Finally in Upper East Region there were two periods of fieldwork: July to December 2009 and April 2010 to March 2011. Women described being injected and tested, but specific mentions of HIV testing were only made frequently in Malawi, and references to syphilis tests and haemoglobin analysis were rare overall. Other women travelled on their husband’s bicycle and, in Kenya, a minority of women used motorbike taxis because of their greater comfort. Educated women tend to have a greater awareness of the Pregnant women’s interactions with healthcare staff at ANC had varying implications for ANC attendance. We would also like to express our gratitude to Lianne Straus who was instrumental in the early phases of setting up the programme of research and to the large teams of fieldworkers who participated in data collection in Ghana and Malawi: Charity Siayire, Louis Alatinga, Dominic Anaseba, Gertrude Nyaaba and Gideon Lugunia in Ghana North; Collins Zamawe, Chikondi Kwalimba, Alinafe Chibwana and Blessings N. Kaunda in Malawi. Data collection took place in the Kassena-Nankana District, which is located in the Upper East Region, in the north of Ghana. focused literature search in order to find out the factors services as compared to their counterparts [25]. upon the transportation system and physical distance between previous history of preterm birth, complications and outcomes, Division of Parasitic Diseases, National Centre for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America. predisposing determinant for utilization of ANC services [18]. Women often use taxis or minibuses, but those who live furthest from health centres face a walk of up to an hour before being picked up, whereas women who live in the urban centres also use transport to travel the short distance. Interactions between pregnant women and health workers during ANC were also influenced by social factors. The distances that respondents travelled to health facilities for ANC vary greatly in Ashanti Region. Health staff who provide ANC exercise significant authority and women generally place trust in the instructions they give. researchers concluded that women who had no support from In Ghana, the HIV prevalence in the research sites was much lower and HIV/AIDS was not raised as an issue affecting ANC attendance. studies suggest that increased age is associated with more planning and developing strategies for the utilization of ANC pregnant woman is issued with an antenatal care card. In Ghana, however, health talks were given less often and information was provided on a one-to-one basis during consultations. In addition, ANC Conceptual model adapted from Anderson and Newman Model. National and regional data on ANC attendance illustrate varying trends across sub-Saharan Africa [12]. Andersen and Newman’s health behavioral model [14] (Figure We investigate the association of ANC in low-income and middle-income countries with short- and long-term mortality and nutritional child outcomes. reproductive and access related factors which affect the knowledge of the benefits of ANC and of the complications The descriptions were also often vague and focused on the experience of procedures, such as receiving injections or tablets, rather than their aim or purpose. Drawing on qualitative data, this article comparatively explores the factors that influence ANC attendance across four sub-Saharan African sites in three countries (Ghana, Kenya and Malawi) with varying levels of ANC attendance. Thus, Antenatal care is a key strategy to improve maternal and infant health. No, Is the Subject Area "Behavioral and social aspects of health" applicable to this article? PDF | On Mar 25, 2018, Nasreen Banu and others published ANTENATAL CARE | Find, read and cite all the research you need on ResearchGate After that, pregnant women undergo A study on knowledge and practices of antenatal care among pregnant women attending antenatal clinic at a Tertiary Care Hospital of Pune, Maharashtra January 2016 DOI: 10.4103/0975-2870.182507 The study was coordinated by a team of social scientists, based in Barcelona (Spain), and was conducted in collaboration with local research centres. as compared to those in the age group 15–19 women [21]. inadequate ANC is associated with worse pregnancy outcomes, it After the first Reports of women delaying ANC initiation because of an objection from their husbands or a relative responsible for household expenditure were however rare. Analyzed the data: CP AM. A hand-full of studies employing qualitative research methods, such as in-depth interviews, focus group discussions and participant observation, have however directly tackled ANC attendance in sub-Saharan [20]–[23]. Nonetheless, across the research sites, survey data indicate two notably different patterns of ANC attendance: on the one hand, over half of Ghanaian women attend ANC in the first trimester of pregnancy and less than 10% initiate ANC in the third trimester; whereas, in Kenya and Malawi, 12% and 15% of women, respectively, initiated ANC in the first trimester and around 40% in the third trimester (Table 2). A strong association between distance to the health available online. Although in Ghana communication problems were observed, this problem-focused strategy was facilitated by the one-to-one nature of communication between pregnant woman and health workers that had replaced the health talks. ferrous sulphate tablets to prevent anemia, calcium tablets to Furthermore, in The Gambia, particularly among young women, such concerns about gossip led women to hide their pregnancy and delay ANC, as this was seen as a clear sign of pregnancy [38]. Women without direct access to cash often relied on their husbands or relatives to meet costs, which further complicates decision-making about ANC initiation. Health knowledge is an important factor. of mucus membranes, blood pressure, check for edema, and existence of ANC services and the advantages of using such Such statistical associations offer little insight into the mechanism(s) through which such factors operate, neglecting the how and the why: questions, to which the answers may provide inspiration for possible policy interventions. The difficulties that some women face to access cash were highlighted by the experience of one Kenyan woman who worked as a live-in carer: she reported waiting for her employer, who knew of her pregnancy, to pay her salary before initiating ANC. Yes The most extreme examples in Kenya involved one direct and one indirect report of women who attended ANC in the first trimester, but were sent home and instructed to return in the second trimester, when their pregnancy was visible and could be confirmed through palpation. delivery and appropriate management [2]. Furthermore, observations confirmed that communication between women attending ANC and the health staff was limited and often didactic. Particularly as these women are often friends, acquaintances or relatives of health staff and if necessary can utilize private healthcare facilities, where they would not tolerate admonishments. miscarriages or stillbirths are more likely to utilize ANC Antenatal care, Factors, Utilization, Pregnancy. As a result, the factor of distance gets strongly adhered to other kilometers (km) [34]. Yes predictor of early ANC initiation [27]. This paper has explored factors affecting ANC attendance across four settings that demonstrate two distinct patterns of ANC attendance. Explaining how these factors contribute to the observed pattern of ANC initiation across the four sites is therefore challenging.

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