Introduction and background
According to the Declaration of Alma-Ata, maternal and child health care
forms an integral component of primary health care. In line with this, the South
African national government legislated free maternal and child healthcare
services in the public sectors to ensure accessibility and availability of basic
health care services to the community of South Africa. However, poor access
and utilization of antenatal care services in rural areas continues and
contributes to high maternal mortality and morbidity rates and untoward
pregnancy outcomes.
Aim
The aim of this study was to explore the experiences of pregnant women from
the KwaMkhizwana rural area regarding antenatal care services in order to
identify the factors affecting effective provision of and access to the antenatal
care services.
Method
A qualitative, explorative, descriptive research design, which was guided by
Rosenstock’s Health Belief Model, was used to conduct the study. Data were
collected by conducting semi-structured interviews with 15 participants who
were purposively sampled between February and March 2016 and was
analysed using Tesch’s method of data analysis. The sample size was
determined by data saturation that was reached after ten interviews were
conducted. A total of five additional interviews were conducted to confirm
saturation of data.
Findings
There were five major themes and several sub-themes that emerged from the
interviews. The major themes included: 1) availability and accessibility of
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antenatal care services; 2) established practices by the health post staff to
reduce the number of clients; management and administration of the health
posts; 3) access to health information by pregnant women; 4) communication
between the pregnant women and the health post staff; and 5) socio-cultural
taboos and beliefs of the community in the area.
Conclusion and recommendations
The information gathered from the participants with regard to their
experiences affirms that challenges still exist in this rural community regarding
access to health care services, particularly antenatal care services.
Recommendations pertaining to policy development, institutional
management, practice, and research were made. Some of these
recommendations included that several policies that are currently non-existent
should be developed in order to promote accessibility of antenatal care
service at primary health care level, more primary health care training schools
should be established to increase the number of primary health care trained
nurses, short courses for training of clinic supervisors should be conducted
and that further research studies looking at ANC service accessibility
especially in rural areas, focusing on health care workers and management
experiences be conducted.