Factors Motivating Early Antenatal Care Attendance in Lesotho: A Qualitative Study
DOI:
https://doi.org/10.25159/2520-5293/18804Keywords:
antenatal care, delayed antenatal care, early antenatal care, Lesotho, pregnant womenAbstract
Introduction: Early antenatal care is key to the World Health Organization’s strategy to reduce maternal morbidity and mortality. However, the rate of early antenatal attendance remains low in Lesotho. Few studies have been conducted on the reasons for late antenatal care attendance, but there is a dearth of information on the factors motivating early antenatal care in Lesotho.
Methods: A qualitative, exploratory and descriptive design study was conducted to explore and describe the factors motivating women to attend antenatal care services before 16 weeks gestation. The study was conducted at a healthcare centre in Lesotho, where 14 participants were purposely selected, and data was collected using semi-structured interviews. Thematic analysis was used following Tesch’s protocol.
Results: Six themes were identified as the factors motivating early antenatal attendance in Lesotho, namely 1) confirmation of pregnancy, 2) concern for foetal well-being, 3) optimising maternal well-being, 4) awareness raising through health education, 5) motivation from family and friends and 6) cultural and social expectations. The findings from this study can inform the development of interventions to promote early antenatal care attendance in Lesotho and reduce maternal and foetal morbidity and mortality.
References
Abegaz, K. H., and E. M. Habtewold. 2019. “Trend and Barriers of Antenatal Care Utilisation from 2000 to 2016 Ethiopian DHS: A Data Mining Approach.” Scientific African 3 (2): 1–8. https://doi.org/10.1016/j.sciaf.2019.e00063
Boraya, J. O., C. Githae, and T. Atandi. 2018. “Determinants of Antenatal Care Booking among Pregnant Women in Selected Hospitals in Embu County, Kenya.” International Journal of Nursing and Midwifery 10 (12): 155–160. http://www.academicjournals.org/IJNM
Brink, H., C. Van der Walt, and G. Van Rensburg. 2018. Fundamentals of Research Methodology for Health Professionals. 4th edition. Cape Town: Juta & Co.
Brucker, M. C., C. M. Jivett, T. L. King, and K. Osborne. 2019. Varney’s Midwifery. 6th edition. Burlington, MA: Jones & Bartlett.
Comfort, A. B., A. M. El Ayadi, C. S. Camlin, A. C. Tsai, H. Nalubwama, J. Byamugisha, D. M. Walker, J. Moody, T. Roberts, U. Senoga, P. J. Krezanoski, and C. C. Harper. 2022. “The Role of Informational Support from Women’s Social Networks on Antenatal Care Initiation: Qualitative Evidence from Pregnant Women in Uganda.” BMC Pregnancy and Childbirth 22 (1): 1–12. https://doi.org/10.1186/s12884-022-05030-1
Creswell, J. W. 2018. Research Design: Qualitative, Quantitative and Mixed Methods Approach. 5th edition. Thousand Oaks: SAGE.
Downe, S., K. Finlayson, Ö. Tunçalp, and A. M. Gülmezoglu. 2019. “Provision and Uptake of Routine Antenatal Services: A Qualitative Evidence Synthesis.” Cochrane Database of Systematic Reviews 6 (6). https://doi.org/10.1002/14651858.cd012392.pub2
Gill, M. M., R. Machekano, A. Isavwa, A. Ahimsibwe, and O. Oyebanji. 2015. “The Association between HIV Status and Antenatal Care Attendance among Pregnant Women in Rural Hospitals in Lesotho.” Journal of Acquired Immune Deficiency Syndromes 68 (3): e33–e38. https://doi.org/10.1097/qai.0000000000000481
Grove, S. K. and J. R. Gray. 2019. Understanding Nursing Research: Building an Evidence-based Practice. 7th edition. St. Louis: Elsevier.
Iacoella, F., F. Gassmann, and N. Tirivayi. 2022. “Which Communication Technology is Effective for Promoting Reproductive Health? Television, Radio, and Mobile Phones in Sub-Saharan Africa.” PLoS ONE 17 (8): e0272501. https://doi.org/10.1371/journal.pone.0272501
Jinga, N., C. Mongwenyana, A. Moolla, G. Malete, and D. Onoya. 2019. “Reasons for Late Presentation for Antenatal Care, Healthcare Providers’ Perspective.” BMC Health Services Research 19 (1016). https://doi.org/10.1186/s12913-019-4855-x
Letsie, T. M, and M. Lenka. 2021. “Factors Contributing to the Late Commencement of Antenatal Care at a Rural District Hospital in Lesotho.” Global Journal of Health Science 13 (5): 32–43. https://doi.org/10.5539/gjhs.v13n5p32
LoBiondo-Wood, G., and W. J. Haber. 2018. Nursing Research Methods and Critical Appraisal for Evidence-based Practice. 9th edition. St. Louis: Elsevier.
Macleod, C. I., and J. H. Reynolds. 2021. “Reproductive health systems analyses and the Reparative Reproductive Justice Approach: A Case Study of Unsafe Abortion in Lesotho.” Global Public Health 17 (6): 801–814. https://doi.org/10.1080/17441692.2021.1887317
Maluka, S. O., C. Joseph, S. Fitzgerald, R. Salim, and P. Kamuzora. 2020. “Why do Pregnant Women in Iringa Region in Tanzania Start Antenatal Care Late? A qualitative analysis.” BMC Pregnancy and Childbirth 20: 126. https://doi.org/10.1186/s12884-020-2823-4
Ministry of Health Lesotho. 2020. National Antenatal Care Guidelines for a positive pregnancy experience. Maseru, Lesotho.
Mkandawire, P. J., C. Walker, R. Antabe, K. Atuoye, and I. Luginaah. 2021. “Pregnancy Intention and Gestational Age at First Antenatal Care Visit in Lesotho.” African Journal of Midwifery and Women’s Health 15 (1): 1–11. https://doi.org/10.12968/ajmw.2018.0034
Mulondo, S. A. 2020. “Factors Associated with Underutilisation of Antenatal Care Services in Limpopo, South Africa.” British Journal of Midwifery 28 (11): 788–795. https://doi.org/10.12968/bjom.2020.28.11.788
Nyando, M., D. Makombe, A. Mboma, E. Mwakilama, and L. Nyirenda. “Perceptions of Pregnant Women on Antenatal Care Visit during Their First Trimester at Area 25 Health Center in Lilongwe, Malawi – a Qualitative Study.”. BMC Women’s Health 23 (646). https://doi.org/10.1186/s12905-023-02800-7
Ndayizigiye, M., L. T. Allan-Blitz, E. Dally, S. Abebe, A. Andom, R. Tlali, E. Gingras, M. Mokoena, M. Msuya, P. Nkundanyirazo, T. Mohlouoa, F. Mosebo, S. Motsamai, J. Mabathoana, P. Chetane, L. Ntlamelle, J. Curtain, C. Whelley, E. Birru, R. McBain, D. M. Andrea, D. Schwarz, and J. S. Mukherjee. 2022. “Improving Access to Health Services through Health Reform in Lesotho: Progress Made Towards Achieving Universal Health Coverage.” PLOS Global Public Health 2 (11): 1–13. https://doi.org/10.1371/journal.pgph.0000985
Ntshanga, N. S. 2018. Reasons for Late Booking of Pregnant Women at Antenatal Care Clinics in King Sabata Dalindyebo Sub-District in the Eastern Cape, South Africa. MPH dissertation. University of Fort Hare. South Africa.
Olaoye, A. and K. Onyenankeya. 2023. “Effectiveness of Mdantsane FM Community Radio in Health Information Promotion among Residents of Eastern Cape Province, South Africa.” Information Development 0 (0). https://doi.org/10.1177/02666669231187362
Phafoli, S. H., E. J. Van Aswegen, and U. U. Alberts. 2007. “Variables Influencing Delay in Antenatal Clinic Attendance among Teenagers in Lesotho.” South African Family Practice Journal 49: 1–49. https://www.ajol.info/index.php/safp/article/view/13405
Polit, D. F. and C. T. Beck. 2017. Nursing Research: Generating and Assessing Evidence for Nursing Practice. 10th edition. London: Wolters Kluwer.
Riang’a, R. M., A. K. Nangulu, and J. E. W. Broerse. 2018. “‘I Should Have Started Earlier, but I was Not Feeling Ill!’ Perceptions of Kalenjin Women on Antenatal Care and its Implications on Initial Access and Differentials in Patterns of Antenatal Care Utilization in Rural Uasin Gishu County Kenya.” PLoS One 13 (10): e0202895. https://doi.org/10.1371/journal.pone.0202895
Seeiso, T. 2017. Review of Antenatal Care Literacy of Pregnant Women in Thaba-Tseka and Maseru Districts, Lesotho. Dissertation, University of South Africa, Pretoria. https://uir.unisa.ac.za/handle/10500/23733
Seidu, A. 2021. “Factors Associated with Early Antenatal Care Attendance among Women in Papua New Guinea: A Population‐based Cross‐sectional Study.” Archives of Public Health 79: 70. https://doi.org/10.1186/s13690-021-00592-6
Sibiya, M. N., T. S. Ngxongo, and T. S. Bhengu. 2018. “Access and Utilization of Antenatal Care Services in a Rural Community of eThekwine District in KwaZulu-Natal.” International Journal of African Nursing Science 8: 1–7. http://dx.doi.org/10.1016/j.ijans.2018.01.002
Teshale, A. B., and G. A. Tesema. 2020. “Prevalence and Associated Factors of Delayed First Antenatal Care Booking among Reproductive Age Women in Ethiopia; A Multilevel Analysis of EDHS 2016 Data.” PLoS ONE, 15 (7): 1–13. https://doi.org/10.1371/journal.pone.0235538
Thetsane, R. M., M. Mokhethi, M. Ramathebane, and N. Leseba. 2022. “Utilisation of Village Health Workers’ Services for Tuberculosis Screening in Lesotho.” South African Family Practice Journal 64 (1): e1-e6. https://doi.org/10.4102/safp.v64i1.5581
Tola, W., E. Negash, T. Sileshi, and N. Wakgari. 2021. “Late Initiation of Antenatal Care and Associated Factors among Pregnant Women Attending Antenatal Clinic of Ilu Ababor Zone, Southwest Ethiopia: A cross-sectional study.” PLoS ONE 16 (1): e0246230. https://doi.org/10.1371/journal.pone.0246230
United Nations Children’s Fund (UNICEF). 2024. Antenatal Care. https://data.unicef.org/topic/maternal-health/antenatal-care/
Warri, D., and A. George. 2020. “Perceptions of Pregnant Women of Reasons for Late Initiation of Antenatal Care: A Qualitative Interview Study.” BMC Pregnancy Childbirth 20 (1): 70. https://doi.org/10.1186/s12884-020-2746-0
World Health Organization (WHO). 2023. Addressing High Maternal Mortality and Newborn Deaths in Lesotho. https://www.afro.who.int/countries/lesotho/news/addressing-high-maternal-mortality-and-newborn-deaths-lesotho
World Health Organization (WHO). 2024. “Maternal mortality.” https://www.who.int/news-room/fact-sheets/detail/maternal-mortality
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