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Factors Influencing Women’s Decision to Seek Antenatal Care in the ANDES of Peru

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Abstract

This qualitative study aimed to assess factors influencing pregnant women’s decision to seek or avoid antenatal care (ANC) in the Andes of Peru. Open-ended, semi-structured interviews were conducted with 24 women utilizing ANC (+) and 10 women avoiding ANC (−). Interviews were translated to English from Quechua and Spanish, transcribed, and analyzed using grounded theory. Factors influencing ANC− women included: expecting criticism for having additional children; long ANC wait time and inconvenient hours of operation; and masculine gender of health workers. For ANC+ women, motivating factors included: maximizing positive health outcomes; past negative maternity experiences; pressure from family members; and avoidance of rumored fines or fees associated with ANC non-attendance and in-hospital deliveries, respectively. Both ANC+ and ANC− women were fearful and embarrassed about possible criticism for having additional children and the gender of the health workers, yet they weighed these factors differently. To better understand how rural women make decisions about ANC attendance, it is important to consider the value they place on the factors influencing their decision, and their emotional assessment of such issues.

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References

  1. Ryan, G. M., Sweeney, P. J., & Solola, A. S. (1980). Prenatal care and pregnancy outcome. American Journal of Obstetrics and Gynecology, 137(8), 876–881.

    PubMed  Google Scholar 

  2. Lindmark, G. (1991). The scientific basis of antenatal care Report from a state-of-the-art conference. Acta Obstetricia et Gynecologica Scandinavica, 70(2), 105.

    Article  PubMed  CAS  Google Scholar 

  3. Donaldson, P. J., & Billy, J. O. G. (1984). The impact of prenatal care on birth weight: Evidence from an international data set. Medical Care, 22(2), 177–188.

    Article  PubMed  CAS  Google Scholar 

  4. Ekwempu, C. C. (1988). The influence of antenatal care on pregnancy outcome. Tropical Journal of Obstetrics and Gynaecology., 1(1), 67–71.

    PubMed  CAS  Google Scholar 

  5. Villar, J. (1997). Scientific basis for the content of routine antenatal care I. Philosophy, recent studies, and power to eliminate or alleviate adverse maternal outcomes. Acta Obstetricia et Gynecologica Scandinavica, 76(1), 1.

    Article  PubMed  CAS  Google Scholar 

  6. Rooney, C. (1992). Antenatal care and maternal health: How effective is it? A review of evidence. Geneva: WHO.

    Google Scholar 

  7. UNICEF. (2008). Progress for children: A report card on maternal mortality. Geneva: UNICEF.

  8. Roost, M., Altamirano, V. C., Liljestrand, J., et al. (2010). Does antenatal care facilitate utilization of emergency obstetric care? A case-referent study of near-miss morbidity in Bolivia. Acta Obstetricia et Gynecologica Scandinavica, 89(3), 335–342. doi:10.3109/00016340903511050.

    Article  PubMed  Google Scholar 

  9. Möller, B. (1990). The outcome of pregnancy and antenatal care in rural tanzania. Acta Obstetricia et Gynecologica Scandinavica, 69(5), 451–452. doi:10.3109/00016349009013314.

    Article  Google Scholar 

  10. Bhatia, J. C. (1995). Determinants of maternal care in a region of South India. Health Transition Review, 5, 127–142.

    Google Scholar 

  11. Van Den Heuvel, O. A., De Mey, W. G., Buddingh, H., et al. (1999). Use of maternal care in a rural area of Zimbabwe, a population-based study. Acta Obstetricia et Gynecologica Scandinavica, 78(10), 838–846.

    Article  PubMed  Google Scholar 

  12. Menown, I. B. (1993). Perinatal outcome and antenatal care in a black South African population. Ulster Medical Journal, 62(1), 37.

    PubMed  CAS  Google Scholar 

  13. Millard, P., et al. (1991). Antenatal village stay and pregnancy outcome in rural Zimbabwe. Salisbury: Central African Journal of Medicine.

    Google Scholar 

  14. Bloom, S. S., Lippeveld, T., & Wypij, D. (1999). Does antenatal care make a difference to safe delivery? A study in urban Uttar Pradesh, India. Health Policy and Planning, 14(1), 38–48.

    Article  PubMed  CAS  Google Scholar 

  15. World Health Organization. (2010). Trends in maternal mortality: 1990 to 2008. Geneva: World Health Organization.

  16. World Health Organization. (2011). Antenatal care. In: Global health observatory. http://www.who.int/gho/maternal_health/reproductive_health/antenatal_care/en/.

  17. Say, L., & Raine, R. (2007). A systematic review of inequalities in the use of maternal health care in developing countries: Examining the scale of the problem and the importance of context. Bulletin of the World Health Organization, 85, 812–819.

    PubMed  Google Scholar 

  18. Houweling, T. A., Ronsmans, C., Campbell, O. M., et al. (2007). Huge poor-rich inequalities in maternity care: An international comparative study of maternity and child care in developing countries. Bulletin of the World Health Organization, 85, 745–754.

    PubMed  Google Scholar 

  19. Carroli, G., Rooney, C., & Villar, J. (2001). How effective is antenatal care in preventing maternal mortality and serious morbidity? An overview of the evidence. Paediatric and Perinatal Epidemiology, 15, 1–42.

    PubMed  Google Scholar 

  20. Amnesty International. (2006). Peru: Poor and excluded women—Denial of the right to maternal and child health. AMR 46/004/2006.

  21. Amnesty International. (2009). Fatal flaws: Barriers to maternal health in Peru. London: Amnesty International.

  22. Bristol, N. (2009). Dying to give birth: Fighting maternal mortality in Peru. Health Affairs, 28(4), 997–1002. doi:10.1377/hlthaff.28.4.997.

    Article  PubMed  Google Scholar 

  23. Hunt, P., & Bueno de Mesquita, J. (2007). Reducing Maternal Mortality: The contribution of the right to the highest attainable standard of health. Essex: University of Essex.

  24. United Nations Population Fund. (2008). State of the world population 2008 reaching common ground: Culture, gender and human rights. New York: United Nations Population Fund.

  25. CARE. (2007). Peru country profile. http://www.care.org/careswork/countryprofiles/89.asp. Accessed February 2, 2010.

  26. Calisaya, E., & Voces de mujeres de Ancash. (2004). Genero y Salud Reproductiva. Lima: Manuela Ramos.

  27. Physicians for Human Rights. (2007). Deadly delays, maternal mortality in Peru, a rights-based approach to safe motherhood. http://physiciansforhumanrights.org/library/report-2007-11-28.html.

  28. Lim, S. S. (2010). India’s Janani Suraksha Yojana, a conditional cash transfer programme to increase births in health facilities: An impact evaluation. Lancet, 375(9730), 2009.

    Article  PubMed  Google Scholar 

  29. ForoSalud. (2007). Vigilencia Ciudadana para evitar la muerte materna en Puno CARE-PERU, Defensoria del Pueblo.

  30. PAHO. (2008). Esquemas de Proteccion Social para la Poblacion Materna, Neonatal e Infantil: Lecciones Aprendidas de la Region de America Latina. Washington, DC: Pan American Health Organization.

  31. Parodi, S. (2005). Evaluando los efectos del Seguro Integral de Salud (SIS) sobre la equidad en la salud materna. Lima: Grupo de Análisis para el Desarrollo- GRADE.

  32. Presidencia del Consejo de Ministros. (2010) Programa Juntos Lima. http://www.juntos.gob.pe/quienes_progr-juntos.php. Accessed October 19, 2010.

  33. Vera la Torre, J. C., & Cobertura, Y. (2003) Financiamiento del Seguro Integral de Salud en el Peru. Lima: Foro Salud, USAID.

  34. Jones, N. (2008). Cash transfers to tackle childhood poverty and vulnerability: An analysis of Peru’s Juntos programme. Environment and urbanization, 20(1), 255.

    Article  Google Scholar 

  35. Hogan, M. C., Foreman, K. J., Naghavi, M., et al. (2010). Maternal mortality for 181 countries, 1980–2008: A systematic analysis of progress towards millennium development goal 5. The Lancet, 375(9726), 1609–1623.

    Article  Google Scholar 

  36. Informatica. (2010). INEI. Peru: DHS, 2010—Final Report Continuous (Spanish). Lima: Instituto Nacional de Estadistica e Informatica.

  37. Banco Central de Reserva del Perú. (2010). Caracterizacion del Departamento de Ancash. Lima: Banco Central de Reserva del Peru.

  38. Creswell, J. (2003). Research design: Qualitative, quantitative, and mixed methods approaches (2nd edn). Ney York: SAGE Publications.

  39. Merriam, S. B. (2002). Introduction to qualitative research. Qualitative research in practice: Examples for discussion and analysis. San Francisco: Jossey-Bass.

  40. Mann, C. J. (2003). Observational research methods. Research design II: Cohort, cross sectional, and case-control studies. Emergency Medicine Journal, 20(1), 54–60.

    Article  PubMed  CAS  Google Scholar 

  41. Miles, M. H. (1994). Michael an expanded sourcebook: Qualitative data analysis (2nd edn). Nee York: SAGE Publications Inc.

  42. CARE Peru. (2008). Evaluacion Basal de la Disponibilidad, Calidad y Uso de los Servicios Obstetricos y Neonatales. Lima: CARE.

  43. Weiss, R. (1994). Learning from Strangers: The art and methods of qualitative interview studies. New York: The Free Press.

    Google Scholar 

  44. Sword, W. (2003). Prenatal care use among women of low income: A matter of “taking care of self”. Qualitative Health Research, 13(3), 319–332. doi:10.1177/0095399702250128.

    Article  PubMed  Google Scholar 

  45. Duarte, S. J. H., de Andrade, S. M. O., Mamede, M. V. (2009). Maternal decision on obtaining prenatal care: A study in Brazil. Midwifery. In press, Corrected Proof.

  46. Salcedo, C. (2004). Voces de mujeres de Ayacucho: Género y salud reproductiva: Movimiento Manuela Ramos. Proyecto ReproSalud (Peru): USAID Mission to Peru.

    Google Scholar 

  47. Nylander, P. P. S., & Adekunle, A. O. (1990). 10 Antenatal care in developing countries. Baillière’s Clinical Obstetrics and Gynaecology, 4(1), 169–186. doi:10.1016/s0950-3552(05)80218-4.

    Article  PubMed  CAS  Google Scholar 

  48. Perú Ministerio de Salud. (2011). Seguro integral de Salud: Preguntas Frequentes. Lima. http://www.sis.gob.pe/a_produ_pregu.html.

  49. Pallikadavath, S., Foss, M., & Stones, R. W. (2004). Antenatal care: Provision and inequality in rural north India. Social Science and Medicine, 59(6), 1147–1158. doi:10.1016/j.socscimed.2003.11.045.

    Article  PubMed  Google Scholar 

  50. Issel, L. M., Forrestal, S. G., Slaughter, J., et al. (2011). A review of prenatal home-visiting effectiveness for improving birth outcomes. JOGNN, 40(2), 157–165. doi:10.1111/j.1552-6909.2011.01219.x.

    Article  PubMed  Google Scholar 

  51. Olds, D. L., Eckenrode, J., & Henderson, C. R., Jr. (1997). et al. Long-term effects of home visitation on maternal life course and child abuse and neglect. Fifteen-year follow-up of a randomized trial. JAMA, 278(8), 637–643.

    Article  PubMed  CAS  Google Scholar 

  52. Leong, K. C., Chen, W. S., Leong, K. W., et al. (2006). The use of text messaging to improve attendance in primary care: A randomized controlled trial. Family practice, 23(6), 699–705. doi:10.1093/fampra/cml044.

    Article  PubMed  Google Scholar 

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Acknowledgments

The authors thank the faculty and staff of the Program in Human Biology for their unconditional support, and the Stanford University Office of Undergraduate Advising and Research for funding this project through a Major Grant.

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Authors and Affiliations

  1. Program in Human Biology, Stanford University, 450 Serra Mall, Building 20, Stanford, CA, 94305, USA

    Laura S. Huaman Ayala

  2. Department of Obstetrics and Gynecology, School of Medicine, Stanford University, 300 Pasteur Drive, HH-333, Stanford, CA, 94305-5317, USA

    Paul D. Blumenthal

  3. Department of Pediatrics, School of Medicine, Stanford University, 301 Ravenswood Road, Suite 100, Menlo Park, CA, 94025, USA

    Clea C. Sarnquist

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  1. Laura S. Huaman Ayala
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  2. Paul D. Blumenthal
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  3. Clea C. Sarnquist
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Correspondence to Laura S. Huaman Ayala.

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Huaman Ayala, L.S., Blumenthal, P.D. & Sarnquist, C.C. Factors Influencing Women’s Decision to Seek Antenatal Care in the ANDES of Peru. Matern Child Health J 17, 1112–1118 (2013). https://doi.org/10.1007/s10995-012-1113-9

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  • DOI: https://doi.org/10.1007/s10995-012-1113-9

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