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
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 |