Barriers to and Facilitators of Antenatal Care Service Use at Primary Health Care Centers in Jeddah, Saudi Arabia: A Cross-Sectional Study

Objective: This study aimed to identify the barriers to and facilitators of antenatal care service use in primary health care centers in Saudi Arabia. Methods: A cross-sectional hospital-based study was conducted. Participants were 239 women (mean age: 30.43 years; standard deviation: 5.49) who had recently delivered. Participants were divided into two groups: Group 1 comprised 80 women with inadequate antenatal care visits and Group 2 comprised 159 women with adequate visits. A structured questionnaire was used to compare barriers and facilitators impacting ANC visit adequacy. Results: Women with inadequate visits experienced more structural and personal barriers than women with adequate visits. The total scores for the structural barriers were 56.3% versus 25.8% (p<0.001) whereas the total scores for personal barriers were 75% versus 35.8% (p<0.001). The most prevalent structural barriers for both groups were inconvenient clinic hours (31.3% versus 21.4%; p=0.112) and dissatisfaction with previous care (23.8% versus 10.1%; p=0.007). The most prevalent personal barriers were fear of examination and medical tests (26.3% versus 14.5%; p=0.034) and transportation problems (33.8% versus 7.5%; p<0.001). The most frequently mentioned facilitator was effective staff communication (80.2%). Conclusion: Several barriers are associated with antenatal care service use. This study contributed to identifying these factors to improve clinical practice. Efforts should be made to arrange convenient clinic hours, reduce waiting times and easily secure appointments, provide transportation, decrease patient fear of examinations and medical tests and patient stress, and increase patient knowledge about existing services and supports.