Optimizing Maternal Health in Refugee Settings: Perspectives on the WHO's Enhanced Antenatal Care Schedule: A Mixed-Methods Study in Zarqa, Jordan

Abstract

Background: Antenatal care (ANC) is essential for improving maternal and newborn health by enabling early detection and treatment of potential complications. In 2016, the World Health Organization (WHO) increased the recommended number of ANC visits from four to eight, aiming to enhance maternal health outcomes. This study explores the experiences of pregnant women in Jordanian refugee camps and examines the perceived impact of the revised WHO ANC schedule. 

Methods: A mixed-methods study was conducted at Zarqa health centers in Jordan from May 28, 2023, to July 26, 2023. Data were collected through structured interviews with 46 female patients (pregnant, postpartum, or trying to conceive), focus group discussions (FGDs) with six participants, and semi-structured interviews with six healthcare providers. Quantitative data were gathered using structured questionnaires, while qualitative data were obtained through FGDs and provider interviews. 

Results: Participants unanimously agreed that eight ANC visits are essential for optimal maternal and fetal health. Approximately 90% expressed a need for clearer communication from healthcare providers during appointments. Despite demonstrating strong self-awareness about when to seek medical attention, participants highlighted key barriers to ANC access, including transportation challenges, childcare responsibilities, and long waiting times. Healthcare providers acknowledged these barriers and emphasized the need for improved patient communication and resource allocation. Overall, participants reported general satisfaction with the services provided at refugee health clinics.

Discussion: While refugee women in Jordan recognize the importance of the WHO-recommended ANC schedule, barriers such as inadequate communication, transportation difficulties, and childcare responsibilities persist. Addressing these barriers through targeted interventions, such as enhanced provider training, better scheduling, and community outreach, could significantly improve maternal and newborn healthcare outcomes in refugee settings.

Conclusion: Optimizing ANC access in refugee settings requires a multifaceted approach that addresses communication gaps, logistical challenges, and systemic healthcare barriers to ensure equitable maternal health outcomes.