Niang Marietou, Dupéré Sophie, Bédard Emmanuelle
Sante Publique. 2015 May-Jun;27(3):405-14.
Despite the importance of prenatal care to decrease maternal and neonatal mortality, uptake remains suboptimal in Burkina Faso. This article documents the reasons for non-uptake of prenatal care, by focusing on women who either completely renounce or delay their access to prenatal care.
Qualitative data collection was performed in the rural town of Kokologho from October 2013 to january 2014. Different collection methods were used: participant observation, twenty-two individual semi-structured interviews with women who accessed prenatal care as a late option and eight informal interviews with key informants identified in the community.
Thematic analysis revealed four barriers against the effective use of prenatal care by women: (1) lack of knowledge about the prenatal care schedule and purpose (2) perception of pregnancy and prenatal care (3) socioeconomic barriers: direct payment for prenatal care and the limited autonomy of women, and (4) perception of the quality of prenatal care.
Based on these observations, non-uptake of prenatal care is discussed using different types of explanatory typologies adopted for this study: non-knowledge, non-claiming by choice or constraints and non-reception of care. This theoretical approach reveals that failures in healthcare services as well as the dichotomy between social representations and medical standards of pregnancy and prenatal care contribute to exclude some women from the prenatal care system.
尽管产前护理对于降低孕产妇和新生儿死亡率至关重要，但布基纳法索的产前护理利用率仍然不理想。本文通过关注那些完全放弃或推迟获得产前护理的女性，记录了未接受产前护理的原因。
2013年10月至2014年1月在科科洛戈农村镇进行了定性数据收集。使用了不同的收集方法：参与观察、对作为晚期选择接受产前护理的女性进行了22次个人半结构化访谈，以及对社区中确定的关键信息提供者进行了8次非正式访谈。
主题分析揭示了阻碍女性有效利用产前护理的四个障碍：（1）对产前护理时间表和目的缺乏了解；（2）对怀孕和产前护理的认知；（3）社会经济障碍：产前护理的直接费用和女性有限的自主权；（4）对产前护理质量的认知。
基于这些观察结果，使用本研究采用的不同类型的解释类型对未接受产前护理进行了讨论：无知、因选择或限制而未要求以及未接受护理。这种理论方法表明，医疗服务的失败以及社会认知与怀孕和产前护理的医学标准之间的二分法导致一些女性被排除在产前护理系统之外。
