Access and utilisation of antenatal care services in a rural community of eThekwini district in KwaZulu-Natal

Although the South African government adopted a primary health care approach to health care service provision in order to ensure equitable access to and utilisation of health care services to all communities, the country continues to face challenges regarding access and utilisation of health care services especially in the rural communities. Antenatal care which is mostly provided at primary health care level is regarded as the cornerstone for the success of the maternal and child health care programme. Therefore, the need to highlight issues of access and utilisation of antenatal care services was significant because poor access to and under-utilisation of health care services could potentially influence the success of this programme and pregnancy outcomes. A qualitative, exploratory, descriptive and contextual study was conducted guided by Thaddeus and Maine's Three Delays Model. The majority of the study participants who were pregnant women reported limited access to health care, with under-utilisation of antenatal services while nurse participants recognised the challenges facing pregnant women regarding the access and utilisation of antenatal care services. Recommendations were made to consider building a centrally located fixed primary health care clinic that would ensure equal access to health care services, strengthening the implementation of policies regarding the referral system and ambulance services, ensuring sustainable availability of human and material resources, developing strategies to ensure that the antenatal care services delivered are in line with the South African Department of Health Guidelines.