Contributory factors leading to non-attendance for ante-natal care by pregnant women in a selected public hospital in Limpopo Province, South Africa

Abstract

Background: Ante-natal care, especially early booking, is key to ensuring that pregnant women receive optimum care during pregnancy and delivery. It is essential in preventing pregnancy-related complications. However, the frequency of pregnant women presenting at the selected regional hospital for delivery with no prior history of ante-natal care remains high. This study aimed to identify and evaluate the contributory factors leading to non-attendance for ante-natal care. Objectives: The study explored and described the contributory factors leading to non-attendance for ante-natal care by pregnant women in a selected regional hospital in Limpopo province, South Africa. Methods: The study was conducted in a selected regional hospital. A qualitative research approach and exploratory, descriptive, and contextual design were adopted. Non-probability purposive sampling was used to select participants. The data were collected through in-person semi-structured interviews and analysed using a thematic analysis technique. A total of 16 participants were interviewed until data saturation was reached. Measures to establish trustworthiness—credibility, conformability, dependability and transferability—were implemented and ethical principles adhered to. Results: The current study found that the most reported factors contributing to non-attendance for ante-natal care were linked to the following themes that emerged from the study’s findings: socio-demographic factors, personal barriers, and system provider factors. Inaccessible healthcare, financial constraints, a low level of education, lack of knowledge of ante-natal care, lack of support, and poor nurse-patient relationships were identified as sub-themes of the current study. The least frequently reported factors—initial denial of pregnancy, late recognition of pregnancy symptoms, considered abortion, long queues/slow service, and operating hours—were also sub-themes emerging from the study. Conclusions: Although maternal services are offered free of charge, women persistently reach full term without seeking ante-natal care. Factors such as insufficient funds, inadequate support from family members, attitudes of healthcare personnel, and denial of pregnancy had a negative impact on attendance for ante-natal care by pregnant women. To mitigate these factors, the study recommended mass media outreach initiatives (TV, radio, newspaper, and social media) to educate the public on the importance of ante-natal care and spousal support. With the help of home-based carers, women can be tested for pregnancy at their homes and encouraged to attend ante-natal care.