Knowledge of pregnant women in rural Mozambique on routine practices to prevent and treat common conditions at the antenatal care clinic

Abstract

Background: Despite an increasing proportion of pregnant women accessing antenatal care (ANC) in low-income countries, preventable maternal morbidity and mortality remains high. Limited women’s knowledge on common diseases during pregnancy and on the indications of routine health interventions delivered at the ANC clinic may reduce the compliance and effectiveness of these interventions. We assessed pregnant women’s knowledge on common diseases in pregnancy and on routine interventions delivered at the ANC clinic as well as their compliance with these interventions. Material & Methods: From December-2019 to October-2020, we undertook a qualitative study using individual semi-structured and in- depth interviews in 79 pregnant women attending the ANC clinic of a rural hospital in Mozambique. Participant’s ability to identify the drugs administrated was assessed by showing them the drugs without the label (antiretroviral, ferrous sulfate, cotrimoxazole, isoniazid, mebendazol and antimalarial). Interviews were recorded, transcribed, coded and a combined Content and Thematic analysis technique used. NVivo 12 software was used to store and retrieve the data. Results: Most of the participants recognized that infectious diseases such as HIV, malaria, sexually transmitted infections, tuberculosis and COVID-19, could be harmful in pregnancy. Overall, knowledge on the indication of the prescribed drugs was limited, being higher for antiretroviral drugs and ferrous sulfate, and lower for mebendazol and isoniazid. The general perception was that all drugs prescribed at the ANC clinic prevent or treat malaria infection. Knowledge on the indication of the prescribed drugs was generally higher in HIV-infected pregnant women compared to HIV uninfected women. Forgetting daily medication intake, non-compliance with the drug intake schedule and perceived importance given to some drugs instead of others, were practices found regarding compliance to the pharmacological interventions. Conclusion: Knowledge of Mozambican pregnant women on health interventions delivered at the ANC clinic was generally limited. The latter may reduce compliance and adherence with these interventions and thus their effectiveness and safety. Reinforcing information and education on ANC health interventions targeting women of childbearing age would improve maternal and infant health.