Abstract
AimThe aim of this study was to explore how Kalenjin women in rural Uasing Gishu County in Kenya perceive antenatal care and how their perceptions impede or motivate earlier access and continuous use of antenatal care services.MethodsA study was conducted among 188 pregnant and post-natal mothers seeking care in 23 rural public health facilities. Gestational age at the initial antenatal care booking was established from their medical cards. Further researcher-administered questionnaire with closed and open-ended questions was used. Key informant interviews with traditional birth attendants (n = 6) and maternal and child health nursing officers (n = 6) were also conducted for triangulation. Descriptive statistics were applied using SPSS programme. The interviews of women who gave consent to be audio recorded (n = 52) were transcribed and thematically analysed using MAXQDA program, based on Andersen and Newman’s (1973) behavioural model of health services utilization.ResultsThe mean gestational age at booking initial biomedical care was 23.36 weeks. Only 18 patients (10%) booked before 13 weeks and 45% made four or more visits. The main reasons given for early booking were: illness in index pregnancy (42%) checking the foetus position and monitoring foetus progress (7%). The main reasons given for late booking were: no reason (31%), was not feeling sick (16%), fear or shame due to unexpected pregnancy (13%). Almost half of the respondents (44%) used both biomedical and traditional antenatal care services. Main reasons for visiting traditional care were to: check foetus position and reposition it (63%), collect medicinal herbs (31%), relief discomforts through massage (18%).ConclusionEarly antenatal care booking is meant for women with unpleasant physical signs and symptoms. Later ANC is meant to check foetus position and reposition it to cephalic presentation and monitor its progress and this is only possible if the foetus is large.
Highlights
Antenatal care (ANC) is regarded as a key entry point for pregnant women to receive a wide range of essential health-promotion and disease-prevention services
This study aimed to assess the gestational age at which women in rural Uasin Gishu County Kenya commence ANC both at the Traditional Birth Attendants (TBAs) and the health facility, their perceptions of ANC and how these perceptions influence the gestational age at commencement and differential patterns in use of ANC services
This percentage is higher than the 80.2% of Kenya overall [10], 86% found in rural western Kenya [14], 71% in Tanzania [23], 83.1% and 82.6% in Nigeria [20,24]
Summary
Antenatal care (ANC) is regarded as a key entry point for pregnant women to receive a wide range of essential health-promotion and disease-prevention services. It is considered an effective means for reducing the risk of maternal morbidity and mortality, especially where the general health status of women is poor [1]. Studies have shown that women who book ANC late more often suffer from medical complications such as anaemia, hypertension, diabetes and intrauterine foetal death[3]. It is associated with pre-term and complicated delivery due to undetectable HIV/AIDS [4]. Studies have further confirmed that women who began ANC early are more likely to opt for skilled professional assistance when they deliver than those who started ANC late [6,7,8]
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