000			03254nam a22003977a 4500
003			OSt
005			20240305193740.0
008			221129b |||||||| |||| 00| 0 eng d
028			_bPhone: +255 28 298 3384
028			_b Fax: +255 28 298 3386
028			_b Email: vc@bugando.ac.tz
028			_b Website: www.bugando.ac.tz
040			_bEnglish _cDLC
041			_aEnglish
100			_aRose Laisser _922811
222			_aAntenatal Grounded theory Africa Interviews Motivation
245			_aThe tipping point of antenatal engagement: A qualitative grounded theory in Tanzania and Zambia
260			_aMwanza, Tanzania: _bElsevier & _b Catholic University of Health and Allied Sciences [CUHAS – Bugando] _c2022/3/1
300			_aPages 100673
490			_vSexual & Reproductive Healthcare Volume 31
520			_aAbstract: Background: Effective antenatal care is fundamental to the promotion of positive maternal and new-born outcomes. International guidance recommends an initial visit in the first trimester of pregnancy, with a minimum of four antenatal visits in total: the optimum schedule being eight antenatal contacts. In low- and middle-income countries, many women do not access antenatal care until later in pregnancy and few have the recommended number of contacts. Aim: To gain understanding of women’s antenatal experiences in Tanzania and Zambia, and the factors that influence antenatal engagement. Methods: The study was underpinned by Strauss’s grounded theory methodology. Interviews were conducted with 48 women, 16 partners, 21 health care providers and 11 stakeholders, and analysed using constant comparison. Findings: The core category was ‘The tipping point of antenatal engagement’, supported by four categories: awareness of health benefits, experiential motivators, influential support, and environmental challenges. Although participants recognised the importance of antenatal care to health outcomes, individual motivations and external influences determined attendance or non-attendance. The ‘tipping point’ for antenatal engagement occurred when women believed that any negative impact could be offset by tangible gain. For some women non-attendance was a conscious decision, for others it was an unchallenged cultural norm. Conclusion: A complex interplay of factors determines antenatal engagement. Short-term modifiable factors to encourage attendance include the development of strategies for increasing respectful care; use of positive women’s narratives, and active community engagement. Further research is required to develop innovative, cost-effective care models that improve health literacy and meet women’s needs.
700			_a Tina Lavender _946134
700			_aPrisca Ringia _946178
700			_a Sabina Wakasiaka _946142
700			_a Khuzuet Tuwele _946165
700			_aHappiness Shayo _946166
700			_a Kutemba Lyangenda _946168
700			_aFlora Kuzenza _945540
700			_a Debora Kimaro _946169
700			_aLivuka Nsemwa _930392
700			_a Chowa Kasengele _946179
700			_aCarol Bedwell _946151
700			_a Rebecca Woods _946180
856			_uhttps://doi.org/10.1016/j.srhc.2021.100673
942			_2ddc _cVM
999			_c19777 _d19777