Midwives' perceptions about adolescents' utilisation of public prenatal services in Bulawayo, Zimbabwe

Objectives: to identify midwives' perceptions about adolescents' failure to utilise prenatal services or to initiate such utilisation late during their pregnancies. Design: a quantitative descriptive and exploratory design, using questionnaires to collect data, to describe midwives' perceptions about factors influencing pregnant adolescents' non-utilisation or late utilisation of prenatal services. Setting: 20 public health centres (comprising two hospitals and 18 primary health-care clinics) rendering prenatal services, distributed throughout the city of Bulawayo, Zimbabwe. Participants: 52 midwives, rendering prenatal services in Bulawayo, completed questionnaires. Measurements and findings: demographic, socio-economic, knowledge-related and service-related factors (unfriendly midwives and substandard prenatal services) influenced pregnant adolescents' late or non-utilisation of prenatal services. Key conclusions: transport costs and charges for prenatal services were major factors influencing adolescents' late or non-utilisation of prenatal services. Adolescents needed more knowledge about the advantages of prenatal services. Effective prenatal services should be provided by friendly and welcoming midwives. Implications for practice: pregnant adolescents need more knowledge about the advantages of prenatal services, and these should be more accessible. Charges for public prenatal services must be reduced or abandoned; subsidised or free public transport for pregnant adolescents could enhance their utilisation of prenatal services. (C) 2009 Elsevier Ltd. All rights reserved.