Laing Susan P, Sinmyee Smruti V, Rafique Khizar, Smith Helen E, Cooper Max J
Department of Global Health and Infection, Brighton and Sussex Medical School Falmer, BN1 9PX, United Kingdom.
Lee Kong Chian School of Medicine, Singapore.
Afr J Reprod Health. 2017 Sep;21(3):62-69. doi: 10.29063/ajrh2017/v21i3.5.
This qualitative study investigated the barriers to obtaining access to antenatal care in a small, urban government-supported health centre in the Gambia. It thus addresses an important issue related to maternal health and the prevention of maternal deaths. In-depth interviews were conducted with 25 pregnant women, 13 healthcare workers and 9 male partners. Three areas were identified for study: recognition and acknowledgment of pregnancy, recognition of the need for care and practical barriers to attendance. Intentional concealment of early pregnancy was common to avoid adverse social consequences or for fear that malign interventions would cause a miscarriage. In the absence of symptoms many women considered it unnecessary to attend the antenatal clinic until well into the second trimester. Practical barriers to attendance included conflicting domestic demands and the attitude of some healthcare workers. Access to antenatal care in the Gambia throughout pregnancy should be considered in a stepwise fashion and barriers to care were identified at each stage. Interviews with male partners and health workers highlighted their key role.
这项定性研究调查了冈比亚一个由政府支持的小型城市健康中心在获得产前护理方面存在的障碍。因此，它解决了一个与孕产妇健康和预防孕产妇死亡相关的重要问题。对25名孕妇、13名医护人员和9名男性伴侣进行了深入访谈。确定了三个研究领域：对怀孕的认知与承认、对护理需求的认知以及就诊的实际障碍。故意隐瞒早孕情况很常见，以避免不良社会后果，或担心恶意干预会导致流产。在没有症状的情况下，许多女性认为直到孕中期才去产前诊所就诊是不必要的。就诊的实际障碍包括家庭需求冲突和一些医护人员的态度。在冈比亚，整个孕期获得产前护理的情况应逐步加以考虑，并且在每个阶段都确定了护理障碍。对男性伴侣和医护人员的访谈突出了他们的关键作用。
