Womens' opinions on antenatal care in developing countries: results of a study in Cuba, Thailand, Saudi Arabia and Argentina

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Abstract

Background

The results of a qualitative study carried out in four developing countries (Cuba, Thailand, Saudi Arabia and Argentina) are presented. The study was conducted in the context of a randomised controlled trial to test the benefits of a new antenatal care protocol that reduced the number of visits to the doctor, rationalised the application of technology, and improved the provision of information to women in relation to the traditional protocol applied in each country.

Methods

Through focus groups discussions we were able to assess the concepts and expectations underlying women's evaluation of concepts and experiences of the care received in antenatal care clinics. 164 women participated in 24 focus groups discussion in all countries.

Results

Three areas are particularly addressed in this paper: a) concepts about pregnancy and health care, b) experience with health services and health providers, and c) opinions about the modified Antenatal Care (ANC) programme. In all three topics similarities were identified as well as particular opinions related to country specific social and cultural values. In general women have a positive view of the new ANC protocol, particularly regarding the information they receive. However, controversial issues emerged such as the reduction in the number of visits, particularly in Cuba where women are used to have 18 ANC visits in one pregnancy period.

Conclusion

Recommendations to improve ANC services performance are being proposed. Any country interested in the application of a new ANC protocol should regard the opinion and acceptability of women towards changes.

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Most cited references 28

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Medicine, rationality, and experience. An anthropological perspective

Byron GOOD, BJ Good, B Good … (1994)

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Fundamental elements of the quality of care: a simple framework.

J Bruce (2015)

This article argues for attention to a neglected dimension of family planning services--their quality. A framework for assessing quality from the client's perspective is offered, consisting of six parts (choice of methods, information given to clients, technical competence, interpersonal relations, follow-up and continuity mechanisms, and the appropriate constellation of services). The literature is reviewed regarding evidence that improvements in these various dimensions of care result in gains at the individual level; an even scarcer body of literature is reviewed for evidence of gains at the level of program efficiency and impact. A concluding section discusses how to make practical use of the framework and distinguishes three vantage points from which to view quality: the structure of the program, the service-giving process itself, and the outcome of care, particularly with respect to individual knowledge, behavior, and satisfaction with services.

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Women's views of pregnancy ultrasound: a systematic review.

Jo Garcia, Tracy Roberts, Jane Henderson … (2002)

Ultrasound has become a routine part of care for pregnant women in most countries with developed health services. It is one of a range of techniques used in screening and diagnosis, but it differs from most others because of the direct access that it gives parents to images of the fetus. A review of women's views of ultrasound was commissioned as part of a larger study of the clinical and economic aspects of routine antenatal ultrasound use. Studies of women's views about antenatal screening and diagnosis were searched for on electronic databases. Studies about pregnancy ultrasound were then identified from this material. Further studies were found by contacting researchers, hand searches, and following up references. The searches were not intentionally limited by date or language. Studies that reported direct data from women about pregnancy ultrasound were then included in a structured review. Studies were not excluded on the basis of methodological quality unless they were impossible to understand. They were read by one author and tabulated. The review then addressed a series of questions in a nonquantitative way. The structured review included 74 primary studies represented by 98 reports. Studies from 18 countries were included, and they employed methods ranging from qualitative interviewing to psychometric testing. The review included studies from the very early period of ultrasound use up to reports of research on contemporary practice. Ultrasound is very attractive to women and families. Women's early concerns about the safety of ultrasound were rarely reported in more recent research. Women often lack information about the purposes for which an ultrasound scan is being done and the technical limitations of the procedure. The strong appeal of diagnostic ultrasound use may contribute to the fact that pregnant women are often unprepared for adverse findings. Despite the highly varied study designs and contexts for the research included, this review provided useful information about women's views of pregnancy ultrasound. One key finding for clinicians was the need for all staff, women, and partners to be well informed about the specific purposes of ultrasound scans and what they can and cannot achieve.

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Author and article information

Journal

Journal ID (nlm-ta): BMC Public Health

Title: BMC Public Health

Publisher: BioMed Central (London )

ISSN (Electronic): 1471-2458

Publication date Collection: 2003

Publication date (Electronic): 20 May 2003

Volume: 3

Page: 17

Affiliations

[1 ]Fundación Mexicana para la Salud, Mexico City, Mexico

[2 ]Regional Office for Latin America and the Caribbean, The Population Council. Mexico City, Mexico

[3 ]Khon Kaen University, Khon Kaen, Thailand

[4 ]Centro Rosarino de Estudios Perinatales, Rosario / Centro de Estudios de Estado y Sociedad-CONICET, Buenos Aires, Argentina

[5 ]Hospital Gineco-Obstétrico 'América Arias', Havana, Havana, Cuba

[6 ]National Guard King Khalid Hospital, Jeddah, Saudi Arabia

[7 ]Special Programme of Research, Development and Research Training in Human Reproduction, World Health Organization, Geneva, Switzerland

[8 ]National Perinatal Epidemiology Unit, Oxford University, Oxford, England

[9 ]Ministry of Health, Riyadh, Saudi Arabia

[10 ]National Guard King Khalid Hospital, Jeddah, Saudi Arabia

[11 ]Centro Rosarino de Estudios Perinatales, Rosario, Argentina

[12 ]Hospital Gineco-Obstétrico 'América Arias', Havana, Havana, Cuba

[13 ]Khon Kaen University, Khon Kaen, Thailand

[14 ]Latin American Centre for Perinatology and Human Development, Montevideo, Uruguay

[15 ]Department of Obstetrics and Gynecology, Oslo, Norway, University of Bergen, Bergen, Norway

[16 ]Department of Obstetrics and Gynecology, University of Bergen, Bergen, Norway

[17 ]Department of Obstetrics and Gynecology, University Hospital, Uppsala, Sweden

Article

Publisher ID: 1471-2458-3-17

DOI: 10.1186/1471-2458-3-17

PMC ID: 166129

PubMed ID: 12756055

SO-VID: e5104702-9cce-4e6c-938f-7bb4889036d8

Copyright © Copyright © 2003 Nigenda et al; licensee BioMed Central Ltd. This is an Open Access article: verbatim copying and redistribution of this article are permitted in all media for any purpose, provided this notice is preserved along with the article's original URL.

History

Date received : 12 September 2002

Date accepted : 20 May 2003

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Womens' opinions on antenatal care in developing countries: results of a study in Cuba, Thailand, Saudi Arabia and Argentina

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Hogrefe: SDG 3 Good Health and Well-being

Most cited references 28

Medicine, rationality, and experience. An anthropological perspective

Fundamental elements of the quality of care: a simple framework.

Women's views of pregnancy ultrasound: a systematic review.

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