Abstract
BackgroundUnderstanding women’s experiences and perspectives of antenatal care services is particularly critical for enhancing effectiveness of services delivery and addressing women’s needs and expectations. As part of a comprehensive assessment of the maternity care services in Iraq, this study aimed to explore the views and experiences of antenatal care in a sample of women.MethodsThis explorative study was conducted in Erbil governorate, Iraq. Data were collected using Q methodology, a technique for eliciting subjective views and identifying shared patterns among individuals. A sample of 38 women of different educational and socioeconomic statuses were invited to sort a set of 39 statements reflecting different aspects of the available antenatal care services and issues related to their last pregnancies into a distribution on a scale of nine from “disagree most” to “agree most”. By-person factor analysis was used to derive latent views through centroid factor extraction and varimax rotation of factors.ResultsAnalysis of the participants’ Q sorts resulted in identifying four distinct views and experiences of pregnancy and antenatal care services: (i) public maternity services second best: preference for, and ability to afford, private care, (ii) dissatisfaction with public maternity services: poor information sharing and lack of health promotion, (iii) satisfaction with public maternity service but information gaps perceived and (iv) public maternity services second best: preference for private care but unaffordable. The typical characterizations that were associated with each view were highlighted.ConclusionsThis study revealed different patterns of views and experiences of women of pregnancy and antenatal care services and recognized the particular issues related to each pattern. Different patterns and types of problems and concerns related mainly to inadequate provision of information and poor interpersonal communication, poor utilization of public services and a general preference to use private services were identified in the different groups of women.
Highlights
Understanding women’s experiences and perspectives of antenatal care services is critical for enhancing effectiveness of services delivery and addressing women’s needs and expectations
While neighboring Iran cut its maternal death rate by 220% between 2000 and 2010, Iraq’s rate dropped by a tenth as much during this period. It is unlikely Iraq can meet its goal of reducing maternal mortality to 20 deaths per 100 000 live births by 2015 [4]
Respondents loading on Factor 1 reflected a typical model of health seeking behavior that result from high dissatisfaction or negative experience with the available public services that eventually lead to the use of private services [35]
Summary
Understanding women’s experiences and perspectives of antenatal care services is critical for enhancing effectiveness of services delivery and addressing women’s needs and expectations. The maternal mortality ratio and neonatal mortality rate remained as high as 84 per 100,000 live births and 23 per 1,000 live births, respectively, in 2010 [1]. These figures are significantly higher than developed countries with higher levels of antenatal care. While neighboring Iran cut its maternal death rate by 220% between 2000 and 2010, Iraq’s rate dropped by a tenth as much during this period. It is unlikely Iraq can meet its goal of reducing maternal mortality to 20 deaths per 100 000 live births by 2015 [4]
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