A pre-implementation study on the experience of ultrasound scanning in selected healthcare facilities of Lusaka, Zambia: the perspectives of pregnant women and male partners

Abstract

Preterm birth and stillbirth are the main causes of the 5 million perinatal deaths worldwide annually. The World Health Organisation recommends that every woman must have an ultrasound scan before 24 weeks gestation. Ultrasound scanning by midwives in Maternal and Child Health (MCH) during antenatal care (ANC) clinics is a new intervention in Zambia. This study sought to determine the feasibility and acceptability of the ultrasound scanning intervention in 11 healthcare facilities drawn from Chisamba, Chongwe, Mumbwa, and Lusaka districts of Zambia. This was an exploratory qualitative study that used focus group discussions with 64 pregnant women and 29 male partners accessed from the ANC clinic through snowball sampling. All data were recorded, transcribed, coded using Nvivo 12, and thematically analysed. Participants expressed their eagerness to accept and use the ultrasound scanning services that would be provided by Midwives during antenatal care in MCH departments. Ultrasound scanning by Midwives in MCH departments is a positive, feasible, and acceptable intervention for pregnant women and male partners. Participants identified a number of barriers to the feasibility and acceptability of ultrasound scanning services, including insufficient infrastructure within MCH departments to conduct ultrasound scanning, unskilled midwives to provide ultrasound scanning services, a lack of ultrasound scanners and ultrasound scanning materials, and misconceptions about the side-effects of ultrasound scanning on the fetus. To address barriers to feasibility and acceptability of USS, there is need to conduct health education on the importance of ultrasound scanning services, provide ultrasound scanners and scanning materials, train midwives in basic ultrasound scanning, and create space for ultrasound scanning services as part of MCH services to improve birth outcomes.