Why Do Women Not Use Antenatal Services in Low- and Middle-Income Countries? A Meta-Synthesis of Qualitative Studies

In a synthesis of 21 qualitative studies representing the views of more than 1,230 women from 15 countries, Kenneth Finlayson and Soo Downe examine the reasons why many women in low- and middle-income countries do not receive adequate antenatal care.

[1]  Grace Bantebya Kyomuhendo,et al.  Low Use of Rural Maternity Services in Uganda: Impact of Women's Status, Traditional Beliefs and Limited Resources , 2003, Reproductive health matters.

[2]  The Worth of Women's Work: A Qualitative Synthesis , 1988 .

[3]  Nick Tilley,et al.  Caring Communities, Paradigm Polemics, Design Debates , 1998 .

[4]  C. Pope,et al.  Using meta ethnography to synthesise qualitative research: a worked example , 2002, Journal of health services research & policy.

[5]  D. Maine,et al.  Too far to walk: maternal mortality in context. , 1991, Social science & medicine.

[6]  P. Simkhada,et al.  Factors affecting the utilization of antenatal care in developing countries: systematic review of the literature. , 2008, Journal of advanced nursing.

[7]  C. Ronsmans,et al.  Maternal mortality: who, when, where, and why , 2006, The Lancet.

[8]  R. Pumfrey,et al.  US agency for international development , 1997 .

[9]  M Sandelowski,et al.  Qualitative Metasynthesis : Issues and Techniques , 1997 .

[10]  L. Atuyambe,et al.  Seeking safety and empathy: adolescent health seeking behavior during pregnancy and early motherhood in central Uganda. , 2009, Journal of adolescence.

[11]  C. Ronsmans,et al.  Huge poor-rich inequalities in maternity care: an international comparative study of maternity and child care in developing countries. , 2007, Bulletin of the World Health Organization.

[12]  I. Adam,et al.  Use of antenatal care services in Kassala, eastern Sudan , 2010, BMC pregnancy and childbirth.

[13]  E. Guba,et al.  Naturalistic inquiry: Beverly Hills, CA: Sage Publications, 1985, 416 pp., $25.00 (Cloth) , 1985 .

[14]  T. Greenhalgh,et al.  Realist review - a new method of systematic review designed for complex policy interventions , 2005, Journal of health services research & policy.

[15]  M. Tanner,et al.  The use of antenatal and postnatal care: perspectives and experiences of women and health care providers in rural southern Tanzania , 2009, BMC pregnancy and childbirth.

[16]  Kelley Oj.  Agency for International Development. , 1973 .

[17]  M. Dibley,et al.  Why don't some women attend antenatal and postnatal care services?: a qualitative study of community members' perspectives in Garut, Sukabumi and Ciamis districts of West Java Province, Indonesia , 2010, BMC pregnancy and childbirth.

[18]  I. Bygbjerg,et al.  Women's experiences and views about costs of seeking malaria chemoprevention and other antenatal services: a qualitative study from two districts in rural Tanzania , 2010, Malaria Journal.

[19]  Cemach.  Saving mothers' lives: reviewing maternal deaths to make motherhood safer - 2003-2005 , 2007 .

[20]  M. Mugford,et al.  WHO antenatal care randomised trial for the evaluation of a new model of routine antenatal care , 2001, The Lancet.

[21]  Fhumulani Mavis Mulaudzi,et al.  Indigenous beliefs and practices that influence the delayed attendance of antenatal clinics by women in the Bohlabelo district in Limpopo, South Africa. , 2012, Midwifery.

[22]  Contributions from M. Walpole.  The Millennium Development Goals Report , 2008 .

[23]  Catherine Pope,et al.  Patients' help-seeking experiences and delay in cancer presentation: a qualitative synthesis , 2005, The Lancet.

[24]  V. Filippi,et al.  Giving birth in maternity hospitals in Benin: Testimonies of women , 2001, Reproductive health matters.

[25]  N. Abrahams,et al.  Health care-seeking practices of pregnant women and the role of the midwife in Cape Town, South Africa. , 2001, Journal of midwifery & women's health.

[26]  M. Greeff,et al.  Health-service utilization by pregnant women in the greater Mafikeng-Mmabatho district. , 2004, Curationis.

[27]  J. Skinner,et al.  Design and evaluation of a community participatory, birth preparedness project in Cambodia. , 2009, Midwifery.

[28]  Catherine Pope,et al.  Resisting medicines: a synthesis of qualitative studies of medicine taking. , 2005, Social science & medicine.

[29]  Mohsen Naghavi,et al.  Maternal Mortality for 181 Countries, 1980−2008: A Systematic Analysis of Progress Toward Millennium Development Goal 5 , 2011 .

[30]  S. Owens,et al.  The right to remain silent: a qualitative study of the medical and social ramifications of pregnancy disclosure for Gambian women , 2008, BJOG : an international journal of obstetrics and gynaecology.

[31]  Rachel R Chapman.  Endangering safe motherhood in Mozambique: prenatal care as pregnancy risk. , 2003, Social science & medicine.

[32]  Louise A. Jensen,et al.  Meta-Synthesis of Qualitative Findings , 1996 .

[33]  J. Pandian,et al.  Poverty and stroke in India: a time to act. , 2007, Stroke.

[34]  O. Campbell,et al.  Strategies for reducing maternal mortality: getting on with what works , 2006, The Lancet.

[35]  R. Stephenson,et al.  UNDERSTANDING USERS’ PERSPECTIVES OF BARRIERS TO MATERNAL HEALTH CARE USE IN MAHARASHTRA, INDIA , 2001, Journal of Biosocial Science.

[36]  E. Brazier,et al.  Out-of-pocket costs for facility-based maternity care in three African countries. , 2009, Health policy and planning.

[37]  H. Aiga,et al.  Perceived barriers to utilization of maternal health services in rural Cambodia. , 2010, Health policy.

[38]  J. Villar,et al.  How effective is antenatal care in preventing maternal mortality and serious morbidity? An overview of the evidence. , 2001, Paediatric and perinatal epidemiology.

[39]  S. Downe,et al.  Meta-synthesis method for qualitative research: a literature review. , 2005, Journal of advanced nursing.

[40]  A. Castro,et al.  Hidden costs: the direct and indirect impact of user fees on access to malaria treatment and primary care in Mali. , 2012, Social science & medicine.

[41]  Z. Iliyasu,et al.  Determinants of utilization of antenatal care services in Kumbotso village, Northern Nigeria , 2005, Tropical doctor.

[42]  Janet Harris.  Supplementary Guidance for Inclusion of Qualitative Research in Cochrane Systematic Reviews of Interventions , 2011 .

[43]  G. Noblit,et al.  Meta-Ethnography: Synthesizing Qualitative Studies , 1988 .

[44]  J. Villar,et al.  WHO antenatal care randomized trial: Manual for the implementation of the new model. , 2002 .

[45]  M. Olinto,et al.  Inadequate use of prenatal services among Brazilian women: the role of maternal characteristics. , 2009, International perspectives on sexual and reproductive health.

[46]  Karen Ritchie,et al.  A guide to synthesising qualitative research for researchers undertaking health technology assessments and systematic reviews , 2011 .

[47]  M. Dibley,et al.  Determinants of antenatal care utilization in three rural areas of Vietnam. , 2007, Public health nursing.

[48]  S. Salway,et al.  Gender, pregnancy and the uptake of antenatal care services in Pakistan. , 2007, Sociology of health & illness.

[49]  S Downe,et al.  ‘Weighing up and balancing out’: a meta‐synthesis of barriers to antenatal care for marginalised women in high‐income countries , 2009, BJOG : an international journal of obstetrics and gynaecology.

[50]  Lalit Dandona,et al.  India's Janani Suraksha Yojana, a conditional cash transfer programme to increase births in health facilities: an impact evaluation , 2010, The Lancet.

[51]  N. Choudhury,et al.  Maternal care practices among the ultra poor households in rural Bangladesh: a qualitative exploratory study , 2011, BMC pregnancy and childbirth.

[52]  O. Pryds,et al.  Antenatal magnesium sulphate may prevent cerebral palsy in preterm infants—but are we convinced? Evaluation of an apparently conclusive meta‐analysis with trial sequential analysis , 2011, BJOG : an international journal of obstetrics and gynaecology.

[53]  Jo Garcia,et al.  Social class, ethnicity and attendance for antenatal care in the United Kingdom: a systematic review. , 2003, Journal of public health medicine.

[54]  T. Ravindran.  Universal access: making health systems work for women , 2012, BMC Public Health.

[55]  P. Magnussen,et al.  The use of formal and informal services for antenatal care and malaria treatment in rural Uganda. , 1998, Health policy and planning.

[56]  B. Simkhada,et al.  The role of mothers-in-law in antenatal care decision-making in Nepal: a qualitative study , 2010, BMC pregnancy and childbirth.

[57]  Gilda Piaggio,et al.  Alternative versus standard packages of antenatal care for low-risk pregnancy. , 2015, The Cochrane database of systematic reviews.

[58]  M. Shediac-Rizkallah,et al.  Women's experiences of maternity care: satisfaction or passivity? , 2000, Social science & medicine.

[59]  Alan D. Lopez,et al.  Maternal mortality for 181 countries, 1980–2008: a systematic analysis of progress towards Millennium Development Goal 5 , 2010, The Lancet.

[60]  A. Costello,et al.  Effect of a participatory intervention with women's groups on birth outcomes in Nepal: cluster-randomised controlled trial , 2004, The Lancet.

[61]  L. Myer,et al.  Why do women seek antenatal care late? Perspectives from rural South Africa. , 2003, Journal of midwifery & women's health.

[62]  K. Khan,et al.  Antenatal care and perinatal outcomes in Kwale district, Kenya , 2008, BMC pregnancy and childbirth.

[63]  D. Peters,et al.  Exploring new health markets: experiences from informal providers of transport for maternal health services in Eastern Uganda , 2011, BMC international health and human rights.

[64]  S. Downe,et al.  Expert intrapartum maternity care: a meta-synthesis. , 2007, Journal of advanced nursing.

[65]  F. Nuwaha,et al.  Factors influencing choice of delivery sites in Rakai district of Uganda. , 2000, Social science & medicine.

[66]  E. Mills,et al.  History, principles, and practice of health and human rights , 2007, The Lancet.

[67]  G. Thomson,et al.  A public health perspective of women's experiences of antenatal care: an exploration of insights from a community consultation. , 2013, Midwifery.

[68]  Margarete Sandelowski,et al.  "Meta-Jeopardy": the crisis of representation in qualitative metasynthesis. , 2006, Nursing outlook.

[69]  Mary Dixon-Woods,et al.  Synthesising qualitative and quantitative evidence: a review of possible methods. , 2005, Journal of health services research & policy.

[70]  Namino Glantz,et al.  Risk screening, emergency care, and lay concepts of complications during pregnancy in Chiapas, Mexico. , 2008, Social science & medicine.

[71]  J. Neilson,et al.  Saving Mothers’ Lives: Reviewing maternal deaths to make motherhood safer: 2006–2008 , 2011, BJOG : an international journal of obstetrics and gynaecology.

[72]  K. Abawi.  Standards for maternal and neonatal care , 2013 .