FGD details response

Province
District name
Interviewer ID
Date of FGD
FGD number
Number of FDG participants
IDs of FGD participants
Start time of FGD
End time of FGD

Discussions
Care-Seeking
Q1:What factors do you think motivate pregnant women in this community to initiate antenatal care
(ANC) early and attend ANC services at the healthcare facility?

IP9: The reason why we attend antenatal care early , it's to preserve maternal and fetal well being .and
also if there is any problem can be screened and solved early, unless ignored it's lead to maternal and
fetal mortality .it's why health care provider encourages us to attend antenatal visit early in order to give
us medication that keeps health for health well.

IP8: On my side ,the reason why Its must to attend antenatal care in early pregnancy ,it's because
disease screening especially genital diseases in order to be treated early before any complication.

IP2: When you attend antenatal visit in early pregnancy ,it's helps you to know your health status .when
same one delayed to be screened she stay at home and feels there is no problem but when she came at
health facility ,and screened they rule-out health problem and be solved . That is Good because it's
prevent abortion or other pregnancy complication like hypertensive disorder .

At how many months do you go for your ANC booking? Who have influenced your
decision to start ANC Services? What influences the decision to continue to come in for
ANC services?

IP8: In our village's , community health workers they teach us and encourage us to attend antenatal
care while we in first month of pregnancy and also they tell us signs and symptoms that shows you got
pregnancy . Like me , I was felt headache and I was immediately came to hospital for consultation and
after lab investigation result shows am pregnancy
And directly health care providers intervene.

IP6: In addition when you screened HIV/AIDS], it's crucial to came early In order to prevent moth r to
child transmission of HIV/AIDS ( PMTCT)

IP1: when. Same one is often to be sick ,it's better to came to health facility in order to be treated
before onset of complication

Overall perceptions and acceptability

 Q1:Have you heard about the changes to ANC services/new ANC services?

a): If yes, how did you get to know about the new ANC services? How many weeks /
months pregnant were you when you first heard about this new ANC package?


IP5: Before,pregnancy women was attend antenatal visit only four times a four times only, but now we
had information that said that"pregnancy women must probably attend antenatal visit like eight times
before delivery . That is only change I had in antenatal care package and all that package are seated to
help pregnancy women .

IP8: Because to be screened is important to pregnancy women , I had news said that " pregnancy
women must attend eight times of antenatal visit and one who complete that times carefully she they
will give her an offer.

IP2: Another thing which is new is when pregnancy women attend visit ,health care provider do all
possible investigations in order to rule-out any concern about maternal and fetus well being .

IP: Another change I have seen is health care provider must do urine exam and blood sample to every
pregnancy women.

IP: Addition is pregnant women doesn't wait a long time while she is paid because health care provider
help us to do it before others and care us early , that is very Good cervices..

Q2:What specific aspects did you like or dislike about the changes in the new ANC services?

IP1: The Good thing I have seen, is how they bring ultrasound ( echo graph) that help in screening of how
fetus is in the womb . But the problem is it's cost high that affect those who haven't capacity of payment
it's lead to lack of same important information like sex of the fetus.

IP3: The best thing I have seen is that,the health care provider is doing all the possible medical tests for
a pregnant women to screen the condition, and they also check you carefully using the ultrasound
machine in order to confirm well being of the fetus in the uterus, so, that is Good change we are happy
to see.

IP8: The only thing I can say I am not happy with, is that now we spend a lot of time without treating us
while before same one came and they worked on him directly without any delay.

IP4:

What I critic! My only complaint is the delayed services . Same one arrives here in the morning and he
returns back at four in the evening ,others they returned without being treated . They have postponed
tomorrow, that lead to an increase the number of pregnant women who will come the next day and also
our health care providers are few in numbers .
 A: Do you prefer to have more or fewer contacts? Why?

IP9: I would prefer to come for more antenatal visit. The reason I why, the health of the maternal and
fetus should be closely monitored.

IP4: We used to complain about it, feeling like something that only bother us and waste our time. Eight
times felt like a lot but now we understand it well and we are happy to come eight times ,if it goes
beyond ,we feel nothing wrong .

IP5: What I would choose is to come eight times in antenatal care because on one visit they can tested
me and found that I haven't complication , but another visit they will find that I have a problem or my
fetus starts to develop complications . so I am very happy to come many times because, before there is
same information ignored when we came four times in antenatal care.

IP8:And why I would be happy to attend antenatal visit many times, it's because when you come here
they give you different pills and vitamins to help you and your fetus or even, they give you injectable
medication.

B; At what stage would you have liked to have more contacts? Do you think the tests you received
were sufficient?
IP5: The last time I gave birth, antenatal visit were four . I was follow antenatal visit schedule correctly
and health care provider told me that if you feel the change, you may come immediately to the health
facility until 7months of pregnancy still going to health facilities many times .

IP: Even though I had problems I delayed in starting antenatal visit , it was at four months, but when I
came they take care of me and they took all possible exams : like blood tests, urine tests and also
monitored my health and I feel really happy.

IP8: Another thing I noticed from coming in antenatal check up eight times and starting early is
that ,when I got here they found that I had very low weight [38kg] and they told me that I have
malnutrition. they helped me a lot by giving me porridge flour and other things . so that now my weight
has been increased well. Just am Good.

Q2;How easy or difficult was it to attend antenatal services today?

IP1:because they have given you a schedule of how you should come here at antenatal visit, on the day
of appointment you try to postpone all the other activities you had to do and you come in antenatal
visit first and then you go back to what you have to do later. It is understood that there are other
activities that you ignored in order to put the health of your fetus first

IP2: I don't think there will be any problem because we usually know that we don't work on the sabbath
day, and one knows this, and knows that there are no other things to attend to unless she leaves the
health care facility on the day of the appointment. The time to come on the health facilities reaches
when you have already finished preparation and planning for everything.

IP6: since it's my life they would care of, I should do my best to come here and arrive on appointment
time, what I should have to do on that day, I put it off and comes on my appointment. So it's so easy for
me.

Interpersonal Communication

Q1;What issues were discussed during your ANC contact today? Did you understand the
issues/information discussed? What information were you given about your pregnancy and caring
for your child?

IP1: Is that they encourage you to prepare for the coming new baby, like buying all needed
materials so that the time of giving birth will not surprise you because your well prepared before .

IP8: What I can say is that they taught me a lot about increasing fruits intake ,so that my health and
fetus health continues to be well. Now am physically fits . and also they told me to eat green vegetable
in order to get enough blood and how to prepare balanced diet.

Q2:Do you believe that the information provided to you was sufficient? If not – what additional
information would you have wanted?

IP1: According to the time the health care provider had, and all the things he explained to me, I can't say
there is anything left he didn't tell me. The information he gave me was quite sufficient.

IP2: I'm telling the truth: I wasn't talked to! Except maybe like listening it on the radio. Also, I don't
know if here they choose those one to teaches based on how a person looks like may be it's the reason
am not included in. It's my third visit.

IP7: what they explained to me was so sufficient especially how to prepare baby package.

IP6: they taught us about the danger signs, like when you are in last trimester and you start to have
bloody discharge they told us that you should immediately go to the nearly health facility and even if
you feel pelvic pain , they also told us that you should immediately go to the health facility in order to
rule-out what going on .

Q3: How does this new ANC experience compare to the previous pregnancies (if applicable)?

IP9: on the previous antenatal guideline same pregnant women were came on first visit and she came
again while she gave birth. But For this new guidelines ,we appreciate that they have given us enough
time to take care of us and our fetus . Compared to previous this new protacal will reduce maternal and
fetal mortality rate that happened before .

IP5: like me on first pregnancy you were came and they help you but now they still help us enough,
like if someone needs to go to the hospital as soon as the ambulance help her to reach there shortly.its
really fantastic .

IP2: otherwise pregnant women were used to sit at home and no one would come to visit her but now
community health workers are around and visit every community pregnant women , encourages her to
attend first antenatal care ,they explained to her the benefit of antenatal visit and other thing related to
pregnancy , that is so Good.above of all there is folic acid distribution to every pregnant women but
before it doesn't.

Supportive care
Now I would like to talk to you about your views and experiences of care received during your ANC
contact

A:How were you received by the health workers, and do you think that you received the type of
care that you imagined you would receive? Please explain.

IP1: On first time I were here for consultation and they found I was pregnant and immediately sent me
for pregnancy test conformation . The health care provider met me at the payment desk and asked me if
I was going to antenatal services. , he immediately helped me and gave me my form. It's helped me to
went to the antenatal consultation without waiting a long time.

IP7: when came here ,I was sitting there, I didn't know where to start, I didn't know any process the
health provider helped me firstly rather than other patients and also , he helped me to go for lab exams
because I didn't know where laboratory is located . for sure he treated me well.

b:What do you think is the role of health providers when you visit the health facility? Could you
describe for me what it means to be supported during antenatal care?

IP9: The role of a health care provider is to welcome you, actively listening and give you good
services, like take lab exams and give you advice on what you should do to keep your health
and fetus also teaches you to prepare balanced diet: includes fruits, vegetables and so on.
IP5: Another thing, is how the health care providers comes and helps pregnant women among
the other clients, they starts treating us early, and we return home early . Also, he
communicate to us therapeutically .he makes us comfortable in discussion and we can tell him
everything without hiding any thing and if you have any questions you are free to ask him and
he respond to you correctly.

c:What was your level of confidence in your ability to participate/engage in the care you received
today?
IP5: When he talked for the first time, he told me a lot, but there same thing new on that
day , I didn't heard before.
IP3: When you reach here and health care provider is around ,your free to ask all questions
you have , I was answered and I was satisfied.

Q2: Would you advise a pregnant family member, friend, or neighbor to use the antenatal care
services you received at the health facility? If yes, what are the reasons behind your
recommendation?

IP3: I would advise her that she must came to health facility because they take care of her as
they did it to me every time. And I believe that when I give that information to her it's helping
action.

IP1: It's good and I encourage them even though sometimes they don't care of it because
same time they got unplanned pregnancy lead to feel uncomfortable but when you care her
and advice her about antenatal consultation, she understand it and follow it's.

IP8: I also agree that" when you found that your friend is pregnant and not attend antenatal
care you may go and talk to her, tell her about ANC and tell her about what health care
provider were talked to you , in order to help her. Still I advised them to came for antenatal
visit here.

Health systems
Q1: In your opinion, what changes do you think could be made to the facility conditions to create a
more supportive environment or facilitate easier access to healthcare services for pregnant
women? Please explain.

IP5: Related to health care providers, they are still few. Some time we came for antenatal
consultation here, because the health care provider who is working for us is the same one who
also works in the maternity ward, unfortunately he stopped taking care of us in order to help
the one who is in labour ward for delivery . What we want is ,If it's possibly number of health
care provider will be increased.

IP7: I also think that what could be improved is increase numbers of health care providers so
that they will work for us Quickly and we return back home early. Example same time we
reach here at 7:00 pm in the morning and we return home evening because one health care
provider working with in two different services at the same time.

IP3: also my complaint is few numbers of health care provider . like when a pregnancy women
reaches on health facility early in the morning and we return back at evening like 5:00 pm because
they started to admit us like 3 o'clock.
Conclusion
Would you like to discuss anything else related to your antenatal care experience that we have not
discussed?

IP2: Before, when someone got unplanned pregnancy, health facility refused to give her mosquito net
because she came late , but now there is change because every pregnant women must take mosquito
net.

IP6: And also before , they give you mosquito net on first pregnancy only ,but now they give you it on
each pregnancy to every women .