Cameroon Baptist Convention Health Services, P. O. Box 1, Bamenda, Cameroon.
School of Public Health, University of the Western Cape, Cape Town, South Africa.
BMC Pregnancy Childbirth. 2020 Feb 3;20(1):70. doi: 10.1186/s12884-020-2746-0.
Antenatal care serves as a key entry point for a pregnant woman to receive a broad range of services and should be initiated at the onset of pregnancy. The aim of the study was to understand the reasons for the late initiation of antenatal care by pregnant women in Nkwen Baptist Health Centre, Bamenda, Cameroon.
The study applied purposive sampling to recruit eighteen pregnant women and three key informants for data collection through individual interviews. Pregnant women who initiated antenatal care after the first trimester were recruited during antenatal care clinics and were interviewed in a room at the Antenatal Care Unit. Key informants were midwives working at the Antenatal Care Unit. Participation in the study was voluntary. The purpose of the study was explained to participants, and they signed a consent form if they were willing to participate in the research. Data were audio-recorded and analyzed using thematic coding analysis.
Pregnant women placed a low value on early antenatal care because they perceived pregnancy to be a normal health condition or to not be a serious issue that required seeking health care. Furthermore, previous positive pregnancy outcomes for which women did not access care made them less motivated to initiate antenatal care early. Participants perceived the booking system to be user-unfriendly and complained of overcrowded conditions, long waiting times and some rude service providers. The cost of services and distance to health facilities that required travel via uncomfortable transport on poor road networks were identified as perceived barriers. The absence of effective community health programmes, perceived lack of support from parents and spouses, fear of bewitchment and stigma due to cultural beliefs about the early initiation of antenatal care were also identified as variables influencing late initiation.
Pregnant women lack information on the purpose of early antenatal care. Health facility barriers as well as socio-cultural beliefs have significant influences on the timing of antenatal care initiation. The government of Cameroon should strengthen the health system and implement activities to engage communities in improving care seeking for antenatal care and thereby improving maternal health status of women.
产前护理是孕妇获得广泛服务的一个重要入口，应在怀孕初期开始。本研究旨在了解喀麦隆班姆恩德 Nkwen 浸礼会保健中心孕妇晚启动产前护理的原因。
本研究采用目的性抽样，通过个人访谈招募了 18 名孕妇和 3 名关键信息提供者收集数据。在产前护理诊所招募了在孕早期后才开始产前护理的孕妇，并在产前护理单元的一个房间内对其进行采访。关键信息提供者是在产前护理单元工作的助产士。参与研究是自愿的。向参与者解释了研究的目的，如果他们愿意参与研究，他们会签署一份同意书。使用主题编码分析对数据进行了音频记录和分析。
孕妇对早期产前护理的重视程度较低，因为她们认为怀孕是一种正常的健康状况，或者不是一个需要寻求医疗保健的严重问题。此外，以前的积极妊娠结果，孕妇没有获得护理，使她们不太有动力早期开始产前护理。参与者认为预约系统不便于用户使用，并抱怨人满为患、长时间等待和一些粗鲁的服务提供者。服务费用和距离保健机构较远，需要通过路况不佳的网络上的不舒适交通工具旅行，被认为是感知到的障碍。缺乏有效的社区卫生方案、父母和配偶的支持感不足、对因文化信仰而导致的早期产前护理的巫术和耻辱感的恐惧，也被认为是影响晚启动的变量。
孕妇缺乏有关早期产前护理目的的信息。卫生机构障碍以及社会文化信仰对产前护理启动时间有重大影响。喀麦隆政府应加强卫生系统，并开展活动，让社区参与改善对产前护理的寻求，从而改善妇女的孕产妇健康状况。
