Abstract
BACKGROUND: Use of timely antenatal care has been identified as key to facilitating healthy pregnancies worldwide. Although considerable investment has been made to enhance maternal health services in Nepal, approximately one-third of women do not attend antenatal care until after the first trimester (late). These women miss out on the benefits of screening and interventions that are most effective in the first trimester.
OBJECTIVE: This study aimed to identify the missed opportunities of women who do not attend antenatal care in the first trimester, and to explore some of the factors underlying late attendance and consider potential solutions for minimizing these missed opportunities in the future.
STUDY DESIGN: This study was conducted in 3 hospitals in Nepal. Focus groups (n=18) with a total of 48 postnatal women and 49 staff members, and 10 individual interviews with stakeholders were conducted. Purposive sampling facilitated the obtainment of a full range of maternity experiences, staff categories, and stakeholder positions. Data were qualitative and analyzed using a thematic approach.
RESULTS: Limited awareness among women of the importance of early antenatal care was reported as a key factor behind attendance only after the first trimester. The family and community were described as significant influencers in women's decision-making regarding the timing of antenatal care. The benefits of early ultrasound scanning and effective supplementation in pregnancy were the major missed opportunities. Increasing awareness, reducing cost, and enhancing interprofessional collaboration were suggested as potential methods for improving timely initiation of antenatal care.
CONCLUSION: Limited awareness continues to drive late attendance to antenatal care after the first trimester. Investment in services in the first trimester and community health education campaigns are needed to improve this issue and enhance maternal and neonatal outcomes.
| Original language | English |
|---|---|
| Article number | 100127 |
| Journal | AJOG Global Reports |
| Volume | 2 |
| Issue number | 4 |
| Early online date | 4 Nov 2022 |
| DOIs | |
| Publication status | Published - 26 Nov 2022 |
Bibliographical note
Funding Information:This study would not have been possible without the active participation of women and staff at the study hospitals, and the regional and national stakeholders. We would also like to thank the wider research team at Mother and Infant Research Activities (MIRA) in Nepal for their contribution to data collection, transcription, and translation. This study was funded through a University of Bristol Global Challenges Research Fund Pump-Priming Award. The funder played no role in the study design. A.M. was funded by a National Institute for Health and Care Research (NIHR) Academic Clinical Lectureship for this research project. M.To. was funded by an NIHR Academic Clinical Fellowship for this research project. This paper presented independent research funded by the NIHR and the University of Bristol Global Challenges Research Fund. The views expressed in this paper are those of the authors and do not necessarily represent those of the University of Bristol, the National Health Service, the NIHR, or the Department of Health and Social Care.
Funding Information:
This study was funded through a University of Bristol Global Challenges Research Fund Pump-Priming Award. The funder played no role in the study design. A.M. was funded by a National Institute for Health and Care Research (NIHR) Academic Clinical Lectureship for this research project. M.To. was funded by an NIHR Academic Clinical Fellowship for this research project. This paper presented independent research funded by the NIHR and the University of Bristol Global Challenges Research Fund. The views expressed in this paper are those of the authors and do not necessarily represent those of the University of Bristol, the National Health Service, the NIHR, or the Department of Health and Social Care.
Publisher Copyright:
© 2022 The Authors
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