Health Workers' Perspectives on Antenatal Care and the Efficacy of a Community-Based Strategy in Augmenting ANC Follow-Up Contacts in Nyamira County, Kenya

Abstract

BACKGROUND Globally, ensuring proper care for pregnant women is vital. In Nyamira County, Kenya, we explored how well community-based methods and clear health messages boost the number of check-ups pregnant women attend. This study explores health workers' perspectives on ANC and assesses the efficacy of a community-based approach in enhancing focused ANC follow-up contacts. MATERIALS AND METHODS Using a mixed-method approach (explanatory sequential study design and quasi-experimental), we employed purposive sampling for key informants and a census for expectant women. Eighteen key informant interviews were conducted, and quantitative data were collected through researcher-administered questionnaires. ANC booklets and registers were analyzed for contact completion. Thematic analysis was applied to qualitative data. Statistical analysis included the chi-square test for independence, odds ratios, and 95% confidence intervals. RESULTS Healthcare providers emphasized the preference for initial ANC attendance and identified gaps in uptake due to ignorance. Primigravida showed higher motivation for scheduled ANC visits. Health education significantly improved compliance with recommended ANC contacts. Initially, no significant difference existed between study sites (p-value 0.065; OR 1.72, 95% CI: 0.963 to 3.076). After the intervention, a substantial difference emerged (P-value <0.001). The intervention group was 4.2 times more likely to complete recommended ANC contacts than the control group (OR: 4.1881; 95% CI: 2.274 to 7.69). CONCLUSION Enhancing ANC contacts involves providing health education through established channels, such as Community Health Volunteers (CHVs), and conducting community-level sensitization and advocacy. RECOMMENDATIONS The county government of Nyamira is advised to adopt a packaged health messages tool to reinforce compliance with recommended ANC contacts.