|Why Do Some Lao Mothers Have Good Practices During Pregnancy? A Qualitative Positive Deviance Study|
|Sysavanh Phommachanh1, Dirk R. Essink2, E. Pamela Wright3, Mayfong Mayxay1,4,5, Jacqueline E.W. Broerse2|
|1Institute of Research and Education Development, University of Health Sciences, Ministry of Health, Vientiane, Lao PDR
2Vrije Universiteit Amsterdam, Athena Institute and Amsterdam Public Health Institute, Amsterdam, The Netherlands
3Guelph International Health Consulting, Amsterdam, The Netherlands
4Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR
5Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom
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Keywords : ANC visits, Influencing factors, Lao women ,Positive deviance
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Objectives: Optimal ANC visits help to improve health outcomes and decrease perinatal mortality and but they are often not optimal in low and middle-income countries; e.g. few mothers attend the recommended four or more ANC visits. The aim of this study was to identify determinants that influenced mothers in rural Laos who did make sufficient visits for ANC, to inform the design of more effective interventions to change behavior of mothers who do not.
Materials and Methods: A qualitative study was conducted using semi-structured interviews with mothers in rural Laos who had made four or more ANC visits during their last pregnancy. Manual analysis used open and thematic coding of the interview data.
Results: All of the mothers reported taking special care of themselves during pregnancy. They perceived clear benefits of ANC visits in giving them reassurance and reducing risk of negative events. Family members, particularly husbands, played a key role in making decisions to seek more ANC when they were aware of its benefits. Friends and neighbors were an important source of information for mothers. The quality of ANC provision and provision of incentives, such as an information booklet, soap and mosquito net, were directly influencing factors in increasing ANC visits.
Conclusion: Feeling a need for taking special care during pregnancy was a common factor among pregnant women in rural Laos who did use ANC. To increase attendance by all mothers, both improving the quality of ANC and increasing appreciation in communities of the need for good ANC are strongly recommended.
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