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Table 3 Barriers and facilitators for completing the two steps of the GDM screening process

From: Factors influencing timely initiation and completion of gestational diabetes mellitus screening and diagnosis - a qualitative study from Tamil Nadu, India

Steps

Barriers

Facilitators

Step 1

Attending the health centre

• Not being informed (timely) about test by HCP

• Weak or lack of social network

• Being informed (timely) about test by HCP

• Strong social network

• Strong motivation

• Awareness of risk

• Social norms about pregnancy and motherhood

• Belief in importance of compliance with instructions from health care providers

• Unsupportive family

• Work

• Feeling unwell

• Being away from home

• Family in support of test

• Conducive clinic timings

• Lack of family member to accompany or help with household work

• Family member to accompany or help with household work

Step 2

Initiating, completing and getting the report of the screening and diagnostic test in a timely manner

• Not being aware of test time schedule

• Lack of or delayed transportation and heavy traffic

• No help with household work

• Inflexible interpretation of timing of test in terms of gestational age

• Awareness of test time schedule

• Available and timely transportation and conducive traffic

• Help with household work

• Glucose solution eliciting vomiting

• Procedure stating that test has to be cancelled and done another day when women vomit

• Adding lemon drops to glucose solution

• Long waiting time

• Uncomfortable physical ambience of health centre and attitude of staff

• Health care provider not informing the women about how and when the results will be available

• Health care provider not informing the women about the results within a reasonable time period

• Barriers mentioned under step 1 when women have to return to the health centre again

• Comfortable physical ambience of health centre and attitude of staff

• Health services being free of charge

• HCP informing the women about how and when the results will be available

• HCP providing the results to the women over the phone or in-person in the village