Online Program

Delayed antenatal care attendance: Are providers part of the problem?

Sunday, November 1, 2015

Joni Roberts, DrPH, CHES, School of Health Related Professions, University of Mississippi Medical Center, Jackson, MS
Diadrey-Anne Sealy, PhD, School of Public Health, Loma Linda University, Loma Linda, CA
Helen Hopp Marshak, PhD, School of Public Health, Loma Linda University, Loma Linda, CA
Lucinda Manda-Taylor, PhD, College of Medicine, University of Malawi, Chichiri Blantyre 3, Malawi
Peter Gleason, Ph.D., School of Public Health, Loma Linda University, Loma Linda, CA
Ron Mataya, MD, School of Public Health, Loma Linda University, Loma Linda, CA
Background: Malawi is identified by the United Nations as a least developed country and ranks among the top 10 poorest countries in the world. Approximately 90% of Malawian women attend antenatal care (ANC) at least once during their pregnancies; however, most mothers first attend ANC during months five and six.

Methods: A qualitative study consisting of interviews with urban pregnant mothers and health workers was conducted during September - December 2014 exploring the reasons why women delay in accessing antenatal care. Two large tertiary care hospitals in the central and southern regions of Malawi were selected as study sites. Twenty pregnant mothers and eight health workers were recruited and interviewed.

Results: Several factors influenced a woman's decision to participate in antenatal care. Major barriers reported include clinic wait time, family and friend support, number of visits, transportation, cost and distance. However, patient-provider relationship was the primary reason stated by maternal interviewees. Mothers indicated that health workers often mistreat and demean them when they come for treatment. In addition, health workers mentioned that, due to staff shortages, patients often do not receive the care they deserve.

Conclusions: The results of this study suggest that, in addition to other factors, healthcare provider’s attitudes influence antenatal attendance. Improving the patient-provider relationship may increase antenatal attendance and decrease pregnancy complications during pregnancy. Professional development opportunities and quality improvement programs are needed to improve patient care and health outcomes while addressing the continued staff shortage in the country.

Learning Areas:

Provision of health care to the public
Public health or related nursing
Public health or related research
Social and behavioral sciences

Learning Objectives:
Discuss the role of the provider during pregnancy Discuss the importance of the patient-provider relationship during pregnancy and childbirth. Identify patient-provider relationship areas for improvement.

Keyword(s): Maternal and Child Health, Prenatal Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I recently collected data for my dissertation research project, in the country of Malawi. The purpose of my project on perceived barriers to delayed antenatal care initiation among Malawian women builds on my long-standing interesting in serving in international communities and my training in the area of maternal and child health. My project addresses the field of health disparities evident globally, particularly as it relates to maternal-child health risk.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.