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Table 1 Barriers to birth preparedness and antenatal-care attendance according to the three delays model [22, 23], in Busoga, Eastern Uganda

From: Acceptability of evidence-based neonatal care practices in rural Uganda – implications for programming

DELAY BARRIER
DELAY 1: DELAY TO SEEK CARE
Knowledge Barriers - ANC misconstrued as provision of medicine for sick pregnant women
- Limited community knowledge on: importance of attending ANC four times; importance of ANC to mother and unborn baby; cause and care for danger signs
Culture and traditional beliefs and practices - Deep rooted beliefs in herbs as part of pregnancy care
- Decision making as a male prerogative (seeking and choice of care)
- Conflicts related to polygamy: men making preferential treatment among wives
- Mother-in-laws making decisions for daughter-in-laws
- Influence from older mothers
- Too much burden of work on women
- The fear of preparing for the unborn whose viability is considered uncertain
DELAY 2: DELAY TO ARRIVE AT A HEALTH UNIT
Financial Constraints - Lack of money for transport and hospital related costs (including under the table payments)
- Women's reliance on male partners for funds and men unable to raise and sometimes unwilling to give the funds
- Health facility requirements for BP being too costly for families
Peer influence on choice of care - Women relying on fellow women for advise on ANC attendance
DELAY 3: DELAY TO GET CARE ONCE AT A HEALTH UNIT
Service delivery gaps - Emphasis on ANC card by health workers as a pre-condition to skilled care
- Lack of skilled staff
- Poor attitude and communication skills of health workers e.g. rudeness and ignoring clients
- Health workers do not actively encourage couples to choose skilled providers for delivery