Recommendations to improve antenatal care uptake through community participation and local accountability

Abstract

Antenatal care, an integral component of primary health care, is offered as a free health service for pregnant women at public health facilities. However, the death of women during pregnancy, during childbirth, or after delivery continues to be a major challenge in health care systems due to poor antenatal care uptake. The main aim of this study was to explore and describe recommendations from local stakeholders and health governance structures to promote the uptake of Basic Antenatal Care (BANC) services in the areas surrounding local clinics. The study used a qualitative, descriptive design, with purposively selected participants sharing detailed information in their own words on the subject. Twenty individual in-depth interviews were conducted at three selected community health centres (CHCs) in the Bushbuckridge sub-district, Mpumalanga province. The results revealed the following needs: clinic committees must participate in promoting BANC awareness through health education, use of existing community-based structures must be strengthened, men’s support for their pregnant partners must be harnessed, and the roles and responsibilities of clinic committees must be amplified. The study showed that community leaders and clinic committees are willing to work in collaboration with health care providers in promoting antenatal care uptake in the community by expanding BANC awareness. Clinic committees’ previous involvement in health awareness campaigns is a strength that could contribute to making antenatal care awareness programmes successful. Vital recommendations include formalising reporting mechanisms for clinic committees so that they can be accountable to the community in promoting BANC services, strengthening stakeholder collaboration, and resourcing.