Nonfinancial barriers to prenatal care

Abstract

This article focused on nonfinancial barriers to prenatal care and pointed out that these barriers cannot be ignored if access to care is to be improved. The strategies suggested by the Consensus Conferences for reducing these barriers provide abundant opportunities for all professionals, and the implications for health policy formulated by the Conferences provide direction for eventually eliminating the barriers. It will take a combination of professional, political and public will to make this happen.

PIP: This article focuses on what is currently known about nonfinancial barriers to prenatal care. The primary source of data is the findings from the Consensus Conferences on Access to Prenatal Care and Low Birthweight which were held in 1986 (American Nurses' Association, 1987). Prior to describing these data, the literature regarding nonfinancial barriers will be reviewed and findings from this author's studies on access to care described. Implications for health policy will conclude this article. The landmark study: Preventing Low Birthweight (Institute of Medicine, Committee to Reduce Low Birthweight, 1985) concluded that there were 5 major categories of nonfinancial barriers to care: 1) limited availability of providers of maternity care; 2) insufficient prenatal services in some sites routinely used by high-risk populations; 3) experiences, attitudes and beliefs among women that make them disinclined to received prenatal care services; 4) poor or absent transportation or child care; and 5) inadequate systems to recruit hard-to-reach women into care. These categories will be used to organize this review. 4 regional consensus conferences on access to prenatal care and low birthweight were held in early 1986. The conferences were designed to build upon the Institute of Medicine's study, "Preventing Low Birthweight" and had 3 specific goals: 1) to identify strategies to reduce the nonfinancial barriers to access to prenatal care; 2) to identify the components of prenatal care most effective in reducing the incidence of low birthweight" and had 3) specific goals: 1) to identify strategies to reduce the nonfinancial barriers to access to prenatal care; 2) to identify the components of prenatal care most effective in reducing the incidence of low birthweight; and 3) to develop health policy recommendations aimed at reducing the incidence of low birthweight. The framework that evolved for categorizing the nonfinancial barriers organized the barriers into 1 of 3 categories: 1) policy or system barriers; 2) provider barriers or 3) patient barriers. The article lists 11 recommendations for health policy proposed by the conference participants. (Author's modified).