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Laisser R, Woods R, Bedwell C, et al. The tipping point of antenatal engagement: A qualitative grounded theory in Tanzania and Zambia. Sex Reprod Healthc. 2021;31:100673doi: 10.1016/j.srhc.2021.100673.
Laisser, R., Woods, R., Bedwell, C., Kasengele, C., Nsemwa, L., Kimaro, D., Kuzenza, F., Lyangenda, K., Shayo, H., Tuwele, K., Wakasiaka, S., Ringia, P., & Lavender, T. (2021). The tipping point of antenatal engagement: A qualitative grounded theory in Tanzania and Zambia. Sexual & reproductive healthcare : official journal of the Swedish Association of Midwives, 31100673. https://doi.org/10.1016/j.srhc.2021.100673
Laisser, Rose, et al. "The tipping point of antenatal engagement: A qualitative grounded theory in Tanzania and Zambia." Sexual & reproductive healthcare : official journal of the Swedish Association of Midwives vol. 31 (2021): 100673. doi: https://doi.org/10.1016/j.srhc.2021.100673
Laisser R, Woods R, Bedwell C, Kasengele C, Nsemwa L, Kimaro D, Kuzenza F, Lyangenda K, Shayo H, Tuwele K, Wakasiaka S, Ringia P, Lavender T. The tipping point of antenatal engagement: A qualitative grounded theory in Tanzania and Zambia. Sex Reprod Healthc. 2021 Oct 27;31:100673. doi: 10.1016/j.srhc.2021.100673. Epub 2021 Oct 27. PMID: 34775355.
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Sex Reprod Healthc. 2021 Oct 27;31:100673. doi: 10.1016/j.srhc.2021.100673. Epub 2021 Oct 27.

The tipping point of antenatal engagement: A qualitative grounded theory in Tanzania and Zambia.

Sexual & reproductive healthcare : official journal of the Swedish Association of Midwives

Rose Laisser, Rebecca Woods, Carol Bedwell, Chowa Kasengele, Livuka Nsemwa, Debora Kimaro, Flora Kuzenza, Kutemba Lyangenda, Happiness Shayo, Khuzuet Tuwele, Sabina Wakasiaka, Prisca Ringia, Tina Lavender

Affiliations

  1. Midwifery and Women's Health, Archibishop Antony Mayalla School of Nursing, Catholic University of Health and Allied Sciences, PO Box 1464, Bugando, Mwanza, Tanzania. Electronic address: [email protected].
  2. Midwifery and Women's Health, Archibishop Antony Mayalla School of Nursing, Catholic University of Health and Allied Sciences, PO Box 1464, Bugando, Mwanza, Tanzania.

PMID: 34775355 DOI: 10.1016/j.srhc.2021.100673

Abstract

BACKGROUND: Effective antenatal care is fundamental to the promotion of positive maternal and new-born outcomes. International guidance recommends an initial visit in the first trimester of pregnancy, with a minimum of four antenatal visits in total: the optimum schedule being eight antenatal contacts. In low- and middle-income countries, many women do not access antenatal care until later in pregnancy and few have the recommended number of contacts.

AIM: To gain understanding of women's antenatal experiences in Tanzania and Zambia, and the factors that influence antenatal engagement.

METHODS: The study was underpinned by Strauss's grounded theory methodology. Interviews were conducted with 48 women, 16 partners, 21 health care providers and 11 stakeholders, and analysed using constant comparison.

FINDINGS: The core category was 'The tipping point of antenatal engagement', supported by four categories: awareness of health benefits, experiential motivators, influential support, and environmental challenges. Although participants recognised the importance of antenatal care to health outcomes, individual motivations and external influences determined attendance or non-attendance. The 'tipping point' for antenatal engagement occurred when women believed that any negative impact could be offset by tangible gain. For some women non-attendance was a conscious decision, for others it was an unchallenged cultural norm.

CONCLUSION: A complex interplay of factors determines antenatal engagement. Short-term modifiable factors to encourage attendance include the development of strategies for increasing respectful care; use of positive women's narratives, and active community engagement. Further research is required to develop innovative, cost-effective care models that improve health literacy and meet women's needs.

Crown Copyright © 2021. Published by Elsevier B.V. All rights reserved.

Keywords: Africa; Antenatal; Grounded theory; Interviews; Motivation

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