A qualitative study to explore women’s perceptions of pregnancy and antenatal care in Chizenga village, Chikwawa, Malawi
- 1Faculty of Education, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
- 2Community Engagement and Bioethics Research Group, Malawi Liverpool Wellcome Research Programme, Blantyre, Malawi
Abstract
National survey data indicate that only around one quarter of women in Malawi attend their first antenatal care (ANC) visit during the first trimester. This study explores women’s perceptions of ANC in Chizenga village, Chikwawa, a rural setting with high maternal mortality and low ANC uptake. Using an interpretivist qualitative design, 14 pregnant women aged 18–44 years were recruited through purposive sampling. Semi-structured interviews were conducted in Chichewa, translated into English, and analysed using thematic analysis to identify patterns across the dataset and develop themes grounded in participants’ accounts. Findings indicate that while women valued ANC and recognised its role in reducing maternal and neonatal mortality, most initiated care after the first trimester. Key themes included understanding of pregnancy health and ANC, nutritional constraints despite awareness, gendered dynamics in ANC attendance, the perceived influence of witchcraft, experiences of respectful and disrespectful care, and structural barriers related to distance and transport. Socioeconomic 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, with some 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, including community-based health education, outreach antenatal services, and improved transport support, to ensure equitable access to respectful antenatal care.
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BibTeX
@article{layton2026qualitative,
title = {{A qualitative study to explore women’s perceptions of pregnancy and antenatal care in Chizenga village, Chikwawa, Malawi}},
author = {Helen Layton and Deborah Nyirenda and Terry Kana},
journal = {PLOS Global Public Health},
year = {2026},
month = sep,
doi = {10.1371/journal.pgph.0005515},
url = {https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0005515},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - A qualitative study to explore women’s perceptions of pregnancy and antenatal care in Chizenga village, Chikwawa, Malawi
AU - Helen Layton
AU - Deborah Nyirenda
AU - Terry Kana
PY - 2026
DA - 2026/09/25
JO - PLOS Global Public Health
DO - 10.1371/journal.pgph.0005515
UR - https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0005515
AB - National survey data indicate that only around one quarter of women in Malawi attend their first antenatal care (ANC) visit during the first trimester. This study explores women’s perceptions of ANC in Chizenga village, Chikwawa, a rural setting with high maternal mortality and low ANC uptake. Using an interpretivist qualitative design, 14 pregnant women aged 18–44 years were recruited through purposive sampling. Semi-structured interviews were conducted in Chichewa, translated into English, and analysed using thematic analysis to identify patterns across the dataset and develop themes grounded in participants’ accounts. Findings indicate that while women valued ANC and recognised its role in reducing maternal and neonatal mortality, most initiated care after the first trimester. Key themes included understanding of pregnancy health and ANC, nutritional constraints despite awareness, gendered dynamics in ANC attendance, the perceived influence of witchcraft, experiences of respectful and disrespectful care, and structural barriers related to distance and transport. Socioeconomic 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, with some 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, including community-based health education, outreach antenatal services, and improved transport support, to ensure equitable access to respectful antenatal care.
SN - 2767-3375
ER -