J Roberts1, D Sealy1, H Hopp Marshak1, L Manda-Taylor2, P Gleason1, R Mataya3. 1. School of Public Health, Loma Linda University, Loma Linda, California, USA. 2. University of Malawi, College of Medicine, Chichiri Blantyre 3, Malawi. 3. School of Public Health, Loma Linda University, Loma Linda, California, USA; University of Malawi, College of Medicine, Chichiri Blantyre 3, Malawi.
Abstract
BACKGROUND: Approximately 90% of Malawian women attend antenatal care at least once during their pregnancies; however, most mothers first present during months five and six and do not adhere to the World Health Organization's recommended four visits. The objective of this study was to explore the role the patient-provider relationship has on antenatal care uptake. METHODS: A qualitative study, consisting of interviews with 20 urban pregnant mothers and eight health workers, was conducted from September to December 2014. Two large tertiary care hospitals in the Central and Southern regions of Malawi were selected as study sites. RESULTS: Several factors influenced antenatal care attendance. Significant barriers reported included the patient-provider relationship, clinic wait times, family and friend support, distance from home to the clinic, transportation, cost, and number of visits. The patient-provider relationship appears to have a large impact on antenatal clinic participation. Mothers indicated that health workers often mistreat or demean them during visits. Additionally, health workers revealed 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 attitudes influence antenatal clinic attendance. Improving the patient-provider relationship may increase antenatal clinic attendance and decrease pregnancy complications during pregnancy. Professional development opportunities and quality improvement programmes are would help improve patient care and health outcomes while the continued staff shortages in the country are addressed.
BACKGROUND: Approximately 90% of Malawian women attend antenatal care at least once during their pregnancies; however, most mothers first present during months five and six and do not adhere to the World Health Organization's recommended four visits. The objective of this study was to explore the role the patient-provider relationship has on antenatal care uptake. METHODS: A qualitative study, consisting of interviews with 20 urban pregnant mothers and eight health workers, was conducted from September to December 2014. Two large tertiary care hospitals in the Central and Southern regions of Malawi were selected as study sites. RESULTS: Several factors influenced antenatal care attendance. Significant barriers reported included the patient-provider relationship, clinic wait times, family and friend support, distance from home to the clinic, transportation, cost, and number of visits. The patient-provider relationship appears to have a large impact on antenatal clinic participation. Mothers indicated that health workers often mistreat or demean them during visits. Additionally, health workers revealed 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 attitudes influence antenatal clinic attendance. Improving the patient-provider relationship may increase antenatal clinic attendance and decrease pregnancy complications during pregnancy. Professional development opportunities and quality improvement programmes are would help improve patient care and health outcomes while the continued staff shortages in the country are addressed.
Authors: Vida Nyagre Yakong; Kathy L Rush; Joan Bassett-Smith; Joan L Bottorff; Carole Robinson Journal: J Adv Nurs Date: 2010-08-23 Impact factor: 3.187
Authors: Anna M van Eijk; Hanneke M Bles; Frank Odhiambo; John G Ayisi; Ilse E Blokland; Daniel H Rosen; Kubaje Adazu; Laurence Slutsker; Kim A Lindblade Journal: Reprod Health Date: 2006-04-06 Impact factor: 3.223
Authors: Peter Waiswa; Margaret Kemigisa; Juliet Kiguli; Sarah Naikoba; George W Pariyo; Stefan Peterson Journal: BMC Pregnancy Childbirth Date: 2008-06-21 Impact factor: 3.007
Authors: Crystal L Patil; Carrie S Klima; Alana D Steffen; Sebalda C Leshabari; Heather Pauls; Kathleen F Norr Journal: Int J Gynaecol Obstet Date: 2017-10-10 Impact factor: 3.561
Authors: Britni L Ayers; Rachel S Purvis; Williamina Ioanna Bing; Jellesen Rubon-Chutaro; Nicola L Hawley; Rebecca Delafield; Ingrid K Adams; Pearl Anna McElfish Journal: Matern Child Health J Date: 2018-07
Authors: Crystal L Patil; Carrie S Klima; Sebalda C Leshabari; Alana D Steffen; Heather Pauls; Molly McGown; Kathleen F Norr Journal: BMC Pregnancy Childbirth Date: 2017-11-08 Impact factor: 3.007
Authors: Fatch W Kalembo; Garth E Kendall; Mohammed Ali; Angela F Chimwaza; Mary M Tallon Journal: BMC Public Health Date: 2018-07-16 Impact factor: 3.295