ArticlePloS one2021
Implications of power imbalance in antenatal care seeking among pregnant adolescents in rural Tanzania: A qualitative study.
Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 20 citations in OpenAlex.
- Barriers and facilitators to maternal healthcare in East Africa: a systematic review and qualitative synthesis of perspectives from women, their families, healthcare providers, and key stakeholders.BMC pregnancy and childbirth · 2025Pooled it
- Midwives' perspectives and care practices for pregnant adolescents: a qualitative study in Northern Malawi.Reproductive health · 2026Article
- A qualitative study exploring the experiences of adolescent mothers accessing perinatal services in Rwanda to inform the delivery of trauma- and violence-informed care: a double-edged sword.BMC pregnancy and childbirth · 2025Article
- Article
- 'Support me like a child, respect me like an adult': a qualitative study on pregnancy experiences of adolescents in Zambia.npj women's health · 2025Article
- Article
- Long-term retention on antiretroviral treatment after enrolment in prevention of vertical HIV transmission services: a prospective cohort study in Dar es Salaam, Tanzania.Journal of the International AIDS Society · 2024Article
- "My father insisted that I have the baby but not in his house": Adolescent pregnancy, social exclusion and (dis)empowerment of girls in an urban informal settlement in Kenya.PLOS global public health · 2024Article
- "My friends said they should no longer be with a b*tch like me…": A qualitative study to explore the consequences of adolescent childbearing among teen mothers in Gatsibo district, Rwanda.PLOS global public health · 2024Article
- Mental health outcomes beyond the post-partum period among adolescent mothers: a systematic review and meta-analysis.Health psychology and behavioral medicine · 2024Review
- Adolescent perspectives on peripartum mental health prevention and promotion from Kenya: Findings from a design thinking approach.PloS one · 2024Article
- The adequacy of ANC components received and associated factors among women of reproductive age in Tanzania.PloS one · 2024Article
- Evaluation of a comprehensive maternal newborn health intervention in rural Tanzania: single-arm pre-post coverage survey results.Global health action · 2022Article
- Determinants of health facility delivery among young mothers in Ghana; insights from the 2014 Ghana Demographic and Health Survey.BMC pregnancy and childbirth · 2022Article
- Utilization of antenatal care among adolescent and young mothers in Ghana; analysis of the 2017/2018 multiple indicator cluster survey.BMC pregnancy and childbirth · 2022Article
- Navigating antenatal care: The lived experiences of adolescent girls and young women and caregiver perspectives in Zambia.Women's health (London, England)Article
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Authors and funding
9 authors at 3 institutions in 2 countries.
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Abstract
backgroundAdolescent girls (10-19 years) are at increased risk of morbidity and mortality from pregnancy and childbirth complications, compared with older mothers. Low and middle-income countries, including Tanzania, bear the largest proportion of adolescent perinatal deaths. Few adolescent girls in Tanzania access antenatal care at health facilities, the reasons for which are poorly understood.
methodsWe conducted a qualitative thematic analysis study of the experiences of pregnant adolescents with accessing antenatal care in Misungwi district, Tanzania. We recruited 22 pregnant or parenting adolescent girls using purposive sampling, and conducted in-depth interviews (IDIs) about antenatal care experiences. IDI data were triangulated with data from eight focus group discussions (FGDs) involving young fathers and elder men/women, and nine key informant interviews (KIIs) conducted with local health care providers. FGDs, KIIs and IDIs were transcribed verbatim in Swahili. Transcripts were then translated to English and analysed using emergent thematic analysis.
resultsFour main themes emerged: 1) Lack of maternal personal autonomy, 2) Stigma and judgment, 3) Vulnerability to violence and abuse, and 4) Knowledge about antenatal care, and highlighted the complex power imbalance that underlies barriers and facilitators to care access at the individual, family/interpersonal, community, and health-systems levels, faced by pregnant adolescents in rural Tanzania.
conclusionAdolescent antenatal care-seeking is compromised by a complex power imbalance that involves financial dependence, lack of choice, lack of personal autonomy in decision making, experiences of social stigma, judgement, violence and abuse. Multi-level interventions are needed to empower adolescent girls, and to address policies and social constructs that may act as barriers, thereby, potentially reducing maternal morbidity and mortality in Tanzania.
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