Theses and Dissertations

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Browsing Theses and Dissertations by Subject "Pregnant women"

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    Determinants of timely first antenatal care visit among pregnant women in Maracha district, northwestern Uganda – a cross-sectional study
    (Muni University, 2025-11-18) Asibo, Gift Patrick
    Background: Pregnant women should make contacts with professional healthcare providers within twelve weeks of conception, to enable timey screening for pre-existing conditions, danger signs and their management as well as birth preparedness planning. Unfortunately, the proportion of women seeking timely first antenatal care visit has remained universally low, especially in the low and middle-low-income countries. Objective: To examine the factors associated with timely first antennal care visit among pregnant attending antenatal care services in Maracha district. Methodology: In three (03) selected health facilities within Maracha district, a cross-sectional study was conducted among 532 pregnant women. A multistage sampling involving quota sampling followed by simple random sampling was done and participants given informed consent. Quantitative data was collected using a pretested semi-structured interviewer administered questionnaires. Descriptive analysis was done using frequencies and percentages while bivariate and multivariable analyses were performed using a modified Poisson regression. Results: Out of the 532 participants, 165(31%) had timely first antenatal care visit. According to the multivariable analysis, the obstetric characteristic that was significantly associated with timely first antenatal care visit was the history of delivery by caesarean section in recent past pregnancy, aPR=0.548, 95% CI [0.398, 0.755], p<0.001, with a marginal statistical significance for planned pregnancy, aPR=0.687, 95% CI [0.467, 1.009], p=0.055. The health systems characteristics that were significantly associated with timely first antenatal care visit were included having a means of transport, either private or public, aPR=0.596, 95% CI [0.405, 0.877], p=0.009; and frequency of integrated outreaches in their communities, aPR=0.634, 95% CI [0.432, 0.930], p=0.020. Conclusion: Only 31% of timely first Antenatal care visit implies a public health problem in Maracha. Interventions should target awareness creation to impact a positive mindset change about utilization of timely first antenatal care services, as well as improve access to antenatal care services for better pregnancy outcomes in Maracha.
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    Understanding the reasons for delayed antenatal care initiation among pregnant women in Adumi HC IV Ayivu west division, Arua city: a qualitative phenomenological study
    (Muni University, 2025-11-25) Dramile, Daniel
    Background: Timely initiation of antenatal care (ANC) within the first trimester is a cornerstone of improving maternal and neonatal health outcomes. Despite its established benefits and being a key target of the Ugandan Ministry of Health and world health organization (WHO,) a significant proportion of pregnant women in Uganda, particularly in the West Nile sub-region initiate ANC late. At Adumi Health Center IV in Arua City, 71.8% of pregnant women begin care after 12 weeks of gestation, hence hindering early risk detection and management. The specific reasons for this persistent delay in this local context remained unclear, thus necessitating this investigation. Methods: This qualitative phenomenological study was conducted at Adumi HC IV, Ayivu West Division, and Arua City. Data were collected through 20 in-depth interviews with purposively selected pregnant women who initiated ANC after 12 weeks, one key informant interview with senior midwife, and three focus group discussions with spouses and Village Health Team members. Semi-structured guides were used, interviews were audio recorded, transcribed, and translated. Data were analyzed using thematic analysis with QDA miner lite software. Findings: The findings revealed several key themes influencing ANC attendance. First, the journey to seeking care was initiated by cues to action, which were supported by comprehensive knowledge of ANC, including its timing, purpose, activities, and benefits, as well as self-efficacy and confidence in acting on this knowledge. However, this journey was often hindered by significant barriers and challenges. These obstacles appeared at multiple levels, including individual and motivational barriers such as personal attitudes and lack of motivation for early initiation; systemic and practical barriers related to healthcare facilities and community health workers; and socio cultural and interpersonal barriers like prevailing cultural norms and the critical role of partner support. Conclusion and Recommendations: The delay in starting ANC at Adumi HC IV was not mainly due to a lack of knowledge, but rather a way to cope with serious structural, economic, and social challenges. Simply providing health education won't be enough. A variety of strategies are suggested, such as offering specific incentives for registering in the first trimester, setting up community outreach clinics, promoting male involvement, and integrating programs to reduce poverty and address economic difficulties.