|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 People’s Democratic Republic
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, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao People’s Democratic Republic
5Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
IJWHR 2020; 8: 276-284
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Keywords : Positive deviance, Lao women, ANC visits, Influencing factors
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Objectives: Optimal antenatal care (ANC) visits help improve health outcomes and decrease perinatal mortality 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 who did make sufficient visits for ANC in rural Lao in order to inform the design of more effective interventions to change the behavior of mothers who do not make such visits.
Materials and Methods: A qualitative study was conducted using semi-structured interviews with mothers who made four or more ANC visits during their last pregnancy in rural Lao. Manual analysis was used for open and thematic coding of the interview data.
Results: All mothers reported taking special care of themselves during pregnancy. They perceived the clear benefits of ANC visits regarding reassuring them of their health and reducing the 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. In addition, friends and neighbors were an important source of information for mothers. The quality of ANC provision and the provision of incentives such as an information booklet, along with soap and mosquito net were directly influencing factors in increasing ANC visits.
Conclusions: In general, feeling a need for taking special care during pregnancy was a common factor among pregnant women who did use ANC in rural Laos. Accordingly, improving the quality of ANC and increasing appreciation in communities regarding the need for good ANC are strongly recommended to increase attendance by all mothers.
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