Tengera Olive, Meharry Pamela, Nkurunziza Aimable, Rugema Joselyne, Babenko-Mould Yolanda, Rulisa Stephen, Nyirazinyoye Laetitia
School of Nursing and Midwifery, College of Medicine and Health Sciences, University of Rwanda, Remera Campus, Kigali, Rwanda.
Department of Women's, Children's and Family Health Services, University of Illinois, Chicago, USA.
Rwanda J Med Health Sci. 2024 Mar 31;7(1):101-115. doi: 10.4314/rjmhs.v7i1.8. eCollection 2024 Mar.
Antenatal care (ANC) helps ensure the best health conditions of the mother and foetus during pregnancy. However, achieving optimal ANC attendance and adherence to the World Health Organization (WHO) recommendations remains a global challenge, with significant disparities in attendance rates. A qualitative study was conducted exploring pregnant women's perspectives of various enablers to their attendance and adherence to recommended ANC visits in Rwanda.
This exploratory qualitative study involved 22 pregnant women attending ANC in four public health centres in the Eastern province, of Rwanda. An interview guide with semi-structured questions was used to gather information about the moderators of ANC attendance and adherence among pregnant women. Data were audio-recorded and transcribed verbatim, and thematic analysis was used to categorize themes under the five-level Social Ecological Model (SEM).
Early recognition of pregnancy, financial stability, and female participation in decision-making were identified as intrapersonal enabling factors of ANC attendance and adherence; spousal support was identified as an interpersonal enabling factor; community health workers, and community relationships as community enabling factors; availability and cost of ANC services as institutional enabling factors; and media campaign, community outreach as public policy enabling factors contributing to the pregnant women's attendance and adherence to ANC visits.
Enablers at multiple levels affect women's attendance and adherence to ANC visits. It is essential to consider each level when implementing effective strategies to maximize ANC attendance and adherence to the WHO recommendations in order to improve maternal-foetal well-being in Rwanda.
产前保健有助于确保孕期母亲和胎儿的最佳健康状况。然而，实现最佳的产前保健就诊率并遵循世界卫生组织（WHO）的建议仍是一项全球挑战，就诊率存在显著差异。在卢旺达开展了一项定性研究，探讨孕妇对促使她们就诊并遵循推荐的产前保健访视的各种因素的看法。
这项探索性定性研究涉及卢旺达东部省四个公共卫生中心的22名接受产前保健的孕妇。使用带有半结构化问题的访谈指南收集有关孕妇产前保健就诊和依从性的调节因素的信息。数据进行了录音并逐字转录，采用主题分析法在五级社会生态模型（SEM）下对主题进行分类。
怀孕的早期识别、经济稳定以及女性参与决策被确定为产前保健就诊和依从性的个人层面促成因素；配偶支持被确定为人际层面促成因素；社区卫生工作者和社区关系被确定为社区层面促成因素；产前保健服务的可及性和成本被确定为机构层面促成因素；媒体宣传、社区外展被确定为公共政策层面促成因素，这些因素有助于孕妇就诊并遵循产前保健访视。
多个层面的促成因素影响妇女的产前保健就诊和依从性。在实施有效策略以最大限度提高产前保健就诊率并遵循WHO的建议时，必须考虑每个层面，以便改善卢旺达的母婴健康状况。
