Experiences of pregnant women from a rural community regarding antenatal care services in eThekwini district, KwaZulu-Natal

Abstract

Introduction and Background According to the Declaration of Alma-Ata, maternal and child health care forms an integral component of primary health care. In line with this, the South African national government legislated free maternal and child healthcare services in the public sectors to ensure accessibility and availability of basic health care services to the community of South Africa. However, poor access and utilization of antenatal care services in rural areas continues and contributes to high maternal mortality and morbidity rates and untoward pregnancy outcomes.

Aim The aim of this study was to explore the experiences of pregnant women from the KwaMkhizwana rural area regarding antenatal care services in order to identify the factors affecting effective provision of and access to the antenatal care services.

Method A qualitative, explorative, descriptive research design, which was guided by Rosenstock’s Health Belief Model, was used to conduct the study. Data were collected by conducting semi-structured interviews with 15 participants who were purposively sampled between February and March 2016 and was analysed using Tesch’s method of data analysis. The sample size was determined by data saturation that was reached after ten interviews were conducted. A total of five additional interviews were conducted to confirm saturation of data.

Findings There were five major themes and several sub-themes that emerged from the interviews. The major themes included: 1) availability and accessibility of antenatal care services; 2) established practices by the health post staff to reduce the number of clients; management and administration of the health posts; 3) access to health information by pregnant women; 4) communication between the pregnant women and the health post staff; and 5) socio-cultural taboos and beliefs of the community in the area.

Conclusion and Recommendations The information gathered from the participants with regard to their experiences affirms that challenges still exist in this rural community regarding access to health care services, particularly antenatal care services. Recommendations pertaining to policy development, institutional management, practice, and research were made. Some of these recommendations included that several policies that are currently non-existent should be developed in order to promote accessibility of antenatal care service at primary health care level, more primary health care training schools should be established to increase the number of primary health care trained nurses, short courses for training of clinic supervisors should be conducted and that further research studies looking at ANC service accessibility especially in rural areas, focusing on health care workers and management experiences be conducted.