Understanding the reasons for delayed antenatal care initiation among pregnant women in Adumi HC IV Ayivu west division, Arua city: a qualitative phenomenological study
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Date
2025-11-25
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Publisher
Muni University
Abstract
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.
Description
A dissertation submitted in fulfillment of the requirements leading to the award of a master of public health of Muni University
Keywords
Antenatal care initiation, Pregnant women, Adumi H/C IV, Ayivu west division, Arua city, Uganda
Citation
Dramile, D. (2025). Understanding the reasons for delayed antenatal care initiation among pregnant women in Adumi H/C IV Ayivu west division, Arua city: a qualitative phenomenological study (Unpublished graduate dissertation). Muni University, Arua, Uganda