Abstract
Antenatal care (ANC) is essential for reducing maternal morbidity and mortality, yet utilization rates remain low across sub-Saharan Africa, including Kenya. This study explores pregnant Kenyan women’s experiences with ANC, focusing on how temporal decision-making affects their access to and attendance during pregnancy. Using a qualitative descriptive approach, 20 pregnant women, were purposively sampled, to understand their perspectives on ANC access and use through in-depth interviews. Analysis, based on the Betty Neuman systems model, categorized factors influencing ANC attendance into three primary areas: intrapersonal (individual beliefs and perceptions), interpersonal (social, cultural, and economic influences), and extra-personal (systemic and structural barriers).
Findings revealed a complex interplay of factors that influenced women’s decisions about access and attendance to ANC. These included intrapersonal barriers like personal beliefs, perceptions and fears, while interpersonal influences encompassed cultural norms, gender roles, and financial challenges and dependencies on the family. Extra-personal barriers included transportation difficulties, uncivil healthcare practices and policies, and the added impact of COVID-19 on access to timely and subsequent care. Many women reported that these factors influenced their temporal decision-making, causing delays in seeking ANC or reducing the frequency of their visits. Financial constraints and lack of respectful maternal care were also cited as significant barriers that led some women to delay or avoid ANC.
These findings emphasize the need for healthcare policies that strengthen community healthcare linkages, promote respectful maternal care, and enhance communication between midwives and clients. Addressing these interconnected barriers is crucial to improving ANC access and, consequently, maternal health outcomes in resource-limited settings. The study highlights the importance of a holistic approach to ANC to consider the diverse challenges women face and further research is needed to develop targeted strategies for improving ANC utilization among pregnant women in Kenya.
Notes
References:
1. Imo, C. K. (2022). Influence of women's decision-making autonomy on antenatal care utilisation and institutional delivery services in Nigeria: evidence from the Nigeria Demographic and Health Survey 2018. BMC Pregnancy and Childbirth, 22(1), 141.
2. Landrian, A., Mboya, J., Golub, G., Moucheraud, C., Kepha, S., & Sudhinaraset, M. (2022). Effects of the COVID-19 pandemic on antenatal care utilisation in Kenya: a cross-sectional study. BMJ open, 12(4), e060185.
3. Mason, L., Dellicour, S., Ter Kuile, F., Ouma, P., Phillips-Howard, P., Were, F., ... & Desai, M. (2015). Barriers and facilitators to antenatal and delivery care in western Kenya: a qualitative study. BMC pregnancy and childbirth, 15, 1-10.
4. Ochieng, C. A., & Odhiambo, A. S. (2019). Barriers to formal health care seeking during pregnancy, childbirth and postnatal period: a qualitative study in Siaya County in rural Kenya. BMC Pregnancy and Childbirth, 19, 1-14.
5. Yuill, C., McCourt, C., Cheyne, H., & Leister, N. (2020). Women’s experiences of decision-making and informed choice about pregnancy and birth care: a systematic review and meta-synthesis of qualitative research. BMC pregnancy and childbirth, 20, 1-21.
Sigma Membership
Non-member
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Descriptive/Correlational
Research Approach
Qualitative Research
Keywords:
Health Equity, Social Determinants of Health, Primary Care, lncivility, Antenatal Care, ANC, Africa, Kenya
Recommended Citation
Maina, Rose Muthoni, "Barriers to Use of Antenatal Services Among Pregnant Women. A Temporal Decision-Making Perspective" (2025). International Nursing Research Congress (INRC). 44.
https://www.sigmarepository.org/inrc/2025/presentations_2025/44
Conference Name
36th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Seattle, Washington, USA
Conference Year
2025
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Barriers to Use of Antenatal Services Among Pregnant Women. A Temporal Decision-Making Perspective
Seattle, Washington, USA
Antenatal care (ANC) is essential for reducing maternal morbidity and mortality, yet utilization rates remain low across sub-Saharan Africa, including Kenya. This study explores pregnant Kenyan women’s experiences with ANC, focusing on how temporal decision-making affects their access to and attendance during pregnancy. Using a qualitative descriptive approach, 20 pregnant women, were purposively sampled, to understand their perspectives on ANC access and use through in-depth interviews. Analysis, based on the Betty Neuman systems model, categorized factors influencing ANC attendance into three primary areas: intrapersonal (individual beliefs and perceptions), interpersonal (social, cultural, and economic influences), and extra-personal (systemic and structural barriers).
Findings revealed a complex interplay of factors that influenced women’s decisions about access and attendance to ANC. These included intrapersonal barriers like personal beliefs, perceptions and fears, while interpersonal influences encompassed cultural norms, gender roles, and financial challenges and dependencies on the family. Extra-personal barriers included transportation difficulties, uncivil healthcare practices and policies, and the added impact of COVID-19 on access to timely and subsequent care. Many women reported that these factors influenced their temporal decision-making, causing delays in seeking ANC or reducing the frequency of their visits. Financial constraints and lack of respectful maternal care were also cited as significant barriers that led some women to delay or avoid ANC.
These findings emphasize the need for healthcare policies that strengthen community healthcare linkages, promote respectful maternal care, and enhance communication between midwives and clients. Addressing these interconnected barriers is crucial to improving ANC access and, consequently, maternal health outcomes in resource-limited settings. The study highlights the importance of a holistic approach to ANC to consider the diverse challenges women face and further research is needed to develop targeted strategies for improving ANC utilization among pregnant women in Kenya.
Description
This study explores barriers to antenatal care (ANC) access among Kenyan women, revealing how beliefs, cultural norms, financial constraints, and systemic challenges, including COVID-19, delay or reduce attendance. Guided by the Betty Neuman systems model, findings highlight the need for respectful care, better community-health linkages, and targeted policies. Attendees will gain insights into addressing barriers to improve ANC utilization and maternal health outcomes in low resource settings.