Vaccines & Vaccination Open Access (VVOA)
ISSN: 2578-5044
Research Article
Exploring Barriers and Facilitators of Group Antenatal Care
Implementation in Kaduna State, Nigeria: A Qualitative
Evaluation
Authors:
Ogirima F
,
Azurunwa O
,
Phillips A
,
Ajibola A
,
Jolaoso I
,
Christopher- Izere P
,
Imarhiagbe C
,
Kanebi E
,
Sagir S
,
Obagunlu V
,
Joseph S
,
Iliyasu N
,
Adebanjo A
,
Anomnachi L
,
Olaniyan D
,
Jaiyeola O
,
Olatosi B
,
Billings D
,
Li X
and
Oyeledun B
DOI:
10.23880/vvoa-16000177
Abstract
Background: Poor access to antenatal care (ANC), skilled birth attendance, and postnatal care services contribute to high maternal and infant mortalities in Nigeria. Traditional ANC model has limitations especially in low resource settings. Group antenatal care (G-ANC) offers an alternative, combining clinical assessments with group discussions, information sharing, selftesting and peer support. This model has proven successful in various countries. This paper evaluated facilitators, barriers and the sustainability of the G-ANC program in Kaduna State, Nigeria, through a qualitative assessment of its implementation and outcomes.
Methods: A descriptive exploratory study was conducted using qualitative methods. Data were collected through structured interview guides via 24 focus group discussions (FGDs) and 20 key informant interviews (KIIs). The sampling frame included health facilities implementing G-ANC, stratified by Senatorial Districts (SDs) and urban/rural locations. Two local government areas (LGAs) (one rural, one urban) were selected per SD, with two health facilities chosen from each, totaling 12 facilities. Purposive sampling recruited participants for FGDs with postpartum women (≤25 years and >25 years), male partners, healthcare workers, and community mobilizers (6–8 participants per group). Trained staff conducted the sessions, and data analysis was performed using ATLAS.ti (v22).
Results: Implementation was shaped by logistical, cultural and systemic factors. Long distances to health facilities, inadequate human resources and inadequate infrastructure among others limited access for many women. Delays in forming cohorts, payment of ANC services and insufficient equipment further hindered service delivery. Cultural norms, such as male dominance and traditional beliefs favoring home deliveries, also posed challenges. Despite these barriers, strong government support, effective community mobilization and inclusive communication tools among others facilitated success. Male involvement increased, with partners supporting antenatal care participation. Social bonding within groups fostered peer learning and sustained attendance.
Conclusion: G-ANC is a feasible, client-centered model for improving maternal and child health outcomes in resource-limited settings. While findings highlight the approach’s potential to improve maternal and child health outcomes, challenges like insecurity, resource constraints, and systemic barriers must be addressed. Further research is needed to explore G-ANC’s applicability in diverse settings.
Keywords: Group Antenatal Care; Qualitative Evaluation; Kaduna State; ANC and Pregnant Women
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