A survey on factors for late antenatal booking amongst pregnant women attending a Community Health Care Centre in Tembisa, Gauteng Province, South Africa

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.