A qualitative study to explore women's perceptions of pregnancy and antenatal care in Chizenga village, Chikwawa, Malawi

Malawi’s Demographic and Health Survey (2015–2016) reports that only 24% of women attended their first antenatal care (ANC) visit in the first trimester [1]. This study explores women's perceptions of ANC in Chizenga village, Chikwawa, a rural setting with high maternal mortality and low ANC uptake. Using a qualitative interpretivist approach, 14 pregnant women aged 19 to 40 years were interviewed to understand their knowledge of ANC and the barriers they face. Findings show that while women value ANC and recognise its role in reducing maternal and neonatal mortality, most initiated care after the first trimester. Socio-economic constraints—particularly distance, transport costs, and limited health literacy—contributed to delayed ANC attendance. Nevertheless, women demonstrated resilience and a strong commitment to maternal health, walking over 22 kilometres to access services. Participants voiced a need for increased ANC education and proposed community-based solutions such as health worker outreach and improved access to services. The study calls for context-sensitive policy interventions to ensure equitable access to respectful ANC for all women, regardless of socio-economic or marital status.