Perceptions of pregnant teenagers concerning the use of antenatal care services at an antenatal clinic, Oshakati intermediate hospital, Namibia

Abstract

Adolescent pregnancy remains a significant public health challenge worldwide, with Namibia, and particularly the Oshakati region, experiencing disproportionately high rates. Approximately 25% of Namibian girls fall pregnant before the age of 18. Despite numerous governmental and non-governmental interventions aimed at reducing teenage pregnancies and enhancing access to antenatal care (ANC), the utilisation of such services by pregnant teenagers remains suboptimal. The problem was compounded by socio-cultural stigmas, fear of discrimination, unwelcoming clinic environments, and systemic healthcare barriers. This study aimed to explore and describe the perceptions of pregnant teenagers regarding the use of ANC services at the Antenatal Clinic at Oshakati Intermediate Hospital, Namibia. Guided by the Health Belief Model, the study employed a qualitative, descriptive design with purposive sampling. Fourteen pregnant teenagers aged 13–19 years who attended the clinic in October 2024 were interviewed using in-depth face-to-face interviews until data saturation was reached. Thematic analysis revealed two major themes: (1) Different aspects indicated with regard to the use of antenatal care services, with sub-themes including information sources, attitudes of healthcare providers, proximity to the clinic, and traditional beliefs; and (2) Frustrations influencing ANC use, with sub-themes such as lack of family support, cost of services, and absence of awareness programs. The findings revealed that while some teenagers understood the importance of ANC, barriers such as judgmental attitudes from staff, cultural taboos, financial constraints, and inadequate information hindered consistent service utilisation. Conversely, supportive family members, positive past healthcare experiences, and proximity to the clinic acted as motivators. Trustworthiness was ensured through credibility, transferability, dependability, and conformability measures. The study concludes that ANC services must be more youth-centred, private, and supportive. Recommendations include staff training, awareness campaigns, and improved community engagement. A key limitation was potential response bias due to the sensitive nature of the topic. This study adds to existing knowledge by revealing factors affecting teenage ANC uptake in northern Namibia. The findings are valuable to the MoHSS, IUM, and other stakeholders in developing adolescent-friendly policies that encourage timely and consistent ANC use, improving maternal and newborn health outcomes.