Title : Facilitators and barriers to antenatal and focused antenatal care (ANC/FANC) utilisation among pregnant women: A mixed-methods study
Abstract:
Background: Existing data quantify maternal deaths but lack hospital-based evidence on barriers and determinants affecting ANC and FANC utilization. This mixed-methods study used a structured questionnaire to assess barriers, stigma, and factors affecting ANC and FANC use among pregnant women.
Methods: A mixed-method study will be conducted among pregnant women attending DUHS, Ojha Campus, Karachi. The quantitative component will assess ANC/FANC utilisation and its associations with sociodemographic, economic, and healthcare factors. ANC utilisation will be assessed by self-report and available records, with adequacy defined as ≥8 contacts, starting within 12 weeks, per WHO guidelines. Qualitative exploration of sociocultural, economic, and systemic barriers and facilitators to ANC/FANC utilisation will be integrated with quantitative findings for a comprehensive analysis.
Result: Preliminary findings from the ongoing data collection show that most women had limited knowledge regarding Antenatal care (ANC), around 80% not hearing about Focused Antenatal Care (FANC).With 55.6% having no knowledge regarding the recommended number of visits and Focused Antenatal Care (FANC) model. 55.6% participants reported uptil now that they had not received adequate information or guidance about ANC from healthcare providers, family embers or other sources. In terms of facilitators, 57% of the women reported that they were able to attend ANC because of family support, availability of transportation and accessibility of healthcare facility. Long wait times were the most common concern.
Conclusion: Results from this ongoing research (n=9; target N=377) suggest that lack of knowledge about ANC/FANC and lengthy waiting periods in standard medical centers were notably often reported obstacles to antenatal care utilization and most participants reported only mild satisfaction with the services they received. Care-seeking behavior is driven primarily by service and information gaps, not cost or permission issues.
