Abstract:
Introduction
Maternal and perinatal deaths remain a major issue in South Africa regardless of various strategies that are in
place. Antenatal care (ANC), which is care given to a pregnant woman during pregnancy, and ANC is vital in
reducing maternal and child mortality. Late antenatal care is associated with several maternal and foetal
complications which are preventable with timely care. Previous studies identified several factors contributing to
late antenatal care booking. Hence, the survey identifies, ranks the importance of the factors for late antenatal
care booking and also elicits, from participants what can be changed to improve and sensitize pregnant women
on the importance of early antenatal care booking.
Methods
A cross-sectional survey was conducted amongst pregnant women attending their first antenatal care at Ebony
Clinic in Ekurhuleni, Gauteng Province, after 20 weeks of gestation. A questionnaire was used to obtain
participants' socio-demographic characteristics, assess factors for late antenatal care, and to rank the
participants responses on the factors for late antenatal care booking. Data analysis was done using descriptive
statistics.
Results
A total of 150 participants took part in the survey. All participants booked after 20 weeks’ gestation.The socio-
demographic factors of maternal age, marital status, level of education, and occupational status did not show
any relationship with late antenatal care booking.
Health care workers’ behaviour and negative attitude were ranked as the most critical factors, with participants
communicating fear of being hit or humiliated by workers as a leading factor in the delay in seeking antenatal
care. Operational management group of factors of waiting in long queues and time spent in clinic were ranked
group of factors, and its individual factors such as waiting in queues and time spent in clinic were ranked
relatively high overall. The third highest-ranking group of factors was socio-economic status, especially not
having a permanent address. At the same time, personal factors, religious beliefs and cultural issues were not
10
acknowledged as factors affecting decision-making to initiate antenatal care. Participants suggested that on-
going staff empowerment, wellness and health educational information can expedite positive outcomes and
encourage early antenatal booking.
Conclusion
The socio-demographic factors of maternal age, marital status, level of education, distance travelled, household
income, and parity did not show any affiliation to late antenatal care booking. Factors for late antenatal care
booking that were mostly rated by participants were negative experiences from the healthcare workers’
behaviour and attitude, operational management, and socio-economic factors. Staff empowerment, wellness
and health educational information can expedite positive outcomes and encourage early antenatal booking.
