Master of Public Health - MPH / Globally, the maternal mortality rate (MMR) dropped by 44%, from 342 deaths per 100 000 to 211 maternal deaths per 100,000 live births in 2017. Developing countries have reached two-thirds coverage (69 %) of the recommended focused visits and first ANC. In sub-Saharan Africa alone, approximately 66% (201,000) of deaths occur during birth. MMR can be reduced if pregnant women initiate ANC early enough and receive quality care. In Swaziland, only 14% of pregnant women make their first ANC visit during the first trimester, 64% during the 2nd trimester and 22% during the 3rd trimester. The study aimed to explore pregnant women's perceptions of the factors contributing to late ANC booking in the Shiselweni Region.

Thesis (MPH.) -- University of Limpopo, 2021 / Background: Late antenatal care (ANC) booking delays treatment and management of high-risk pregnancies, which may result to maternal deaths. Early ANC booking has been found to be effective in most of the pregnancy related risk factors that can be detected and managed at early stages of pregnancy. Aim: The aim of the study was to investigate the prevalence and factors contributing to late ANC booking amongst pregnant women in primary health care facilities at Dikgale-Mamabolo local area. Methods: Quantitative cross-sectional research approach was used. The study was conducted at Dikgale-Mamabolo local area, which consists of seven clinics at Polokwane, Limpopo province in South Africa. Only three clinics were purposefully selected for the study. The population of the study included pregnant women who were 18 years and above. The sample size consisted of 238 pregnant women who came for ANC services in primary health care facilities during the period of the study. Convenience sampling method was used to select pregnant women from the population. Data was collected using an adapted questionnaire. Data was analysed using Statistical Package for Social Sciences (SPPS) version 25. Results: The results indicated that 86% of pregnant women booked antenatal care before five months gestational age and 14% booked after five months gestational age. Factors contributing to late ANC booking amongst pregnant women were marital status, educational level, employment status, mode of transport to clinic, lack of information, cultural beliefs, long distance to the clinic, long waiting time in the clinic and clinic operating hours. Conclusion: Late ANC booking remains a major public health issue. The study showed that lack of information and cultural beliefs are major contributing factors to late ANC booking. It is recommended that awareness campaigns should be conducted in the community and schools to empower women with knowledge about ANC services.

Late booking is associated with high perinatal and maternal morbidity and mortality. The World Health Organization (WHO, 2016) recommends that pregnant women should book for ANC full first before 12 weeks of gestation. The aim of the study was to explore and describe factors contributing to late antenatal care booking at public health facilities of Mopani District. A qualitative approach was used. In-depth interviews were conducted with twenty one pregnant women who booked after twelve weeks of gestation and agreed to participate in the study. The study was conducted at four selected public health care facilities rendering maternal health services in Mopani district. Data was collected through in-depth interview with the aid of an interview guide. The analysis of data was done manually using a coding system to develop themes. The results revealed that there are personal and provider factors contributing to late antenatal care booking in Mopani district. Personal factors contributing to late antenatal care booking were unplanned and unaccepted pregnancy, lack of support, late recognition of pregnancy, cultural and religious beliefs, ignorance of the importance of antenatal care and fear. System or provider factors contributing to late booking were long waiting time, midwives’ attitude and lack of resources. / Health Studies / M.A. (Public Health)