Socio-cultural and health system factors influencing late booking among pregnant women: Case of selected health care facilities in Temeke Municipality

Abstract

The study examined the socio-cultural and health system factors influencing late booking of antenatal care among pregnant women in Temeke District. Guided by the Health Belief Model, the study used qualitative techniques of data collection. Open-ended semistructured interviews were used and a hospital-based crosssectional study design applied. The findings revealed various sociocultural and health system factors influencing late booking among pregnant women. Poor knowledge on when to first book for antenatal care, poor knowledge on the importance of early booking, past experience of their pregnancy, unfriendly provider-patient relationship and shortage of staff. Other factors include beliefs and fear of being bewitched during the early stages of pregnancy made women book late, the belief that they are not at high risk of getting pregnant related complications as well as family and economic activities attribute to late booking. The timing of antenatal care service, though believed to be the best practice for positive pregnancy, is challenging for most women due to various socioeconomic and systemic factors. The age for the first booking of antenatal care was 15.5 weeks, which is late according to the WHO recommended time of first booking within the first 12 weeks of the gestational age. The study recommends for more educational initiatives which will liberate the public especially women from ignorance and misconceptions related to pregnancy complications as well as poor socio-economic beliefs.