An Analysis of Factors Contributing to Late Focused Antenatal Clinic (FANC) Booking for Pregnant Women Attending Hartcliffe Polyclinic in Harare, Zimbabwe

Introduction: Expectant mothers are recommended and encouraged to book for focused antenatal care on or before the 12th week of pregnancy or within the first trimester to prevent or manage pregnancy-associated challenges. Booking late is when a pregnant woman reports for focused antenatal care for the first time after the first trimester. Focused antennal care is an individualized and quality care provided to pregnant woman for good outcomes. Antenatal care registers at Hartcliffe Polyclinic indicated that the majority of pregnant women were booking late for antenatal care which means they booked after the first trimester against the recommendations. Booking late in pregnancy suggests missed antenatal care as the woman is unlikely to have the recommended visits required of that pregnancy. Without focused antenatal care, the wellbeing of the mother and in-utero child may be potentially to be negatively impacted. This study aims to establish the major factors that lead to late booking for focused antenatal care. Unmasking these factors may be an important precursor-step which may provide insight and trigger thoughts around mitigating strategies, which potentially will promote early booking for focused antenatal care services.

Methods: Fifty pregnant women, who had booked late for focused antenatal care, were randomly selected to participate in the study. Questionnaires were used to collect data from the participants and quantitative methods were used for data analysis.

Results: The majority of the pregnant women were not aware of the correct time of booking for focused antenatal care and were not aware of the recommended number of clinic visits per pregnancy. The major factors suggested to lead to late-booking were financial challenges, attitude of health personnel, quality of health service, further to cultural and religious beliefs.

Conclusion: Lack of knowledge, age, level of education, marital status, parity, financial difficulties, bad attitude and some cultural beliefs were noted to be the main drivers of late booking. It is envisaged that in future, if these main factors are addressed, potentially an increase in pregnant women registering early for FANC may proportionally be achieved.