Factors associated with underutilisation of antenatal care services in Limpopo, South Africa

Abstract

Background The aim of this study was to explore and describe factors associated with underutilisation of antenatal care services. In South Africa, maternal and child healthcare services are provided free of charge. Despite this, utilisation of antenatal care services remains a major public health challenge. Literature affirms that 96% of pregnant women present at antenatal care services only after 12 weeks of pregnancy, and this is influenced by several factors. Women's attitude plays an integral role. Methods This study used a qualitative, exploratory, descriptive design. Purposive and convenient sampling methods were used to select 10 hospitals and 83 pregnant women, respectively. Ten focus group discussions were conducted to collect data. Trustworthiness was ensured by means of Guba's model and data were analysed, qualitatively, using Tesch's eight steps. Results The majority of the pregnant women (83%) were from rural areas, had unplanned pregnancies, had five pregnancies/children or more, factors that are associated with underutilisation of antenatal care services. Cultural practices and beliefs regarding early presentation to antenatal care services and its effect on pregnancies were also found to be associated with underutilisation. Conclusions Some pregnant women do not consider antenatal care services as essential and choose to present late, despite the knowledge that monitoring of maternal health during pregnancy by midwives could prevent maternal and neonatal morbidity, while improving maternal and neonatal health and wellness. Recommendations include the provision of information and education materials to women, as well as health education, to sensitise and increase women's awareness of the urgency in utilising antenatal care services.