Community-Delivered Antenatal Care to Address Access Barriers: Perspectives of Women and Healthcare Workers
- 1Makerere University College of Health Sciences
Abstract
Stillbirth remains a major public health concern, particularly in resource-constrained settings. Barriers to timely, high-quality antenatal care may delay the recognition and management of pregnancy complications. We explored the perspectives of women, Village Health Team (VHT) members and healthcare workers on community-delivered approaches to improve pregnancy care, in particular prevention of stillbirth in Uganda.
An exploratory qualitative study was conducted at four referral hospitals in Uganda. Data were collected through focus group discussions, in-depth interviews, and key informants interviews with women, Village Health Team members and healthcare workers. Audio-recordings were transcribed verbatim and translated into English where required. Data were analysed thematically using an iteratively developed codebook and NVivo software.
In total, 56 participants took part, comprising women (n=27), Village Health Team members (n=11) and frontline healthcare workers (n=18). Participants highlighted the need for the adoption of simple and user-friendly wearable pregnancy monitoring tools for self-monitoring of early warning signs. Health education sessions focused on identifying early warning signs of pregnancy complications highlighted, emphasizing the importance of empowering women with information to seek care early through digital platforms. Limited follow-up support was also a critical concern, with the majority of the women advocating for better emotional and psychological care after a stillbirth, both at a facility and at home.
Participants viewed community-delivered antenatal care as an acceptable approach to reducing access barriers. Implementation would require trained personnel, quality-assured tools, clear referral pathways and integration with facility-based care. Structured communication and psychosocial support after stillbirth were also identified as priorities. These findings should inform co-design and prospective evaluation of community-delivered models.
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BibTeX
@misc{kabajaasi2026communitydelivered,
title = {{Community-Delivered Antenatal Care to Address Access Barriers: Perspectives of Women and Healthcare Workers}},
author = {O. Kabajaasi and W. N. Nansozi and A. Younger and J. Kiconco and S. Nankya and D. Lukakamwa and A. Kamwesigye and I. Bwaga and A. Odur and R. Mukisa-Bisoborwa and W. Ganzevoort and S. Gordijn and K. Klipstein-Grobusch and M. Rijken and J. Byamugisha and A. T. Papageorghiou and S. Ali},
howpublished = {medRxiv},
year = {2026},
month = sep,
doi = {10.64898/2026.09.23.26363848},
url = {https://www.medrxiv.org/content/10.64898/2026.09.23.26363848v1},
note = {CC BY},
}
RIS
TY - UNPB
TI - Community-Delivered Antenatal Care to Address Access Barriers: Perspectives of Women and Healthcare Workers
AU - O. Kabajaasi
AU - W. N. Nansozi
AU - A. Younger
AU - J. Kiconco
AU - S. Nankya
AU - D. Lukakamwa
AU - A. Kamwesigye
AU - I. Bwaga
AU - A. Odur
AU - R. Mukisa-Bisoborwa
AU - W. Ganzevoort
AU - S. Gordijn
AU - K. Klipstein-Grobusch
AU - M. Rijken
AU - J. Byamugisha
AU - A. T. Papageorghiou
AU - S. Ali
PY - 2026
DA - 2026/09/23
PB - medRxiv
DO - 10.64898/2026.09.23.26363848
UR - https://www.medrxiv.org/content/10.64898/2026.09.23.26363848v1
AB - Stillbirth remains a major public health concern, particularly in resource-constrained settings. Barriers to timely, high-quality antenatal care may delay the recognition and management of pregnancy complications. We explored the perspectives of women, Village Health Team (VHT) members and healthcare workers on community-delivered approaches to improve pregnancy care, in particular prevention of stillbirth in Uganda. An exploratory qualitative study was conducted at four referral hospitals in Uganda. Data were collected through focus group discussions, in-depth interviews, and key informants interviews with women, Village Health Team members and healthcare workers. Audio-recordings were transcribed verbatim and translated into English where required. Data were analysed thematically using an iteratively developed codebook and NVivo software. In total, 56 participants took part, comprising women (n=27), Village Health Team members (n=11) and frontline healthcare workers (n=18). Participants highlighted the need for the adoption of simple and user-friendly wearable pregnancy monitoring tools for self-monitoring of early warning signs. Health education sessions focused on identifying early warning signs of pregnancy complications highlighted, emphasizing the importance of empowering women with information to seek care early through digital platforms. Limited follow-up support was also a critical concern, with the majority of the women advocating for better emotional and psychological care after a stillbirth, both at a facility and at home. Participants viewed community-delivered antenatal care as an acceptable approach to reducing access barriers. Implementation would require trained personnel, quality-assured tools, clear referral pathways and integration with facility-based care. Structured communication and psychosocial support after stillbirth were also identified as priorities. These findings should inform co-design and prospective evaluation of community-delivered models.
ER -