Barriers for optimal use of antenatal services among pregnant women in Tarime district - Mara, Tanzania

Abstract

ABSTRACT Background: Antenatal care is an approach employed to reduce the maternal and perinatal morbidity and mortality. Tanzania adapted the WHO focus antenatal care which focus on risk approach, which targeted women based on risk factors, to an individualized, targeted approach, which aims to detect complications as they arise. It also deals with treatment of identified conditions, supplementation of minerals and health information[1]. Despite the effort of the government to provide antenatal care services for free from public and some faith based facilities, still large percentage of pregnancy women attend less than four antenatal visits compared to the standard which require to have more the four antenatal visits to be able to receive complete package [2, 3]. Many studies have been conducted to understand the barriers but mostly were quantitative studies and non-have been conducted in Tarime District. This study was conducted qualitatively and it explored the barriers for optimal use of ANC among pregnant women in Tarime Dc. Objective: The study aimed to explore the barriers for optimal use of antenatal care among pregnant women in Tarime District- Mara, Tanzania. Methodology: The study employed a cross section explorative approach by conducting in-depth interviews to 8 pregnant women, 4 community health workers and 4 health facility in-charges and also focus group discussions to 32 pregnant women to explore individual barriers, community barriers and facility barriers for optimal use of ANC among pregnant women. Data were recorded in tape recorder and then stored in computer before transcribed. Data were then analysed by thematic approach by familiarized with data, assigned preliminary codes to the data in order to describe the content, searched for patterns or themes in the codes across the different interviews, reviewed themes, defined and named themes and produced the report. Results: Upon analysis of the result, the study revealed the following key findings: barriers for optimal use of ANC can be grouped into community barriers, facility barriers and individual barriers. The identified community barriers were low community awareness on ANC and myths about ANC in the community. The identified themes under facility barriers were facility accessibility, shortage of skilled staff which goes in hand with quality of ANC services and availability of essential medical supplies. The generated themes under individual barriers were age of the pregnant women, level of education, economic status, presence of risk factors, marital status, presence of history of complication and number of parity. Conclusion: This study revealed that there are a number of community, individual and health facility barriers which hinder optimal use of antenatal care services in Tarime district. Health education at health facilities and at community should be strengthened to remove community and individual barriers among pregnant women to utilize antenatal care. Health facility in-charges should make sure the essential supplies are available in advances to avoid stock out.