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Background A good Antenatal Care during pregnancy is important to ensure the health of the mother and the healthy development of the fetus. In 2016, at Ethiopian Somali region (43.6%) of pregnant mothers had an Antenatal Care (ANC) visit at least once during their last pregnancy and only (11.8%) had a history of Four or more visits for Antenatal Care, which are the lowest rates among all regions in Ethiopia.Objective The objective of the study was to explore the barriers and determine enabling factors affecting Antenatal Care service utilization in Somali Regional state.Methods A qualitative exploration was conducted from February 18 to March 11, 2017. A pre-tested semi-structured interview guides, and facility abstractions with checklists were used to collect the data. A total of 31 individual interviews, 12 focus group discussions, and 21 facility abstractions were collected. The population of the region were stratified into three areas based on their settlement characteristics as agro-pastoralist, pastoralist, and urban. Two districts were selected from each category based on their performance. The data was entered, coded, categorized, and analyzed by utilizing Nvivo version 11software. A thematic analysis was conducted using themes that were developed based on the constructs of the socio-ecological model.Results According to the study, economic constraints, place of residence, mothers’ being lack of awareness, preference of female health care provider, husband’s disapproval, lack of acceptance by the community, absence of full ANC services packages related with shortage of manpower, medical supply in majority of the health facilities and lack of perceived benefits from ANC service were the main barriers of ANC service utilization.Conclusion Individual, interpersonal, and organizational level factors were the most dominant barriers for ANC service utilization. Therefore, FMOH, regional, zonal and district level health administrators and other stakeholders should design effective IEC, community mobilization and work on supply-related problems to .increase ANC utilization in the region. |
