Qualitative study reveals incentives boost antenatal care demand among pregnant women, highlighting health system shortages that hinder service delivery.
Key Points
To explore pregnant women's, nurses', and community health workers' perceptions of an integrated intervention targeting both supply- and demand-side barriers to antenatal care and facility delivery.
Conducted 19 pre- and post-intervention focus group discussions with pregnant women, nurses, and community health workers in western Kenya.
Evaluated supply-side interventions (nurse training and supplies for obstetric emergencies and neonatal resuscitation) combined with demand-side incentives (text message reminders, group education, and vouchers).
Applied thematic analysis to qualitative transcripts to capture experiential barriers and facilitators to care.
Pregnant women reported that vouchers and text reminders increased motivation to attend clinic visits, despite facing poverty, transport hurdles, and poor treatment by staff.
Nurses observed that incentives effectively attracted women to facilities, but emphasized that high workloads, low compensation, understaffing, and equipment shortages impeded adequate care delivery.
Community health workers identified text messages as useful tools for health education while noting practical delivery limitations.