Barriers to accessing maternal health care amongst pregnant adolescents in South Africa: a qualitative study

Abstract

Objectives This study explores the barriers to accessing antenatal care (ANC) services amongst pregnant adolescents within a particular community of South Africa. Methods An exploratory qualitative design was applied to examine the views of pregnant adolescents. In-depth interviews were conducted with pregnant adolescents at the Mitchells Plain Midwifery Obstetric Unit, as well as nursing staff working at the facility. Thematic analysis was then used and analysis was framed using the social-ecological model for healthseeking behaviour. Results This study found that barriers to adolescents seeking ANC often centered on a discourse of adolescent pregnancy being deviant, irresponsible, and shameful. Pregnant adolescents often absorbed these beliefs and were fearful of other's reaction within their family, the community, at school, and within the ANC facilities. Conclusions Stigma regarding adolescent pregnancy participates in the perpetuation of a culture of non-disclosure and shame, which stands in the way of young pregnant people seeking the care they require. Such beliefs and attitudes need to be challenged at a community and national level. Keywords Adolescent pregnancy Á Adolescent sexual and reproductive health Á Antenatal care Á Reproductive health in South Africa Á Stigma Á Gender This article is part of the special issue ''Sexual and reproductive health of young people -Focus Africa''. The Rudolf Geigy Foundation (Basel, Switzerland) funded the open access publication of this article.

Factors associated with perceived barriers of health care access among reproductive-age women in Ethiopia: a Secondary data analysis of 2016 Ethiopian Demographic and Health Survey

“…Access to healthcare can be broadly defined based on availability, affordability, accessibility, and acceptability of services for best health outcomes [6]. Access to comprehensive, quality health care services is important for promoting and maintaining health, preventing and managing the disease, reducing unnecessary disability and premature death, and achieving health equity for all women [7][8][9][10]. It agreed that socio-demographic, cultural, and geographical and literacy level and economic conditions plays a vital role to affect the accessibility and utilization of health care services among women [11][12][13][14][15].…”

“…Reproductive, maternal, newborn and child health are indictors of equity in health care access in the country [16][17][18][19][20]. Difficulties to access health care among reproductive-age women may lead to different negative health outcomes such as unwanted pregnancies resulted from low family planning use, maternal and child mortality from home delivery [7,9,[19][20][21].…”

Evidence on Respectful Maternity Care For Adolescents: A Systematic Review Protocol

“…Ideally, they should be treated with the utmost care and professionalism 14,15 . Some interventions have sought to improve RMC in facilities using a variety of methods such as educating parturients on their SRH rights and seeking legal redress in some reported cases 16,17 .…”

Factors associated with the perceived barriers of health care access among reproductive-age women in Ethiopia: a secondary data analysis of 2016 Ethiopian Demographic and Health Survey

“…Access to health care broadly de ned based on availability, affordability, accessibility, and acceptability of services for best health outcomes [6]. Access to all-inclusive and quality health care is essential for promoting and maintaining health, preventing and managing the diseases, reducing unnecessary disabilities and premature deaths, and achieving health equity for all women [7][8][9][10]. Moreover, reproductive, maternal, newborn, and child health are indicators of the country's socio-economic status and equitable o distribution of health care in the community [11][12][13][14][15].…”

“…It is known that literacy levels, economic conditions, socio-demographic and cultural characteristics, and geographical disparities play a vital role in affecting the accessibility and utilization of health care services among women [16][17][18][19][20]. Troubles conditions in accessing health care among reproductive-age women lead to diverse adverse health outcomes like unwanted pregnancies, unsafe abortion, maternal and child mortality resulting from low family planning uptakes, and home deliveries [7,9,14,15,21].…”