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Peer-reviewedCC BY-NCJournal of multidisciplinary healthcare

Stakeholder Experiences of Community-Linked Group Antenatal Care in Rural Northern Uganda: A Qualitative Study.

  • Sean Steven Puleh1
  • Stella Immaculate Akech1
  • Nicholas Okunu2
  • Brenda Apio2
  • Harriet Anyinge2
  • Eustes Kigongo3
  • John Peter Awio4
  • Moses Ojok5
  • Patrick Buchan Ocen6
  • Gerald Rukundo7
7 affiliations
  1. 1Department of Epidemiology and Biostatistics, Faculty of Public Health, Lira University, Lira City, Uganda.
  2. 2Child Hug Uganda (CHU), Lira City, Uganda.
  3. 3Department of Health Policy and Planning, Faculty of Public Health, Lira University, Lira City, Uganda.
  4. 4Department of Surgery, Faculty of Medicine, Lira University, Lira City, Uganda.
  5. 5United Nations Entity for Gender Equality and Women's Empowerment, Kampala City, Uganda.
  6. 6Department of Health, Lira District Local Government, Lira District, Lira City, Uganda.
  7. 7National Malaria Control Division, Ministry of Health, Kampala City, Uganda.
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Abstract

Background

Group antenatal care (G-ANC) combines shared learning and peer support with antenatal services. Evidence on stakeholder experiences of community-linked models in post-conflict settings remains limited. This study explored the experiences of pregnant women, Village Health Team (VHT) members and facility midwives participating in or implementing G-ANC in Kole District, Northern Uganda.Methods

An exploratory qualitative study conducted in June 2024 included nine key-informant interviews with four VHT members and five facility midwives, and four focus-group discussions with 33 pregnant women. Audio-recorded data were transcribed and analysed using a combined deductive-inductive thematic approach supported by ATLAS.ti version 23.Results

Five themes concerned education and services, acceptability and perceived benefits, implementation and access challenges, cultural and gender influences and conditions for continuation. Participants valued shared discussion, peer reassurance, health information, and encouragement to attend care. VHT members described mobilization, education, and referral support, while midwives described clinical oversight and staffing pressures. Group-specific constraints included insufficient meeting space, materials, and facilitator capacity. Medicine shortages, provider absence, and transport difficulties affected the linked routine antenatal care pathway. Participants identified training, supervision, reliable clinical services, community engagement, and district integration as conditions for continuation.Conclusion

Participants perceived community-linked G-ANC as acceptable and supportive of learning, peer support and motivation to attend care. This study did not measure changes in knowledge, attendance or clinical outcomes, or demonstrate effectiveness or long-term sustainability. Implementation requires support for group facilitation alongside reliable facility-based antenatal services.

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Cite

BibTeXRIS
BibTeX
@article{puleh2026stakeholder,
  title = {{Stakeholder Experiences of Community-Linked Group Antenatal Care in Rural Northern Uganda: A Qualitative Study.}},
  author = {Sean Steven Puleh and Stella Immaculate Akech and Nicholas Okunu and Brenda Apio and Harriet Anyinge and Eustes Kigongo and John Peter Awio and Moses Ojok and Patrick Buchan Ocen and Gerald Rukundo},
  journal = {Journal of multidisciplinary healthcare},
  year = {2026},
  month = oct,
  doi = {10.2147/jmdh.s651789},
  url = {https://europepmc.org/article/MED/42928883},
  note = {CC BY-NC},
}
RIS
TY  - JOUR
TI  - Stakeholder Experiences of Community-Linked Group Antenatal Care in Rural Northern Uganda: A Qualitative Study.
AU  - Sean Steven Puleh
AU  - Stella Immaculate Akech
AU  - Nicholas Okunu
AU  - Brenda Apio
AU  - Harriet Anyinge
AU  - Eustes Kigongo
AU  - John Peter Awio
AU  - Moses Ojok
AU  - Patrick Buchan Ocen
AU  - Gerald Rukundo
PY  - 2026
DA  - 2026/10/21
JO  - Journal of multidisciplinary healthcare
DO  - 10.2147/jmdh.s651789
UR  - https://europepmc.org/article/MED/42928883
AB  - Background  Group antenatal care (G-ANC) combines shared learning and peer support with antenatal services. Evidence on stakeholder experiences of community-linked models in post-conflict settings remains limited. This study explored the experiences of pregnant women, Village Health Team (VHT) members and facility midwives participating in or implementing G-ANC in Kole District, Northern Uganda.Methods  An exploratory qualitative study conducted in June 2024 included nine key-informant interviews with four VHT members and five facility midwives, and four focus-group discussions with 33 pregnant women. Audio-recorded data were transcribed and analysed using a combined deductive-inductive thematic approach supported by ATLAS.ti version 23.Results  Five themes concerned education and services, acceptability and perceived benefits, implementation and access challenges, cultural and gender influences and conditions for continuation. Participants valued shared discussion, peer reassurance, health information, and encouragement to attend care. VHT members described mobilization, education, and referral support, while midwives described clinical oversight and staffing pressures. Group-specific constraints included insufficient meeting space, materials, and facilitator capacity. Medicine shortages, provider absence, and transport difficulties affected the linked routine antenatal care pathway. Participants identified training, supervision, reliable clinical services, community engagement, and district integration as conditions for continuation.Conclusion  Participants perceived community-linked G-ANC as acceptable and supportive of learning, peer support and motivation to attend care. This study did not measure changes in knowledge, attendance or clinical outcomes, or demonstrate effectiveness or long-term sustainability. Implementation requires support for group facilitation alongside reliable facility-based antenatal services.
SN  - 1178-2390
ER  -