Knowledge and perceptions of antenatal services need and delivery and reasons for seeking such services among women in Tanzania: Implications for utilization and coverage of intermittent presumptive treatment of malaria in pregnancy in two districts

Abstract

Background: Learning from a volume of the literature that lacks information regarding people's opportunity to access health services for disease control, a study was conducted to assess knowledge, perceptions of antenatal care (ANC) services and actually delivered services and reasons for seeking ANC including intermittent presumptive treatment during pregnancy (IPTp) against malaria in Mkuranga and Mufindi districts, Tanzania. Methodology: Quantitative and qualitative techniques were employed, involving interviews with ANC clients, informal communications with health care workers, focus group discussions with mothers of young children, and intertemporal observations. Data were collected for six months in 2006. Results: ANC seeking was mainly influenced by motivation for one's safe pregnancy and childbirth and not necessarily and specifically seeking IPTp. The main barriers reported to hinder pregnant women effectively utilize ANC include socio-cultural values stigmatizing and discriminating women during pregnancy, service providers' unfriendly attitudes towards clients, shortages of drugs and other essential service supplies, existence of user-fees in health facilities, and pregnant women's unawareness of essential ANC services needed or actually delivered at ANC clinics. Conclusion: While client demand for services depends on volume, cost/price and quality of services supplied, lack of knowledge of what one deserves also influences one's care seeking behavior. Therefore, it is imperative to do periodic evaluations of population knowledge, perceptions of the introduced policy, and service delivery programs if the health care system is to be made more effective by providing a room for corrective actions.

Motivators and demotivators to accessing malaria in pregnancy interventions in sub-Saharan Africa: a meta-ethnographic review

“…The key motivation for women to attend ANC, was to have their pregnancy monitored and managed with the hope that it will lead to healthier pregnancies and babies and reduce the risk of complications at delivery [ 3 , 24 , 49 , 50 , 54 , 64 , 67 ]. A respondent in an interview stated: “ … because I felt I must take care of myself and the baby to ensure that both of us are healthy” [50:7].…”

“…A respondent in an interview stated: “ … because I felt I must take care of myself and the baby to ensure that both of us are healthy” [50:7]. Other reasons for ANC attendance was to avoid reprimand, since women who did not attend ANC at least once risked being sent away by midwives, even if they came with complications at delivery [ 24 , 49 , 54 , 67 ].…”

Combination of Interventions Needed to Improve Maternal Healthcare Utilization: A Multinomial Analysis of the Inequity in Place of Childbirth in Afghanistan

“…Some studies have used ANC as a proxy for need by assuming that women who use ANC are likely to have knowledge of the services or perceive the need due to problems during pregnancy ( 34 , 35 ). However, receiving ANC is likely to lead to childbirth in certain locations because the woman is better connected to the health care system and not necessarily because she has more need.…”

Managing Malaria in Pregnancy Policy Interventions in A Challenging Environment: an Ethnographic Study of two Ghanaian Administrative Regions

“…Challenges and gaps in the implementation of MiP interventions have been reported in the sub region (13)(14)(15)(16)(17)(18). Health facility factors such as poor organization of health delivery, leading to poor quality of care, confusion over the timing of each IPTp dose, stock outs, user fees and negative health worker attitudes contributed to women delaying in accessing health care in the prevention and treatment of MiP (19)(20)(21)(22)(23)(24)(25)(26). Poverty, the nancial and social cost of antenatal care, women's lack of power in decision making in the household, socio-cultural practices and women's poor antenatal attendance affected uptake of MiP interventions (19,20,22,24,(27)(28)(29).…”