Potential barriers to focused antenatal care utilisation by HIV-positive pregnant women in Swaziland

Abstract

Background: Maternal mortality and human immunodeficiency virus (HIV) continue to be major challenges to the Kingdom of Swaziland. In the past, the government introduced focused antenatal care and integrated it with national strategies to reduce maternal mortality and the mother-to-child transmission of HIV. It was anticipated that individualised and integrated principles guiding the focused antenatal care model would enhance the quality of care received by pregnant women, consequently leading to high utilisation of the antenatal care services, a low rate of mother-to-child transmission of HIV and better pregnancy outcomes. Method: The study used a qualitative, descriptive and exploratory design, with individual semi-structured, face-to-face interviews. A total of 18 interviews were conducted with 18 HIV-positive pregnant women who attended at least two antenatal care visits at a regional referral hospital. Results: Seven potential barriers emerged from the thematic comparative content analysis of the participants’ descriptions. These were long waiting hours, poor equipment, nonadherence by the nurses with the working hours, fragmented care, lack of privacy, the length of time spent with health professionals, and inadequate health education. Conclusion: It is essential for healthcare providers to understand and address the factors which are viewed by HIV-positive pregnant women as being potential barriers to the use of focused antenatal care. (Full text available online at www.medpharm.tandfonline.com/ojfp) S Afr Fam Pract 2015; DOI: 10.1080/20786190.2015.1085223