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Barriers and facilitators related to use of prenatal care by inner-city women: perceptions of health care providers
BACKGROUND: Socioeconomic disparities in the use of prenatal care (PNC) exist even where care is universally available and publicly funded. Few studies have sought the perspectives of health care providers to understand and address this problem. The purpose of this study was to elicit the experienti...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4302607/ https://www.ncbi.nlm.nih.gov/pubmed/25591945 http://dx.doi.org/10.1186/s12884-015-0431-5 |
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author | Heaman, Maureen I Sword, Wendy Elliott, Lawrence Moffatt, Michael Helewa, Michael E Morris, Heather Gregory, Patricia Tjaden, Lynda Cook, Catherine |
author_facet | Heaman, Maureen I Sword, Wendy Elliott, Lawrence Moffatt, Michael Helewa, Michael E Morris, Heather Gregory, Patricia Tjaden, Lynda Cook, Catherine |
author_sort | Heaman, Maureen I |
collection | PubMed |
description | BACKGROUND: Socioeconomic disparities in the use of prenatal care (PNC) exist even where care is universally available and publicly funded. Few studies have sought the perspectives of health care providers to understand and address this problem. The purpose of this study was to elicit the experiential knowledge of PNC providers in inner-city Winnipeg, Canada regarding their perceptions of the barriers and facilitators to PNC for the clients they serve and their suggestions on how PNC services might be improved to reduce disparities in utilization. METHODS: A descriptive exploratory qualitative design was used. Semi-structured interviews were conducted with 24 health care providers serving women in inner-city neighborhoods with high rates of inadequate PNC. Content analysis was used to code the interviews based on broad categories (barriers, facilitators, suggestions). Emerging themes and subthemes were then developed and revised through the use of comparative analysis. RESULTS: Many of the barriers identified related to personal challenges faced by inner-city women (e.g., child care, transportation, addictions, lack of support). Other barriers related to aspects of service provision: caregiver qualities (lack of time, negative behaviors), health system barriers (shortage of providers), and program/service characteristics (distance, long waits, short visits). Suggestions to improve care mirrored the facilitators identified and included ideas to make PNC more accessible and convenient, and more responsive to the complex needs of this population. CONCLUSIONS: The broad scope of our findings reflects a socio-ecological approach to understanding the many determinants that influence whether or not inner-city women use PNC services. A shift to community-based PNC supported by a multidisciplinary team and expanded midwifery services has potential to address many of the barriers identified in our study. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12884-015-0431-5) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-4302607 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-43026072015-01-23 Barriers and facilitators related to use of prenatal care by inner-city women: perceptions of health care providers Heaman, Maureen I Sword, Wendy Elliott, Lawrence Moffatt, Michael Helewa, Michael E Morris, Heather Gregory, Patricia Tjaden, Lynda Cook, Catherine BMC Pregnancy Childbirth Research Article BACKGROUND: Socioeconomic disparities in the use of prenatal care (PNC) exist even where care is universally available and publicly funded. Few studies have sought the perspectives of health care providers to understand and address this problem. The purpose of this study was to elicit the experiential knowledge of PNC providers in inner-city Winnipeg, Canada regarding their perceptions of the barriers and facilitators to PNC for the clients they serve and their suggestions on how PNC services might be improved to reduce disparities in utilization. METHODS: A descriptive exploratory qualitative design was used. Semi-structured interviews were conducted with 24 health care providers serving women in inner-city neighborhoods with high rates of inadequate PNC. Content analysis was used to code the interviews based on broad categories (barriers, facilitators, suggestions). Emerging themes and subthemes were then developed and revised through the use of comparative analysis. RESULTS: Many of the barriers identified related to personal challenges faced by inner-city women (e.g., child care, transportation, addictions, lack of support). Other barriers related to aspects of service provision: caregiver qualities (lack of time, negative behaviors), health system barriers (shortage of providers), and program/service characteristics (distance, long waits, short visits). Suggestions to improve care mirrored the facilitators identified and included ideas to make PNC more accessible and convenient, and more responsive to the complex needs of this population. CONCLUSIONS: The broad scope of our findings reflects a socio-ecological approach to understanding the many determinants that influence whether or not inner-city women use PNC services. A shift to community-based PNC supported by a multidisciplinary team and expanded midwifery services has potential to address many of the barriers identified in our study. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12884-015-0431-5) contains supplementary material, which is available to authorized users. BioMed Central 2015-01-16 /pmc/articles/PMC4302607/ /pubmed/25591945 http://dx.doi.org/10.1186/s12884-015-0431-5 Text en © Heaman et al.; licensee BioMed Central. 2015 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Heaman, Maureen I Sword, Wendy Elliott, Lawrence Moffatt, Michael Helewa, Michael E Morris, Heather Gregory, Patricia Tjaden, Lynda Cook, Catherine Barriers and facilitators related to use of prenatal care by inner-city women: perceptions of health care providers |
title | Barriers and facilitators related to use of prenatal care by inner-city women: perceptions of health care providers |
title_full | Barriers and facilitators related to use of prenatal care by inner-city women: perceptions of health care providers |
title_fullStr | Barriers and facilitators related to use of prenatal care by inner-city women: perceptions of health care providers |
title_full_unstemmed | Barriers and facilitators related to use of prenatal care by inner-city women: perceptions of health care providers |
title_short | Barriers and facilitators related to use of prenatal care by inner-city women: perceptions of health care providers |
title_sort | barriers and facilitators related to use of prenatal care by inner-city women: perceptions of health care providers |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4302607/ https://www.ncbi.nlm.nih.gov/pubmed/25591945 http://dx.doi.org/10.1186/s12884-015-0431-5 |
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