Research article

Womens' opinions on antenatal care in developing countries: results of a study in Cuba, Thailand, Saudi Arabia and Argentina

Gustavo Nigenda¹ , Ana Langer² , Chusri Kuchaisit³ , Mariana Romero⁴ , Georgina Rojas⁵ , Muneera Al-Osimy⁶ , José Villar⁷ , Jo Garcia⁸ , Yagob Al-Mazrou⁹ , Hassan Ba'aqeel¹⁰ , Guillermo Carroli¹¹ , Ubaldo Farnot¹² , Pisake Lumbiganon¹³ , José Belizán¹⁴ , Per Bergsjo¹⁵ , Leiv Bakketeig¹⁶ and Gunilla Lindmark¹⁷

¹Fundación Mexicana para la Salud, Mexico City, Mexico

²Regional Office for Latin America and the Caribbean, The Population Council. Mexico City, Mexico

³Khon Kaen University, Khon Kaen, Thailand

⁴Centro Rosarino de Estudios Perinatales, Rosario / Centro de Estudios de Estado y Sociedad-CONICET, Buenos Aires, Argentina

⁵Hospital Gineco-Obstétrico 'América Arias', Havana, Havana, Cuba

⁶National Guard King Khalid Hospital, Jeddah, Saudi Arabia

⁷Special Programme of Research, Development and Research Training in Human Reproduction, World Health Organization, Geneva, Switzerland

⁸National Perinatal Epidemiology Unit, Oxford University, Oxford, England

⁹Ministry of Health, Riyadh, Saudi Arabia

¹⁰National Guard King Khalid Hospital, Jeddah, Saudi Arabia

¹¹Centro Rosarino de Estudios Perinatales, Rosario, Argentina

¹²Hospital Gineco-Obstétrico 'América Arias', Havana, Havana, Cuba

¹³Khon Kaen University, Khon Kaen, Thailand

¹⁴Latin American Centre for Perinatology and Human Development, Montevideo, Uruguay

¹⁵Department of Obstetrics and Gynecology, Oslo, Norway, University of Bergen, Bergen, Norway

¹⁶Department of Obstetrics and Gynecology, University of Bergen, Bergen, Norway

¹⁷Department of Obstetrics and Gynecology, University Hospital, Uppsala, Sweden

author email corresponding author email

BMC Public Health 2003, 3:17doi:10.1186/1471-2458-3-17

Published:	20 May 2003

Abstract

Background

The results of a qualitative study carried out in four developing countries (Cuba, Thailand, Saudi Arabia and Argentina) are presented. The study was conducted in the context of a randomised controlled trial to test the benefits of a new antenatal care protocol that reduced the number of visits to the doctor, rationalised the application of technology, and improved the provision of information to women in relation to the traditional protocol applied in each country.

Methods

Through focus groups discussions we were able to assess the concepts and expectations underlying women's evaluation of concepts and experiences of the care received in antenatal care clinics. 164 women participated in 24 focus groups discussion in all countries.

Results

Three areas are particularly addressed in this paper: a) concepts about pregnancy and health care, b) experience with health services and health providers, and c) opinions about the modified Antenatal Care (ANC) programme. In all three topics similarities were identified as well as particular opinions related to country specific social and cultural values. In general women have a positive view of the new ANC protocol, particularly regarding the information they receive. However, controversial issues emerged such as the reduction in the number of visits, particularly in Cuba where women are used to have 18 ANC visits in one pregnancy period.

Conclusion

Recommendations to improve ANC services performance are being proposed. Any country interested in the application of a new ANC protocol should regard the opinion and acceptability of women towards changes.