Factors affecting antenatal care attendance: results from qualitative studies in Ghana, Kenya and Malawi.
Factors affecting antenatal care attendance: results from qualitative studies in Ghana, Kenya and Malawi.
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DOI：
10.1371/journal.pone.0053747
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发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Pool R
中科院分区：
文献类型：
--
作者：
Pell C;Meñaca A;Were F;Afrah NA;Chatio S;Manda-Taylor L;Hamel MJ;Hodgson A;Tagbor H;Kalilani L;Ouma P;Pool R
产前护理是改善母婴健康的一项关键战略。然而，撒哈拉以南非洲的调查数据表明，妇女往往在头三个月后才开始产前护理，而且没有达到产前护理的建议就诊次数。利用定性数据，本文比较探讨了影响ANC出勤率在三个国家（加纳，肯尼亚和马拉维）的四个撒哈拉以南非洲地区的ANC出勤率不同水平的因素。收集数据是定性研究方案的一部分，该方案调查了妊娠期疟疾的社会和文化背景。采用了一系列方法，包括访谈、与不同受访者的焦点小组以及对当地社区和卫生设施的观察。在所有地点，妇女至少参加过一次ANC。然而，他们对非国大的描述往往是模糊的。关于怀孕护理的一般观念-检查胎儿的位置或监测其进展-促使妇女参加产前护理;特别是在肯尼亚，获得产前护理卡以避免卫生工作者的斥责也是如此。妇女开始ANC的时间受到生殖问题和怀孕不确定性的影响，特别是在头三个月，以及ANC服务如何应对这种不确定性;年龄，产次和怀孕披露的相关影响;与医护人员的互动，特别是关于ANC时间的信息;产前检查的费用，包括产前检查程序的收费-尽管实行免费产前检查政策-以及关于后续预约的强制性质的想法。在这些社会和文化多样性的网站，研究结果表明，“供应”方面的因素有一个重要的影响，对ANC出席：ANC的设计，特别是ANC如何处理的需求和关注的妇女在头三个月的启动时间的影响。
Antenatal care (ANC) is a key strategy to improve maternal and infant health. However, survey data from sub-Saharan Africa indicate that women often only initiate ANC after the first trimester and do not achieve the recommended number of ANC visits. Drawing on qualitative data, this article comparatively explores the factors that influence ANC attendance across four sub-Saharan African sites in three countries (Ghana, Kenya and Malawi) with varying levels of ANC attendance. Data were collected as part of a programme of qualitative research investigating the social and cultural context of malaria in pregnancy. A range of methods was employed interviews, focus groups with diverse respondents and observations in local communities and health facilities. Across the sites, women attended ANC at least once. However, their descriptions of ANC were often vague. General ideas about pregnancy care – checking the foetus’ position or monitoring its progress – motivated women to attend ANC; as did, especially in Kenya, obtaining the ANC card to avoid reprimands from health workers. Women’s timing of ANC initiation was influenced by reproductive concerns and pregnancy uncertainties, particularly during the first trimester, and how ANC services responded to this uncertainty; age, parity and the associated implications for pregnancy disclosure; interactions with healthcare workers, particularly messages about timing of ANC; and the cost of ANC, including charges levied for ANC procedures – in spite of policies of free ANC – combined with ideas about the compulsory nature of follow-up appointments. In these socially and culturally diverse sites, the findings suggest that ‘supply’ side factors have an important influence on ANC attendance: the design of ANC and particularly how ANC deals with the needs and concerns of women during the first trimester has implications for timing of initiation.
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影响因子：
4.3
作者：
Bergsjo, P;Villar, J
通讯作者：
Villar, J
影响因子：
3.3
作者：
Conrad, Paul;Schmid, Gerhrd;Sarker, Malabika
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Sarker, Malabika
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作者：
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影响因子：
168.9
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作者：
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通讯作者：
Obrist B