Pregnant women's access to maternal health information and its impact on healthcare utilization behaviour in rural Tanzania

Objectives: The purpose of this study was to examine rural women s access to maternal health information and its impact on levels of skilled healthcare utilization. Method: A qualitative study involving twenty five (25) pregnant women,five (5) Skilled healthcare providers and five (5) Traditional Birth Attendants (TBAs) was conducted in Chamwino District in Dodoma Region, Tanzania for a period of six months. Due to time and resource limitation the researcher selected two (2) of the 32 wards in the district where the problem of maternal mortality and non-utilization of skilled healthcare was most prominent. The two selected wards were Msanga and Buigiri wards. The researcher used The Health Belief Model and Theory of Planned Behaviour to develop interview questions and focus group guides as well as the interpretation of the findings. The researcher examined how variable factors e.g. maternal health literacy, individual perceptions, local knowledge and care provider-related factors affect pregnant women s health behaviours and utilization of skilled maternal services. The Data was analysed thematically using the 6-stage guide to thematic data analysis with the help of NVIvo Software. Results: The inadequate conditions of the health facilities and the poor working conditions of the care providers affected the provision of quality of maternal services and health information to pregnant women in the study area. The limited access to skilled maternal health information from skilled healthcare providers and lack of alternative sources of reliable health information led pregnant women to seek health information from their Mothers-in-laws, TBAs and other women in the society. However, there was a shortcoming of information inaccuracy as their health advice was not based on previous expert advice but rather on the personal opinion and attitude towards skilled maternal services. The limited access to maternal health information caused majority of pregnant women to underestimate the risks of pregnancy related complications and how they responded to pregnancy danger signs and other ill-health conditions that raised during pregnancy. The majority of pregnant women reported not to seek and kind of care when experienced a health problem. It was also found that during labour some would go to the TBA for childbirth and later go to the dispensary when the TBA failed while others would just go for TBAs opinion and confirmation that it was real labour then go to the health facility. This delayed women s timely access to obstetric care which is essential for positive outcome when a pregnant woman experiences a pregnancy or childbirth complications. Conclusion: The improvement of the quality of skilled healthcare services in rural areas is a prerequisite for achieving desired outcomes in maternal mortality reduction efforts in Tanzania. However, improvement of quality itself is not a panacea if pregnant women are not aware of the services, hence the healthcare providers should also focus in increasing provision of maternal health information to pregnant women. The findings show that the limited access to skilled maternal health information from healthcare providers and lack of alternative sources for reliable health information has constrained majority of these women from becoming maternal health literate hence affecting their levels of utilization of skilled maternal services. The healthcare providers and policy makers should focus on meeting the health information needs of general rural populations and enable them to become well-informed and knowledgeable to make better and well-informed maternal health decisions.