ADOLESCENTS' PERSPECTIVES ON GROUP ANTENATAL CARE IN SENEGAL

• Published in: Journal of adolescent health 2020-02, Vol.66 (2S), p.S98
• Main Authors: Witol, Adrian, McKinnon, Britt, Sall, Mohamadou, Vandermorris, Ashley
• Format: Article
• Language: English
• Subjects: Adolescents; Connectedness; Embarrassment; Gestational age; Health education; Information sharing; Intergenerational transfer; Interviews; Marginality; Older women; Pregnancy; Prenatal care; Psychosocial factors; Psychosocial support; Shyness; Social networks; Social norms; Teams; Teenagers; Women
• ISSN: 1054-139X; 1879-1972

Purpose: Group antenatal care (G-ANC) is an innovative model in which prenatal care is delivered to a group of 8-12 women of similar gestational age. This model emphasizes education, psychosocial support, and patient engagement. There is evidence from high-income countries that suggests that G-ANC is particularly effective for women from marginalized populations, including adolescents. However, there remains a limited exploration in the literature of the experiences of adolescents engaged in G-ANC in low- and middleincome countries (LMIC). This study, which is a subset of a larger pilot study of G-ANC in Senegal, explored adolescents' perspectives on their experiences of G-ANC. Methods: As part of the pilot study, G-ANC was carried out in 4 health posts in Kaolack District, Senegal. Pregnant women aged ≥15 who were looking to initiate ANC at ≤5 months gestation at one of the 4 health posts were invited to participate. Those who accepted were assigned to a group based on their estimated date of delivery. After the final G-ANC session, local research assistants conducted one-on-one interviews with adolescents who participated in G-ANC. Interviews were audio recorded and concurrently transcribed and translated into French from local languages. The transcripts were analyzed with a qualitative thematic analysis approach. Two individuals coded all the transcripts independently and the team collaborated to develop themes. Results: 33 adolescents participated in individual interviews (median age = 18 years, 67% formally educated at primary or secondary level, 82% participated in ≥3 G-ANC sessions). Three key themes were developed: (1) G-ANC facilitated social connectedness that provided a source of confidence and support; (2) social norms influenced adolescents' expectations and experiences of G-ANC; (3) adolescents were highly motivated to learn and actively engage in their healthcare within the G-ANC setting. Adolescents were satisfied overall with their decision to pursue G-ANC: 29 out of 33 respondents reported that they would prefer G-ANC over traditional individual ANC for future pregnancies. Conclusions: Adolescents reported overwhelmingly positive experiences with G-ANC. Key features of the model that adolescents identified as contributing to this positive experience included collective information sharing and engaging in medical self-assessments. Many adolescents valued the social aspect of G-ANC, including intergenerational support and reciprocal learnin