Midwifery and Women's Health, Archibishop Antony Mayalla School of Nursing, Catholic University of Health and Allied Sciences, PO Box 1464, Bugando, Mwanza, Tanzania.
Midwifery and Women's Health, Archibishop Antony Mayalla School of Nursing, Catholic University of Health and Allied Sciences, PO Box 1464, Bugando, Mwanza, Tanzania.
Sex Reprod Healthc. 2022 Mar;31:100673. doi: 10.1016/j.srhc.2021.100673. Epub 2021 Oct 27.
Effective antenatal care is fundamental to the promotion of positive maternal and new-born outcomes. International guidance recommends an initial visit in the first trimester of pregnancy, with a minimum of four antenatal visits in total: the optimum schedule being eight antenatal contacts. In low- and middle-income countries, many women do not access antenatal care until later in pregnancy and few have the recommended number of contacts.
To gain understanding of women's antenatal experiences in Tanzania and Zambia, and the factors that influence antenatal engagement.
The study was underpinned by Strauss's grounded theory methodology. Interviews were conducted with 48 women, 16 partners, 21 health care providers and 11 stakeholders, and analysed using constant comparison.
The core category was 'The tipping point of antenatal engagement', supported by four categories: awareness of health benefits, experiential motivators, influential support, and environmental challenges. Although participants recognised the importance of antenatal care to health outcomes, individual motivations and external influences determined attendance or non-attendance. The 'tipping point' for antenatal engagement occurred when women believed that any negative impact could be offset by tangible gain. For some women non-attendance was a conscious decision, for others it was an unchallenged cultural norm.
A complex interplay of factors determines antenatal engagement. Short-term modifiable factors to encourage attendance include the development of strategies for increasing respectful care; use of positive women's narratives, and active community engagement. Further research is required to develop innovative, cost-effective care models that improve health literacy and meet women's needs.
有效的产前护理是促进母婴和新生儿良好结局的基础。国际指南建议在妊娠早期进行首次就诊，并总共进行至少四次产前检查：最佳时间表是八次产前接触。在低收入和中等收入国家，许多妇女直到妊娠晚期才开始接受产前护理，很少有妇女接受建议的接触次数。
了解坦桑尼亚和赞比亚妇女的产前经历，以及影响产前参与的因素。
该研究基于施特劳斯的扎根理论方法。对 48 名妇女、16 名伴侣、21 名医疗保健提供者和 11 名利益相关者进行了访谈，并使用恒定比较进行了分析。
核心类别是“产前参与的转折点”，由四个类别支持：对健康益处的认识、经验驱动因素、有影响力的支持和环境挑战。尽管参与者认识到产前护理对健康结果的重要性，但个人动机和外部影响决定了是否参加。当妇女相信任何负面影响都可以通过实际收益来抵消时，“产前参与的转折点”就出现了。对于一些妇女来说，不参加是有意识的决定，对于另一些妇女来说，这是一种未经挑战的文化规范。
一系列复杂的因素决定了产前参与。鼓励参加的短期可改变因素包括制定增加尊重性护理的策略；利用积极的女性叙述和积极的社区参与。需要进一步研究以开发创新、具有成本效益的护理模式，提高健康素养并满足妇女的需求。
