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. 2018 Oct 5;18(1):394.
doi: 10.1186/s12884-018-2014-8.

Missed opportunities in antenatal care for improving the health of pregnant women and newborns in Geita district, Northwest Tanzania

Eveline Thobias Konje  1   2 , Moke Tito Nyambita Magoma  3 , Jennifer Hatfield  4 , Susan Kuhn  5 , Reginald S Sauve  4 , Deborah Margret Dewey  4   5   6
Affiliations

Missed opportunities in antenatal care for improving the health of pregnant women and newborns in Geita district, Northwest Tanzania

Eveline Thobias Konje et al. BMC Pregnancy Childbirth. .

Abstract

Background: Despite the significant benefits of early detection and management of pregnancy related complications during antenatal care (ANC) visits, not all pregnant women in Tanzania initiate ANC in a timely manner. The primary objectives of this research study in rural communities of Geita district, Northwest Tanzania were: 1) to conduct a population-based study that examined the utilization and availability of ANC services; and 2) to explore the challenges faced by women who visited ANC clinics and barriers to utilization of ANC among pregnant women.

Methods: A sequential explanatory mixed method design was utilized. Household surveys that examined antenatal service utilization and availability were conducted in 11 randomly selected wards in Geita district. One thousand, seven hundred and nineteen pregnant women in their 3rd trimester participated in household surveys. It was followed by focus group discussions with community health workers and pregnant women that examined challenges and barriers to ANC.

Results: Of the pregnant women who participated, 86.74% attended an ANC clinic at least once; 3.62% initiated ANC in the first trimester; 13.26% had not initiated ANC when they were interviewed in their 3rd trimester. Of the women who had attended ANC at least once, the majority (82.96%) had been checked for HIV status, less than a half (48.36%) were checked for hemoglobin level, and only a minority had been screened for syphilis (6.51%). Among women offered laboratory testing, the prevalence of HIV was 3.88%, syphilis, 18.57%, and anemia, 54.09%. In terms of other preventive measures, 91.01% received a tetanus toxoid vaccination, 76.32%, antimalarial drugs, 65.13%, antihelminthic drugs, and 76.12%, iron supplements at least once. Significant challenges identified by women who visited ANC clinics included lack of male partner involvement, informal regulations imposed by health care providers, perceived poor quality of care, and health care system related factors. Socio-cultural beliefs, fear of HIV testing, poverty and distance from health clinics were reported as barriers to early ANC utilization.

Conclusion: Access to effective ANC remains a challenge among women in Geita district. Notably, most women initiated ANC late and early initiation did not guarantee care that could contribute to better pregnancy outcomes.

Keywords: Antenatal care; Missed opportunity; Sequential explanatory mixed method; Tanzania.

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Conflict of interest statement

Ethics approval and consent to participate

The study received ethics approval from CUHAS/BMC Joint Institutional Ethical Review Committee (CREC/098/2015) and the Conjoint Health Research Ethics Board at the University of Calgary (REB16–0183). Before conducting the study, we sought and obtained the permission at the region, district, ward, and village levels in Geita District. Written informed consent was obtained from all pregnant women during the household surveys. For participants who were less than 18 years of age, written informed assent and consent from the guardians or parents were obtained for participation in this study.

Consent for publication

Not applicable

Competing interests

MM declares that he is an associate editor of the BMC Pregnancy and Childbirth in Low and Middle-Income Countries’ series. All other co-authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

References

    1. Tunҁalp Ö, Pena-Rosas JP, Lawrie T, Bucagu M, Oladapo OT, Portela A, Gülmezoglu AM. WHO recommendations on antenatal care for a positive pregnancy experience - going beyond survival. BJOG. 2017;124:860–862. doi: 10.1111/1471-0528.14599. - DOI - PubMed
    1. United Nations Economic Commission for Africa, African Union, African Development Bank, United Nations Development Programme: MDG Report 2015: Assessing progress in Africa toward the millennium development goals. Addis Ababa: The ECA Printing and Publishing Unit; 2015.
    1. WHO, editor. Mother baby package: implementing safe motherhood in countries (practical guide), vol. 360. Geneva: WHO. p. 1994.
    1. Tunҁalp Ö, Were W, MacLennan C, Oladapo OT, Gülmezoglu AM, Bahl R, Daelmans B, Mathai M, Say L, Temmerman M, et al. Quality of care for pregnant women and newborns - the WHO vision. BJOG. 2015;122:1045–1049. doi: 10.1111/1471-0528.13451. - DOI - PMC - PubMed
    1. Bhutta Z, Das J, Bahl R, Lawn J, Salam R, Paul V, Sankar M, Blencowe H, Rizvi A, Chou V, et al. Can available interventions end preventable deaths in mothers, newborn babies, and stillbirths, and at what cost? Lancet. 2014;384(9940):347–370. doi: 10.1016/S0140-6736(1014)60792-60793. - DOI - PubMed

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