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Table 1 Overview of the factors according to the conceptual framework of Foets et al.

From: Factors affecting the use of prenatal care by non-western women in industrialized western countries: a systematic review

 

Category

Barriers

Facilitators

Individual factors

Demographics, genetics and pregnancy

Being younger than 20 [20]*

 

Multiparity [20]*

Unplanned pregnancy [20]*

Migration

Lack of knowledge of or information about the Western healthcare system [22, 23, 2527, 3032, 35]

Recognition of prenatal care as an important issue in the community [30]

Arriving in the new country late in pregnancy [22]*

Culture

Adherence to cultural and religious practices [23, 25, 34]

Care provider of the same ethnic origin [27]

Poor language proficiency [20, 22, 24, 26, 27, 30, 31]

Belief that prenatal care ensures baby’s well-being [23, 34]

Lack of assertiveness [24]

Belief in looking after your own health for a healthy baby [34]

Dependency on husband [22, 34, 35]

Perceiving pregnancy as a normal state [29]

 

Belief that prenatal care is more a burden than a benefit [25]

Belief that prenatal classes are not necessary [22, 34]

Position in host country

Financial problems [22, 23, 31]

Better socio-economic follow-up [31]

Unemployment [21]*

Low or intermediate educational level [20, 21]*

Social inequality (education, economic resources and residence (rural or urban)) [35]

Lack of time [22, 23, 27, 30]

Lack of childcare [23, 25]

No medical leave from work [31]

Social network

No support from family [35]

Husband with a good command of the industrialized country’s official language [34]

Acquiring or following advice from family and friends [22, 23]

Isolated community [35]

Health service factors

Accessibility

Inappropriate timing and incompatible opening hours [23, 35]

 

Transport and mobility problems [22, 26, 27, 35]

Indirect discrimination [32]

Expertise

Care provider lacking knowledge of cultural practices [25]

A mature, experienced healthcare provider with a command of the native language [30]

Care provider showing interest and respect [23]

Care provider alleviating worries and fears [23]

Personal treatment and communication

Poor communication [23, 32, 35]

Use of native language [27, 28, 30, 31]

Perceiving yourself as having been badly treated by a care provider [33]

Improved communication [23, 31]

Audio-visual material [27]

Renaming prenatal classes to prenatal sessions [30]

  1. Ad* Factors only reported in quantitative studies.
  2. Ad• Factors only reported in qualitative studies or the qualitative part of the mixed-methods study.