Audet Carolyn M, Chire Yazalde Manual, Vaz Lara M E, Bechtel Ruth, Carlson-Bremer Daphne, Wester C William, Amico K Rivet, Gonzaléz-Calvo Lázaro
Vanderbilt University, Nashville, Tennessee, USA
Friends in Global Health (FGH), Quelimane, Mozambique.
Qual Health Res. 2016 Oct;26(12):1721-31. doi: 10.1177/1049732315580302. Epub 2015 Apr 8.
Low rates of antenatal care (ANC) service uptake limit the potential impact of mother-to-child HIV-prevention strategies. Zambézia province, Mozambique, has one of the lowest proportions of ANC uptake among pregnant women in the country, despite the availability of free services. We sought to identify factors influencing ANC service uptake (including HIV counseling and testing) through qualitative methods. In addition, we encouraged discussion about strategies to improve uptake of services. We conducted 14 focus groups to explore community views on these topics. Based on thematic coding of discourse, two main themes emerged: (a) gender inequality in decision making and responsibility for pregnancy and (b) community beliefs that uptake of ANC services, particularly, if supported by a male partner, reflects a woman's HIV-positive status. Interventions to promote ANC uptake must work to shift cultural norms through male partner participation. Potential strategies to promote male engagement in ANC services are discussed.
产前保健（ANC）服务利用率低限制了母婴艾滋病毒预防策略的潜在影响。莫桑比克的赞比西亚省，尽管有免费服务，但该国孕妇中接受ANC服务的比例却是最低的之一。我们试图通过定性方法确定影响ANC服务利用（包括艾滋病毒咨询和检测）的因素。此外，我们鼓励讨论改善服务利用的策略。我们开展了14个焦点小组来探讨社区对这些主题的看法。基于对话的主题编码，出现了两个主要主题：（a）怀孕决策和责任方面的性别不平等；（b）社区认为接受ANC服务，特别是在男性伴侣支持下，反映了女性的艾滋病毒阳性状态。促进ANC服务利用的干预措施必须通过男性伴侣的参与来努力改变文化规范。讨论了促进男性参与ANC服务的潜在策略。
