factors promoting and preventing utilization. Recommendations have been formulated for nursing education, nursing research and nursing practice with specific reference to the formulation of guidelines for antenatal health service providers to promote optimal ANHSU by pregnant women.
Highlights
Introduction and problem statementSince 1977 Provincial Administrations in South Africa provided maternity services and facilities, while the local authorities provided medication and family planning serv ices (SA,1977)
Since the implementation of free maternity services for preg nant women and children under six years of age without medical funds in 1994, M cCoy (1996:5-6) determined that more maternity services were provided in rural areas, they were still inaccessible to many pregnant women
According to the National Committee on Confidential En quiries into Maternal Deaths (NCCEMD), under-utilization and non-utilization of antenatal health-services as well as late-utilization of the other components of maternity serv ices, leads to an increase in maternal mortality (NCCEMD, 1998b :3 -4). It was reported in the first maternal mortality report, that sub-optimal antenatal health service utilization (ANHSU) played a major role in each maternal death caused by the existing causes of maternal deaths in South Africa (NCCEMD, 1998a: 7,10,12, 20)
Summary
Introduction and problem statementSince 1977 Provincial Administrations in South Africa provided maternity services and facilities, while the local authorities provided medication and family planning serv ices (SA,1977). According to the National Committee on Confidential En quiries into Maternal Deaths (NCCEMD), under-utilization and non-utilization of antenatal health-services as well as late-utilization of the other components of maternity serv ices, leads to an increase in maternal mortality (NCCEMD, 1998b :3 -4). It was reported in the first maternal mortality report, that sub-optimal ANHSU played a major role in each maternal death caused by the existing causes of maternal deaths in South Africa (NCCEMD, 1998a: 7,10,12, 20)
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