Reasons for seeking private sector antenatal care by pregnant women delivering in government hospitals in Kalutara district

Abstract

BACKGROUND: Anecdotal evidence suggests there is an increased tendency to use private sector for antenatal care in the recent past, despite provision of high quality free antenatal care services by the country. OBJECTIVE: To assess the reasons for seeking antenatal care from the private sector by pregnant women who deliver in government hospitals. METHODS: Descriptive cross sectional study was carried out in the Kalutara district of Sri Lanka over a period of two months using an interviewer administered questionnaire and a check list, from pregnant women admitted for the delivery to all the government hospitals in the district with specialized care. RESULTS: Among the study participants, 70% (n=282) of the pregnant women had visited the Consultant Obstetrician in the private sector and majority (more than 70%) had done the investigations the in private sector. Ethnicity, residence, planned pregnancy and not having children were significantly associated with private sector clinic attendance. Field staff had more influence over family in the selection of private health services. Availability of an appointment system (52.6%), less waiting time (47.1%) and being a primipara (33.7%) were the commonest reasons behind their choice. Not been seeing by the Consultant Obstetrician in all hospital clinic visits (47.3%) and husbands’ desire to meet Consultant Obstetrician (15.2%) made them attend private sector while attending the specialized hospital clinics. CONCLUSIONS: This study reveals the extent of peoples’ demand for antenatal care from both public and private sectors. Public sector service delivery need improvements related to patients’ aspirations.