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BMC pregnancy and childbirth
Nov 08, 2024;24 (1): 730.

Factors influencing the uptake of antenatal care in Uganda: a mixed methods systematic review.

Kiran Bhutada, Mahima Venkateswaran, Maureen Atim, Susan Munabi-Babigumira, Victoria Nankabirwa, Flavia Namagembe, J Frederik Fr��en, Eleni Papadopoulou
Author Information
  1. Kiran Bhutada: Global Health Cluster, Division for Health Services, Norwegian Institute of Public Health, PO Box 222, Sk��yen, Oslo, Norway.
  2. Mahima Venkateswaran: Global Health Cluster, Division for Health Services, Norwegian Institute of Public Health, PO Box 222, Sk��yen, Oslo, Norway.
  3. Maureen Atim: Makerere University School of Public Health, New Mulago Gate Rd, Kampala, Uganda.
  4. Susan Munabi-Babigumira: Department of Health and Functioning, Western Norway University of Applied Sciences, Bergen, Norway.
  5. Victoria Nankabirwa: Centre for Intervention Science in Maternal and Child Health (CISMAC), University of Bergen, Bergen, Norway.
  6. Flavia Namagembe: Makerere University School of Public Health, New Mulago Gate Rd, Kampala, Uganda.
  7. J Frederik Fr��en: Global Health Cluster, Division for Health Services, Norwegian Institute of Public Health, PO Box 222, Sk��yen, Oslo, Norway.
  8. Eleni Papadopoulou: Global Health Cluster, Division for Health Services, Norwegian Institute of Public Health, PO Box 222, Sk��yen, Oslo, Norway. EleniZoumpoulia.Papadopoulou@fhi.no.
PMID: 39516857 DOI: 10.1186/s12884-024-06938-6

Abstract

BACKGROUND: In 2016, the World Health Organization (WHO) recommended increasing antenatal care (ANC) visits from four to eight to reduce maternal morbidity and mortality. However, many low-middle income countries (LMICs), including Uganda, struggle to achieve even the basic four ANC visits. To further improve ANC attendance, understanding the perceptions and beliefs of end users is crucial. This systematic review explores the perceptions, experiences, and behavior of pregnant or previously pregnant women, their families and healthcare workers on ANC attendance in Uganda.
METHODS: The review includes qualitative and quantitative studies published from January 2012 to September 2022. Outcomes include early initiation of ANC visits and any attendance or utilization of routine ANC services. The Critical Appraisal Skills Programme (CASP) checklist was used to assess the quality of included studies.
RESULTS: We searched 7 databases, identified 725 references and assessed 107 in full text for eligibility based on selected inclusion criteria. Forty-seven studies were eligible and are included in this review. Quantitative findings highlight socioeconomic factors like occupation, wealth index, and marital status as key determinants of ANC uptake and timely uptake of care, favoring higher wealth, younger age, marriage, and media access. Qualitative evidence reveals challenges to ANC attendance including financial constraints, cultural beliefs, gendered decision-making, and geographical distance from healthcare facilities. Potential solutions involve financially empowering women, providing reliable ANC equipment and medication, and community engagement and education.
CONCLUSIONS: This review offers valuable insights for policymakers and healthcare providers seeking to tailor interventions that address the unique needs and challenges faced by pregnant women, their families, and healthcare workers in Uganda. By doing so, it may enhance ANC accessibility and quality, ultimately aligning with the WHO's recommendation of eight ANC contacts (ANC8) and contributing to reducing maternal morbidity and mortality rates.

Keywords

ANC guidelines Antenatal care Barriers Delivery of health care Health workers Healthcare utilization Implementation Maternity care Respectful care Uganda

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MeSH Term

Humans
Uganda
Female
Prenatal Care
Pregnancy
Patient Acceptance of Health Care
Socioeconomic Factors
Health Knowledge, Attitudes, Practice
Health Services Accessibility
Adult
Systematic Review Journal Article

Word Cloud

Created with Highcharts 10.0.0ANCcarereviewUgandaattendancehealthcarevisitspregnantwomenworkersstudiesuptakeHealthantenatalfoureightmaternalmorbiditymortalityincludingperceptionsbeliefssystematicfamiliesutilizationqualityincludedwealthchallengesBACKGROUND:2016WorldOrganizationWHOrecommendedincreasingreduceHowevermanylow-middleincomecountriesLMICsstruggleachieveevenbasicimproveunderstandingenduserscrucialexploresexperiencesbehaviorpreviouslyMETHODS:includesqualitativequantitativepublishedJanuary2012September2022OutcomesincludeearlyinitiationroutineservicesCriticalAppraisalSkillsProgrammeCASPchecklistusedassessRESULTS:searched7databasesidentified725referencesassessed107fulltexteligibilitybasedselectedinclusioncriteriaForty-seveneligibleQuantitativefindingshighlightsocioeconomicfactorslikeoccupationindexmaritalstatuskeydeterminantstimelyfavoringhigheryoungeragemarriagemediaaccessQualitativeevidencerevealsfinancialconstraintsculturalgendereddecision-makinggeographicaldistancefacilitiesPotentialsolutionsinvolvefinanciallyempoweringprovidingreliableequipmentmedicationcommunityengagementeducationCONCLUSIONS:offersvaluableinsightspolicymakersprovidersseekingtailorinterventionsaddressuniqueneedsfacedmayenhanceaccessibilityultimatelyaligningWHO'srecommendationcontactsANC8contributingreducingratesFactorsinfluencingUganda:mixedmethodsguidelinesAntenatalBarriersDeliveryhealthHealthcareImplementationMaternityRespectful

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