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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.