Knowledge and perceptions of antenatal services need and delivery and reasons for seeking such services among women in Tanzania: Implications for utilization and coverage of intermittent presumptive treatment of malaria in pregnancy in two districts

Abstract

Background: Learning from a volume of the literature that lacks information regarding people’s  opportunity to access health services for disease control, a study was conducted to assess knowledge, perceptions of antenatal care (ANC) services and actually delivered services and reasons for seeking ANC including intermittent presumptive treatment during pregnancy (IPTp) against malaria in Mkuranga and Mufindi districts, Tanzania.

Methodology: Quantitative and qualitative techniques were employed, involving interviews with ANC clients, informal communications with health care workers, focus group discussions with mothers of young children, and intertemporal observations. Data were collected for six months in 2006. Results: ANC seeking was mainly influenced by motivation for one’s safe pregnancy and childbirth and not necessarily and specifically seeking IPTp. The main barriers reported to hinder pregnant women effectively utilize ANC include socio-cultural values stigmatizing and discriminating women during  pregnancy, service providers’ unfriendly attitudes towards clients, shortages of drugs and other essential service supplies, existence of user-fees in health facilities, and pregnant women’s unawareness of essential ANC services needed or actually delivered at ANC clinics.

Conclusion: While client demand for services depends on volume, cost/price and quality of services supplied, lack of knowledge of what one deserves also influences one’s care seeking behavior. Therefore, it is imperative to do periodic  evaluations of population knowledge, perceptions of the introduced policy, and service delivery programs if the health care system  is to be made more effective by providing a room for corrective actions.

Key words: antenatal care, malaria, pregnancy, maternal health, intermittent preventive treatment