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Qualitative exploration of facilitating factors and barriers to use of antenatal care services by pregnant women in urban and rural settings in Pakistan.
BMC Pregnancy Childbirth. 2016 Mar 01; 16:42.BP

Abstract

BACKGROUND

World Health Organisation recommends that pregnant women with no complications should visit a healthcare provider at least four times to receive sufficient antenatal care services. In Pakistan only 37% of women reported to have had four or more antenatal care visits during their last pregnancy. This study aimed to explore facilitators and barriers to use of antenatal care services in rural and urban communities of two selected districts in Pakistan.

METHODS

Qualitative explorative study using in-depth interviews with currently pregnant women, lady health workers and doctors providing antenatal care services, and focus group discussion with women who had a child aged 5 years or younger, was conducted in a rural community in the district Swabi and in a tertiary care hospital in urban Islamabad in Pakistan. The audio-recorded interviews and discussions were transcribed verbatim in Urdu (the language spoken by the respondents). A list of topical codes for all topics related to the research questions was developed. Subsequently the text pertaining to each topical code was discussed and summarised in a document that presented the findings for each topic using quotes and tables.

RESULTS

We conducted in-depth interviews with six lady health workers, four doctors, and ten currently pregnant women, and facilitated ten focus group discussions with women who had a child aged 5 years or younger. Currently pregnant women, and women who had a child aged 5 years or younger, were not aware of the recommended minimum number of antenatal care visits to be made during pregnancy. Facilitating factors to visit a particular health care facility were: availability of qualified healthcare providers (private facility); trust in healthcare providers; recommendation from a family member, friend or lady health worker (in rural areas); availability of good quality services including medical equipment and laboratory facilities; low cost (public facility); and easy access to the health facility (private facility). Common barriers to visiting a health facility for antenatal care services were: financial limitations; perceived absence of any major health problems during pregnancy; difficulties in reaching the health facility; restriction from husband or mother-in-law; busy performing household chores; no previous experience of antenatal care visits; and perceived unavailability of healthcare providers and/or services.

CONCLUSIONS

The current study identified several policy-relevant facilitating factors and barriers to visiting a health facility for antenatal care services as reported by urban and rural women, and healthcare providers. There is a need to formulate and implement intervention packages based on these findings to increase the coverage of the recommended four antenatal care visits in Pakistan.

Links

PMC Free PDF

Authors+Show Affiliations

Nisar YB
Sydney School of Public Health, The University of Sydney, Sydney, NSW, 2006, Australia. drbin01@hotmail.com. United Nations Office for Project Services (UNOPS), UN Compound, Diplomatic Enclave, Islamabad, Pakistan. drbin01@hotmail.com.
Aurangzeb B
Children's Hospital, Pakistan Institute of Medical Sciences, Islamabad, Pakistan.
Dibley MJ
Sydney School of Public Health, The University of Sydney, Sydney, NSW, 2006, Australia.
Alam A
Sydney School of Public Health, The University of Sydney, Sydney, NSW, 2006, Australia.

MeSH

AdultChild, PreschoolFemaleFocus GroupsHealth Knowledge, Attitudes, PracticeHealth Services AccessibilityHumansInfantInfant, NewbornMalePakistanPregnancyPregnant WomenPrenatal CareQualitative ResearchRural PopulationTrustUrban Population

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26931205

Citation

Nisar, Yasir Bin, et al. "Qualitative Exploration of Facilitating Factors and Barriers to Use of Antenatal Care Services By Pregnant Women in Urban and Rural Settings in Pakistan." BMC Pregnancy and Childbirth, vol. 16, 2016, p. 42.
Nisar YB, Aurangzeb B, Dibley MJ, et al. Qualitative exploration of facilitating factors and barriers to use of antenatal care services by pregnant women in urban and rural settings in Pakistan. BMC Pregnancy Childbirth. 2016;16:42.
Nisar, Y. B., Aurangzeb, B., Dibley, M. J., & Alam, A. (2016). Qualitative exploration of facilitating factors and barriers to use of antenatal care services by pregnant women in urban and rural settings in Pakistan. BMC Pregnancy and Childbirth, 16, 42. https://doi.org/10.1186/s12884-016-0829-8
Nisar YB, et al. Qualitative Exploration of Facilitating Factors and Barriers to Use of Antenatal Care Services By Pregnant Women in Urban and Rural Settings in Pakistan. BMC Pregnancy Childbirth. 2016 Mar 1;16:42. PubMed PMID: 26931205.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Qualitative exploration of facilitating factors and barriers to use of antenatal care services by pregnant women in urban and rural settings in Pakistan. AU - Nisar,Yasir Bin, AU - Aurangzeb,Brekhna, AU - Dibley,Michael J, AU - Alam,Ashraful, Y1 - 2016/03/01/ PY - 2015/01/30/received PY - 2016/02/16/accepted PY - 2016/3/3/entrez PY - 2016/3/5/pubmed PY - 2016/10/1/medline SP - 42 EP - 42 JF - BMC pregnancy and childbirth JO - BMC Pregnancy Childbirth VL - 16 N2 - BACKGROUND: World Health Organisation recommends that pregnant women with no complications should visit a healthcare provider at least four times to receive sufficient antenatal care services. In Pakistan only 37% of women reported to have had four or more antenatal care visits during their last pregnancy. This study aimed to explore facilitators and barriers to use of antenatal care services in rural and urban communities of two selected districts in Pakistan. METHODS: Qualitative explorative study using in-depth interviews with currently pregnant women, lady health workers and doctors providing antenatal care services, and focus group discussion with women who had a child aged 5 years or younger, was conducted in a rural community in the district Swabi and in a tertiary care hospital in urban Islamabad in Pakistan. The audio-recorded interviews and discussions were transcribed verbatim in Urdu (the language spoken by the respondents). A list of topical codes for all topics related to the research questions was developed. Subsequently the text pertaining to each topical code was discussed and summarised in a document that presented the findings for each topic using quotes and tables. RESULTS: We conducted in-depth interviews with six lady health workers, four doctors, and ten currently pregnant women, and facilitated ten focus group discussions with women who had a child aged 5 years or younger. Currently pregnant women, and women who had a child aged 5 years or younger, were not aware of the recommended minimum number of antenatal care visits to be made during pregnancy. Facilitating factors to visit a particular health care facility were: availability of qualified healthcare providers (private facility); trust in healthcare providers; recommendation from a family member, friend or lady health worker (in rural areas); availability of good quality services including medical equipment and laboratory facilities; low cost (public facility); and easy access to the health facility (private facility). Common barriers to visiting a health facility for antenatal care services were: financial limitations; perceived absence of any major health problems during pregnancy; difficulties in reaching the health facility; restriction from husband or mother-in-law; busy performing household chores; no previous experience of antenatal care visits; and perceived unavailability of healthcare providers and/or services. CONCLUSIONS: The current study identified several policy-relevant facilitating factors and barriers to visiting a health facility for antenatal care services as reported by urban and rural women, and healthcare providers. There is a need to formulate and implement intervention packages based on these findings to increase the coverage of the recommended four antenatal care visits in Pakistan. SN - 1471-2393 UR - https://www.unboundmedicine.com/medline/citation/26931205/Qualitative_exploration_of_facilitating_factors_and_barriers_to_use_of_antenatal_care_services_by_pregnant_women_in_urban_and_rural_settings_in_Pakistan_ DB - PRIME DP - Unbound Medicine ER -