Ronel Sewpaul1,2, Rik Crutzen3, Natisha Dukhi4, Derrick Sekgala4, Priscilla Reddy4,5. 1. Department of Health Promotion, Maastricht University/CAPHRI, Minderbroedersberg 4-6, 6211 LK, Maastricht, The Netherlands. rsewpaul@hsrc.ac.za. 2. Health & Wellbeing, Human and Social Capabilities Division, Human Sciences Research Council, 118 Buitengraght Street, Cape Town, 8000, South Africa. rsewpaul@hsrc.ac.za. 3. Department of Health Promotion, Maastricht University/CAPHRI, Minderbroedersberg 4-6, 6211 LK, Maastricht, The Netherlands. 4. Health & Wellbeing, Human and Social Capabilities Division, Human Sciences Research Council, 118 Buitengraght Street, Cape Town, 8000, South Africa. 5. Faculty of Health Sciences, Nelson Mandela University, Port Elizabeth, South Africa.
Abstract
BACKGROUND: Maternal mortality among adolescent mothers in South Africa is higher than many middle-income countries. This is largely attributable to conditions that can be prevented or managed by high quality antenatal care. The way in which pregnant adolescents are treated at antenatal clinics influences their timely utilization of antenatal services. This qualitative study reports on the experiences of pregnant adolescents with health care workers when accessing antenatal care. METHODS: Pregnant girls aged 13-19 (n = 19) who attended public health care facilities that provide Basic Antenatal Care (BANC) services in Cape Town, South Africa were recruited. Four face to face in-depth interviews and four mini focus group discussions were undertaken, facilitated by a topic guide. Thematic analyses were used to analyse the data. RESULTS: Experiences that reinforce antenatal attendance, such as respectful and supportive treatment, were outweighed by negative experiences, such as victimization; discrimination against being pregnant at a young age; experiencing disregard and exclusion; inadequate provision of information about pregnancy, health and childbirth; clinic attendance discouragement; and mental health turmoil. CONCLUSIONS: There is evidence of a discordant relationship between the health care workers and the pregnant adolescents. Adolescents feel mistreated and discriminated against by the health care workers, which in turn discourages their attendance at antenatal clinics. Maternal health care workers need to receive support and regular training on the provision of youth friendly antenatal care and be regularly evaluated, to promote the provision of fair and high quality antenatal services for adolescent girls.
BACKGROUND: Maternal mortality among adolescent mothers in South Africa is higher than many middle-income countries. This is largely attributable to conditions that can be prevented or managed by high quality antenatal care. The way in which pregnant adolescents are treated at antenatal clinics influences their timely utilization of antenatal services. This qualitative study reports on the experiences of pregnant adolescents with health care workers when accessing antenatal care. METHODS: Pregnant girls aged 13-19 (n = 19) who attended public health care facilities that provide Basic Antenatal Care (BANC) services in Cape Town, South Africa were recruited. Four face to face in-depth interviews and four mini focus group discussions were undertaken, facilitated by a topic guide. Thematic analyses were used to analyse the data. RESULTS: Experiences that reinforce antenatal attendance, such as respectful and supportive treatment, were outweighed by negative experiences, such as victimization; discrimination against being pregnant at a young age; experiencing disregard and exclusion; inadequate provision of information about pregnancy, health and childbirth; clinic attendance discouragement; and mental health turmoil. CONCLUSIONS: There is evidence of a discordant relationship between the health care workers and the pregnant adolescents. Adolescents feel mistreated and discriminated against by the health care workers, which in turn discourages their attendance at antenatal clinics. Maternal health care workers need to receive support and regular training on the provision of youth friendly antenatal care and be regularly evaluated, to promote the provision of fair and high quality antenatal services for adolescent girls.
Keywords:
Adolescents; Antenatal attendance; Antenatal care; Maternal healthcare workers; Sexual and reproductive health services; South Africa; Teenage pregnancy
Authors: Anna Glasier; A Metin Gülmezoglu; George P Schmid; Claudia Garcia Moreno; Paul F A Van Look Journal: Lancet Date: 2006-11-04 Impact factor: 79.321
Authors: Kim Jonas; Priscilla Reddy; Bart van den Borne; Ronel Sewpaul; Anam Nyembezi; Pamela Naidoo; Rik Crutzen Journal: BMC Health Serv Res Date: 2016-11-15 Impact factor: 2.655
Authors: Kim Jonas; Rik Crutzen; Anja Krumeich; Nicolette Roman; Bart van den Borne; Priscilla Reddy Journal: BMC Health Serv Res Date: 2018-02-13 Impact factor: 2.655