Midwives' perceptions about adolescents' utilisation of public prenatal services in Bulawayo, Zimbabwe.

OBJECTIVES to identify midwives' perceptions about adolescents' failure to utilise prenatal services or to initiate such utilisation late during their pregnancies. DESIGN a quantitative descriptive and exploratory design, using questionnaires to collect data, to describe midwives' perceptions about factors influencing pregnant adolescents' non-utilisation or late utilisation of prenatal services. SETTING 20 public health centres (comprising two hospitals and 18 primary health-care clinics) rendering prenatal services, distributed throughout the city of Bulawayo, Zimbabwe. PARTICIPANTS 52 midwives, rendering prenatal services in Bulawayo, completed questionnaires. MEASUREMENTS AND FINDINGS demographic, socio-economic, knowledge-related and service-related factors (unfriendly midwives and substandard prenatal services) influenced pregnant adolescents' late or non-utilisation of prenatal services. KEY CONCLUSIONS transport costs and charges for prenatal services were major factors influencing adolescents' late or non-utilisation of prenatal services. Adolescents needed more knowledge about the advantages of prenatal services. Effective prenatal services should be provided by friendly and welcoming midwives. IMPLICATIONS FOR PRACTICE pregnant adolescents need more knowledge about the advantages of prenatal services, and these should be more accessible. Charges for public prenatal services must be reduced or abandoned; subsidised or free public transport for pregnant adolescents could enhance their utilisation of prenatal services.