Factors influencing the uptake of antenatal care services among pregnant women in South Gaalkacyo district, Mudug region, Somalia

Abstract

Prenatal attention is necessary for health care of pregnant mothers. The purpose of this research was to determine issues that influence the uptake of antenatal care service by expectant mothers in South Gaalkacyo district in Mudug Region, Somalia. Specific objectives of the study were: To assess pregnant women’s awareness of Antenatal Care services (ANC); Determining the socio-economic factors that act as barriers to the uptake of ANC among pregnant women; Evaluating infrastructural factors that act as Barriers to uptake of ANC care services among pregnant women; and Assessing cultural factors that contribute to underutilization of ANC, in South Galkayo District, Mudug Region, Somalia. Maternal Mortality Rate (MMR) is 732 deaths of mothers for every 100,000 live births. The high maternal mortality is attributed to a number of factors some of which were investigated in this study. A sample population of 460 was selected from a target population of 6,847 pregnant women in the study area using Yamane formulae of 1967.This research used a descriptive cross-sectional study design. The target population was pregnant women aged between (15-49) years of age who met the inclusion criteria. The sampling techniques of this study were systematic and simple random sampling techniques. A Semi- structured questionnaire was used to collect quantitative data. Focus Group Discussion (FGD) and Key Informant Interview (KII) guides were used to collect qualitative data. Quantitative data was analyzed and presented in figures and pie Charts. Qualitative data was analysed using themes and sub-themes and presented in summaries of individual “quotes in boxes” after transcription and triangulation of saturated FGD and KII participation. Chi-square test was used to test the associations while logistic forward simple linear regression analysis using bi-variate and multi-variate was used to detect the relationship between study variables. The result showed that knowledge was poor among women (p=0.0001), source of income and family income influenced mothers’ use of ANC services (P=0.002), accessibility and availability of ANC services affect the utilization at p-value of 0.016 and 0.005 respectively. Cultural belief on TBA and husbands’ control over their wives were listed among reasons why women underutilize the ANC services. The study concluded that underutilization of ANC among expectant mothers is influenced by women’s knowledge, level of education, socio-economic and cultural factors as well as infrastructural factors. Cultural beliefs in patriarchy negatively influenced wives to seek care. The study recommended the awareness by the government and health partners to sensitize women on the importance of ANC service utilization using the Community health workers and TBAs. Girl child education and micro-finance support to women group have to be undertaken by the Government and partners to address the education and poverty gaps. Taking health services to remote areas and use of mobile clinic outreaches were among the recommendation to address the accessibility and availability of health services gaps. The parliament should enact laws that reinforce women rights to alleviate men’s control over their choice for ANC services.