Facilitators and Barriers to Healthcare Seeking Behaviour and Antenatal Care Visits Among Pregnant Adolescents in Brunei Darussalam: A Qualitative Study Based on Maternity Health Care Professionals’ Perspectives

Abstract IntroductionPregnant adolescents, a significant public health concern, are categorised as high-risk due to various associated challenges. In Brunei Darussalam, this issue is particularly pressing, affecting pregnancies with complications such as severe anaemia. A concerning trend observed is the reduced frequency of antenatal care visits among these pregnant adolescents compared to adult pregnant women, highlighting a gap in healthcare utilisation. This study aimed to identify the facilitators and barriers of healthcare-seeking Behaviours (HSB) and Ante Natal Care (ANC) visits among pregnant adolescents in Brunei, framed by the Socio-Ecological Model (SEM), offering a unique perspective from maternal health professionals.MethodThis study involved thirty-five maternal healthcare professionals (MHCPs) from Brunei's Maternal and Child Health Clinics (MCHCs), including doctors and midwives, with one-year minimum of working experience. They were selected using purposive sampling. We conducted semi-structured, in-depth interviews to collect detailed insights into their experiences and viewpoints. Data analysis utilised thematic analysis within the framework of the Socio-ecological Model, enabling a comprehensive understanding of the multi-level influences on pregnant adolescents' healthcare-seeking Behaviours.ResultThe results of this study reveal four themes influencing HSB and ANC among pregnant adolescents in Brunei based on MHCPs perspective: individual factors, family factors, community and social factors, and government factors. At the individual level, factors like marital status, knowledge, physical and emotional pregnancy experiences, transportation, financial status, and self-motivation play a role. Family dynamics, including support, motivation, education, and emotional status, are critical at the interpersonal layer. Community and social influences involve societal support, stigmatisation, and Islamic values. Lastly, governmental factors, such as delays in marriage certification and lack of affordable transportation, also significantly impact HSB and ANC visits.ConclusionThe study concludes that pregnancy-related complaints were a primary motivator for pregnant adolescents in Brunei to seek healthcare and visit ANC clinic. Conversely, barriers such as transportation issues and the status of being unmarried or awaiting marriage notably hinder access to care. MHCPs stressed a crucial need for enhanced support systems, especially from maternity healthcare providers, to improve health outcomes and facilitate early clinic visits. Furthermore, the government should ensure accessible and adequate transportation for regular antenatal visits. These measures are vital for addressing the unique challenges faced by pregnant adolescents in accessing timely and appropriate healthcare services.