Understanding women’s perceptions of, and engagement with, antenatal care in rural Kenya
Hannah Griffin, a 4th year medical student, shares how her research led to change in practice at a community clinic in Kenya.
Hannah Griffin, a 4th year medical student at Leeds who studied iBSc International Health with us in 2022/23, reflects on her time conducting research in Kenya. This work was conducted as part of her research project module.
Kenya’s maternal health services are free, but maternal mortality is high
In Kenya more than 6000 maternal deaths occur each year. Antenatal care (ANC) is the key entry point for contact with health professionals who can also offer phycological and social support to women. According to the Ministry of Health of Kenya, in June 2013 maternal health services were made free for all but Kenya’s maternal mortality ratio remained high.
My project aimed to understand influences on women’s perceptions of ANC and how perceptions affect their engagement with Antenatal care services. To answer this, I conducted interviews with 11 women in a rural area of Kenya to gain insights into their experiences.
Three Key Findings:
- A need to better communicate the function of ANC for local women
Currently, education and service provision for all ANC is held at the local clinic. Participants were often unsure about the best time to seek ANC or aware that they could seek preventative care from their ANC providers. - Unpacking decisions at the local level
Sociocultural and institutional factors played a role in decisions to seek support from ANC. Husbands and family members often influenced decisions and the church was highlighted as key to building trust between health services and the local community. - Improving access to ANC
Financial and geographical barriers to ANC have been identified in much of the wider literature on this topic, however these barriers are often difficult to address. Social influences and perceptions in this research gave insight from the women themselves on how attitudes may be adapted, and education increased. Women expressed a desire for independence in decision making which must also be recognised and held in balance with peer and family involvement. By utilising local churches, amongst other community gatherings, to provide education programmes, women may be empowered and supported in their use of ANC.
This insight has been shared with the healthcare workers in the clinic where I conducted the research who currently run an education programme located at the clinic.
Taking my research forward:
I have arranged to go back to Kenya for my elective next July.
We discussed the possible relocation of the education programme to take place within the local communities as a result of my research. I am hoping to go back to the ANC clinic and help with the education programme. I would love to be able to see if any of the recommendations as a result of my research have begun to be implemented. I formed a strong connection with the members of the community health team, so I am really looking forward to a seeing them again as friends as well as colleagues.
I felt very privileged to have had my first experience with research in such a knowledgeable and welcoming team
I was initially anxious about conducting interviews in Swahili and working with a translator; however, this hugely enabled me. Conducting interviews with a local translator seemed to lessen the disparity between myself as a foreign researcher and the participants. Participants seemed to relaxed when they could speak in their own language and voice their concerns through someone who understood their local context. I have realised how essential it is to work alongside local stakeholders in order to conduct good quality research.
Adapting to the Kenyan culture I was emersed in took some adjustment. I greatly benefitted from having a few days to orientate myself. Understanding the context I was working in greatly enhanced my experience conducting interviews as I was able to connect more with the participants. Using the local transport, food shopping in the markets, and learning some Swahili phrases allowed me to acclimatise.
I would highly recommend doing primary research overseas
Being immersed in a new culture and experiencing how health care systems work abroad is an experience you will carry with you for the rest of your life. It gives you a much better perspective. It has really inspired me in my future practice as a doctor. I hope to work overseas at some point in my career and be involved in research or public health as well as practicing as a clinician.
About the author
Hannah Griffin is a 4th year medical student at the University of Leeds. She obtained her intercalated Bachelor of Science degree from The Nuffield Centre in 2023.
- This blog has been edited by Dr Nichola Jones and Dr Francis Poitier
