Access to antenatal care in East Africa: An examination of factors influencing antenatal care attendance in Kanungu District, Uganda

Abstract

Despite its potential to reduce maternal mortality globally, antenatal care (ANC) remains difficult to access for many women. This thesis examined ANC attendance in East Africa. First, a scoping review explored ANC research in East Africa. A total of 211 articles were analysed. Interrelated physical and social factors influenced seeking, reaching, and receiving ANC. Second, a mixed-methods study examined ANC attendance among Indigenous and non-Indigenous women in Uganda. Data included local hospital records (n=2,299 records), and interviews and focus group discussions with Indigenous (n=60) and non-Indigenous (n=20) women, and healthcare workers (n=10). Only 7.4% of patients attended the recommended minimum four visits, and distance to the hospital significantly lowered the odds of attending all four visits. Qualitative results indicated that long distances to health centres, high costs of ANC, lack of power in household decision-making, and poor interactions with healthcare providers influenced ANC attendance for both Indigenous and non-Indigenous women.