Challenges of the primigravida’s in accessing antenatal care early and regularly in Buffalo city Metropolitan Municipality, Eastern Cape Province, South Africa

According to National Department of Health (NDOH National :2015), antenatal care is free in South Africa’s public health system and nearly all pregnant women and girls attend an antenatal clinic at least once during their pregnancy. However, most pregnant women do not access antenatal care until the later stage of pregnancy. Such delays have been linked to nearly a quarter of avoidable maternal deaths in South Africa. According to World Health Organisation (WHO, 2016; 11), maternal mortality and morbidity are some of the most important global health issues facing the world today. Worldwide, approximately 1000 women die each day from pregnancy and childbirth related causes (WHO, 2016; 11). In addition, 99% of these maternal deaths occur in the developing world, with sub-Saharan Africa accounting for over half of these deaths. The international community has committed to improving maternal health by 2015 with Millennium Development Goal (MDG) number five, which aimed to reduce maternal mortality by three quarters and reach universal access to reproductive health care (www.worldbank.org/mdgs/). Even with this commitment, many countries like South Africa have failed to implement effective programs to reduce maternal mortality and morbidity, and women around the world continue to die and suffer from the complications of pregnancy and childbirth. According to NDOH (2015; 2), women who suspect that they might be pregnant should schedule a booking and visit to their clinic and begin antenatal care as soon as possible. These visits include a physical examination, which includes blood pressure checks, weight checks, providing a urine sample, testing for sexually transmitted infections and checking for tuberculosis. Depending on the stage of the pregnancy, healthcare providers may also do blood tests and examination, which includes an ultrasound. The purpose of the study was to to investigate the challenges of Primigravida’s in accessing antenatal care early and regularly in Buffalo City Metropolitan (BCM) and to assist in formulating recommendations for improving factors that are perceived as obstacles to the utilisation of antenatal care services in the BCM District. vii The study was conducted in five facilities at BCM (Dimbaza Community Health Centre, Empilweni Gompo Clinic, Moore Street Clinic, Central Clinic and Notyatyambo Clinic). BCM is one of the seven districts of Eastern Cape Province of South Africa. The seat of BCM is East London. The data was collected using cross-sectional, self-administered questionnaires that were conducted in selected health facilities of Buffalo City Metropolitan. In this study, the population consisted of primigravida’s between the ages of 18-35 who start clinic attendance in the second trimester of pregnancy at five facilities, Buffalo City Metropolitan. Findings: The biggest challenges, as expressed by the participants, were lack of money, unsuitable clinic times, work commitments, delays at clinic and family control. Most of the participants had good experiences of antenatal care. The timing of antenatal clinic attendance is not influenced by age, education, residential zone, employment status and proximity of clini