The aim of the study was to investigate the knowledge and utilisation of antenatal care (ANC) services by pregnant women at a clinic in Ekurhuleni. A quantitative, descriptive correlational study was carried out on 90 eligible pregnant women. Data were collected with a self-administered questionnaire and analysed with the help of a statistician using the Epi Info version 7 computer program. The results of the study indicate that most women initiated ANC later than the recommendations by the World Health Organization (WHO). Over half of the respondents had overall good knowledge of ANC, but lacked knowledge of medication and screening tests done during pregnancy, some danger signs during pregnancy and of exclusive breastfeeding. Factors that were identified as associated with late initiation of ANC were current employment status, number of children, transport costs to clinic and number of antenatal visits. / Department of Health Studies / M.A. (Public Health)

The aim of the study was to determine factors contributing to late booking amongst pregnant women at Ekurhuleni health district in order to offer recommendations for enhancing early booking. Interpretative phenomenological analysis design was used. Data were collected using semi-structured individual face-to-face interviews from 20 purposively selected pregnant women. Each interview was audio recorded and lasted between 45-60 minutes. Fields notes were taken to triangulate data collection method. Audio recorded interviews were transcribed verbatim. Data were thematically analysed using Interpretative Phenomenological Analysis framework for data analysis. Results indicate that healthcare service related factors such as human resources, infrastructure and the type of service rendered at the clinic contribute to late bookings. Client related factors such as socioeconomic status, cultural beliefs and knowledge deficit also contribute to late bookings. Recommendations are made addressing both healthcare service and client related factors in order to enhance early booking among pregnant woman at Ekurhuleni district. / Health Studies / M.A. (Nursing science)

The purpose of the study is to determine the barriers to utilisation of antenatal care services among pregnant women in Omaheke Region - Namibia. A quantitative, cross-sectional descriptive research was followed, and a structured questionnaire was used to obtain information from study participants. One hundred and ten (110) women of child-bearing age between 18 to 49 years who visited Gobabis District Hospital in Omaheke Region for deliveries (full-term) or kept for postnatal care purposes were selected. A questionnaire with open-ended and closed-ended questions was designed using a Likert scale to gather information. SPSS software was used to generate descriptive statistics. Results indicated that the majority of respondents (39%) who attended antenatal care services, fell within the age range of 18-21 years. Participants demonstrated higher knowledge of the recommended number of antenatal care visits and of the importance of antenatal care services. Transport money and cost, long distances to health facilities, desirability, unplanned or unwanted pregnancy, and limited transportation options are the barriers that contribute to low utilisation of antenatal care services among pregnant women in Omaheke Region. Recommendations for deployment of more qualified midwives at rural antenatal clinics, building more antenatal care clinics in the region and creation of community awareness campaigns on the importance of antenatal care may increase the utilisation of antenatal care services in the Region. It is anticipated that this research will contribute to the promotion and utilisation of antenatal care services among pregnant women in Omaheke Region. / Health Studies / M. P. H.

This study was carried out as part of efforts to better understand the factors that impinge on childbirth service delivery and to develop guidelines to help improve the quality and safety of childbirth services in Ghana. The objectives were to: assess the factors that influence client-centredness; explore women’s and health professional’s views of and experiences with client-centred childbirth services; and develop guidelines to assist improve client-centred childbirth services in hospitals. The fixed mixed methods design comprising both quantitative and qualitative methods was employed. Structured questionnaire and exit interviews were used to gather data from 754 women who delivered in the hospitals. Furthermore, in-depth interviews were used to examine the experiences of women, doctors and midwives. STATA MP Version 13 was used to analyse the data by generating frequencies, chi-square and binary logistic regression results. Qualitative data analysis was analysed through data reduction, data display and generation of themes and categories. The process of developing the guidelines comprised: drafting based on the findings of the study and additional literature review, and a number of reviews by senior health professionls to build consesnsus on the content. With a response rate of 97.8%, the results indicated average performance. A number of the items examined under demographic characteristics, ante-natal, labour and postnatal care were significantly associated with the experience of excellent client-centred care. These included: number of weeks pregnant before delivery; health professional who assisted with delivery; mode of delivery; labour pain management; and length of stay after delivery. On the whole, the findings of the quantitative study were support by that of the structured interviews. Most of the themes from in-depth interviews with women were had to do with the relationship between health care provider and clients. Issues of support during childbirth; decision-making and informed choice; and continuity were raised. Themes deduced from the doctors’ and midwives’ interviews demonstrated a fair understanding of principles of client-centred care and delineated relational as well as client, health care worker and organisational factors that facilitate or limit effective implementation of client-centred care. The findings of the studies were used to develop guidelines to help improve services. It is recommended that the Ministry of Health, Ghana adopt the guidelines and provide the enabling environment for its effective implementation. / Health Studies / D. Litt. et Phil. (Health Studies)

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)