Counselling practices during focused antenatal care are considered an effective
strategy to improve pregnancy outcome. Using the Explanatory design of mixed method
approach, 369 women who have ever attended antenatal care and gave birth in the health
facilities, opinion leaders in the communities and practicing midwives within the Effutu
Municipality were sampled randomly and purposively. Two research questions were
formulated and were analysed using Mean, Standard Deviation and Spearman's Correlation
Coefficient. The study revealed that the general perception of women in the municipality was
that counselling during FANC was not effective and that reasons for counselling
implementation gaps were: poor communication, negative midwives’ attitudes, lack of
knowledge and experience of midwives in counselling, poor time management and
uncooperative client behaviour. The study recommended that Midwives, the ministry of health
and the Ghana health service should improve accessibility to antenatal services and the
municipal health directorate and the midwife should improve midwives’ knowledge and skills
in antenatal counselling and focused antenatal services as a whole. Finally, a model was
developed to improve counselling during focused antenatal care.