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Table 2 Reasons why one antenatal care visit with a skilled provider seemed more common than four ANC visits among women in remote and poorest districts of Zambia

From: Why do rural women in the most remote and poorest areas of Zambia predominantly attend only one antenatal care visit with a skilled provider? A qualitative inquiry

Theme Sub-Themes
Mothers Community Health volunteers Healthcare Provider
1. Factors that affect timing of the first ANC appointment • Uncertainty in the timing of ANC initiation
• Lack of transport
• Waiting for elderly women to confirm pregnancy • Waiting for elderly women to confirm pregnancy
2. Factors that affect failure to return for subsequent appointments • Unavailability/Low quality services at health posts closest to women
 º Inadequate supplies at the health facilities
 º Inadequate health personnel
• Lack of awareness and education about the services
• Low quality services at health posts • Unavailable and Poor-quality services in the health posts
• Inadequate supplies
• Unavailable/Inadequate skilled health care providers
3. Factors that affect both timing of the first ANC appointment and return for subsequent appointments • Livelihoods as a priority
Nomadic lifestylesBusy schedules with house chores house chores
• Long distances to the health facilities
• Denied subsequent care for ANC
• Nomadic lifestyles
• Long distances to the health facilities
• Nomadic lifestyles
• Seasonal migration to places where they might be no health centres
• Lack of transport
• Lack of money for transport
4. Opportunities for the intervention to modify factors affecting timing of the first ANC appointment and failure to return for subsequent appointments. Assessment of Health Status
 • To confirm if really pregnant
 • Check the health of the unborn baby
 • Need to get tested for HIV
 • Need to receive medication such as IPTp
 • Protection for the unborn baby
• To obtain ANC cards
• Financial charges imposed on women for late booking
Assessment of Health Status
 º To check the health of the mother and their unborn baby
• To obtain ANC cards
• Incentives provided by NGO
Assessment of Health Status
 º To confirm if really pregnant
• Access for services such as mosquito nets, folic acid and test for HIBV
• Incentives provided by NGO