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  1.  Barriers to consistent prenatal care by women residing in rural area


    Discuss  Barriers to consistent prenatal care by women residing in rural area



Subject Nursing Pages 6 Style APA


Barriers to Consistent Prenatal Care by Women Residing in Rural Area


Consistence in prenatal care by women residing in rural areas is a factor worth studying since most pregnant women in those areas rarely follow up on health care through their pregnancies. Prenatal care is essential for any pregnant woman as it entails an overall body check up to ensure both the woman and the unborn child, are in good health. Using the Theory of Planned Behavior (TPB), there will be an identification of how the theory impacts the concept of prenatal care and the insights it provides for the analysis of the concept.

Theory of Planned Behavior

Understanding human behavior and all its complexities is quite a demanding task. The theory of planned behavior (TPB), is very essential in understanding and predicting human conduct as it contends that different actions are determined by intentions and under some circumstances, professed behavioral control (Kan & Fabrigar, 2017). Its key component is behavioral intent as the theory’s intended purpose was to explain human behaviors and that which enables individuals to exert self-control. The Theory of reasoned action contributed to the development of this theory after the researchers discovered that not all conducts are under volitional mechanism (Kan & Fabrigar, 2017). It means that there is a certain degree of control that people have over a behavior. The perceived component of behavioral control is the component that differentiates this theory from that of reasoned action.

TPB has been incorporated successfully in the prediction and explaining of a variety of health behaviors including health services utilization and prenatal care. According to the theory, the achievement of a specific behavior depends on the intention behind it and the ability to control it (Kan & Fabrigar, 2017). Motivation and behavior control are the main concepts that contribute to various human behaviors. Some factors that exist to help determine behavior intentions in TPB include; attitudes towards the identified behavior, behavioral intention, the supposed behavior control and perceived power, and the subjective and social norms. These constructs collectively represent the ability of an individual to take actual control over a certain behavior.

Major Concepts of TPB and how they relate to Prenatal Care

Intention is a major concept of TPB and it has a significant impact on prenatal care. According to the theory, a person will have the motivation to act in a certain way when he or she evaluates the action positively, believes that other individuals think that that is the proper way to act, and recognize that it is within their control (Kan & Fabrigar, 2017). Motivation is the main idea behind the model whereby an individual evaluates the thoughts of others and their ability to behave in a certain manner. Intention has a significant impact on prenatal care since the motivation to attend maternity care and prepare for childbirth is swayed by how a person values child preparedness. According to Moshi, Kibusi, and Fabian (2018), if an expectant mother has a positive perception of a behavior, and believe that other important individuals think that the action is worth doing in addition to believing that they can do it, then she will have the intention  to prepare for safe delivery. It all begins with the intention to do something that is the reason some pregnant women seek to access prenatal care while others choose not to, resulting in unprepared birth emergencies.

Another major concept is the attitude towards a certain behavior and the perceived behavior control. Attitude in TPB refers to the extent in which an individual positively or negatively views a behavior (Kan & Fabrigar, 2017). It is basically a consideration of whether or not to engage in the behavior with regard to whether other important individuals would approve of the action. The ability of an expectant woman to engage in prenatal care is influenced by the family, community, and other social contexts and beliefs that that are important to the woman. According to Lee, Chiang, Hwang, Chi, and Lin (2016), engaging in regular exercises is part of prenatal care. Many expectant women lack the intention to exercise regularly and are often influenced to do it by the family, community, and other social contexts. The male partners are important figures to these women and their opinions regarding prenatal care quickly influences a woman’s behavior regarding birth preparedness (Moshi, Kibusi & Fabian, 2020). This concept of the theory can be influenced by the attitudes of the male partners, the innovative intervention strategies present in health care facilities, and the perceived subjective norms all of which can influence the intention to take part in prenatal care. 

Insights of TPB for Analysis of Prenatal Care

TPB is essential in the analysis of prenatal care since it examines the domains of attitude, intention, and perceived behavior control as they contribute to whether or not a pregnant woman engages in prenatal care. These concepts influence the motive for birth preparedness contributing to a better understanding of the concept of prenatal care and the reason a large number of pregnant women residing in rural areas do not choose to engage in it.

Literature Review

A free maternal health policy implemented by the National Health Insurance Team in Ghana affects prenatal care and pregnant women in rural areas. According to Dalinjong, Wang, and Homer (2018), the policy gives pregnant women the right to enjoy free health services throughout their pregnancy and during childbirth. Pregnant women got to access prenatal care even when they did not have any money which increased the level of birth preparedness among expectant women in rural areas. As a result of the free maternal health policy, prenatal care has become easily accessible to pregnant women in the rural areas hence promoting increased levels of birth preparedness and fewer cases of mortality during childbirth. 


The TPB theory is essential in studying the concept of prenatal care as the matter of birth preparedness is determined by an individual’s attitude, intention, and perceived behavior control. These factors are the major concepts of TPB and they are also the major drivers of prenatal care. Before engaging in prenatal care, women often look at several factors including the attitudes and Perceptions of their male partners and the willingness to do so. TPB is therefore insightful in the study and analysis of prenatal care. Additionally, the free maternal health policy implemented by the NHIT in Ghana impacts the concept of prenatal care as it increases the chances of pregnant women to engage in birth preparedness during the pregnancy period. Pregnant women in rural areas would therefore, have easy access to prenatal care increasing their overall chances of having healthy and safe child deliveries.




Dalinjong, P. A., Wang, A. Y., & Homer, C. S. E. (2018). The implementation of the free maternal health policy in rural Northern Ghana: synthesised results and lessons learnt, BMC Research Notes, 11(341).

Kan, M. H., & Fabrigar, L. R. (2017). Theory of Planned Behavior, In: Zeigler-Hill V., Shackelford T. (eds) Encyclopedia of Personality and Individual Differences. Springer, Cham. https://doi.org/10.1007/978-3-319-28099-8_1191-1

Lee, C., Chiang, I., Hwang, F., Chi, L., & Lin, H. (2016). Using the Theory of Planned Behavior to Predict Pregnant Women’s Intention to Engage in Regular Exercise, Midwifery 42. DOI: 10.1016/j.midw.2016.09.014

Moshi, F. V., Kibusi, S. M., & Fabian, F. (2018). Using the Theory of Planned Behavior to Explain Expecting Couples Birth Preparedness Intentions in a Rural Setting: A Cross-Sectional Study from Rukwa, Southern Tanzania, Advances in Public Health, 1(1087342). https://doi.org/10.1155/2018/1087342

Moshi, F. V., Kibusi, S. M., & Fabian, F. (2020). Using the theory of planned behavior to explain birth in health facility intention among expecting couples in a rural setting Rukwa Tanzania: a cross-sectional survey, Reproductive Health, 17(2). https://reproductive-health-journal.biomedcentral.com/articles/10.1186/s12978-020-0851-1




Street, G., James, R., Cutt, H., (2007). The relationship between organised physical recreation and mental health. Health Promot J Austr. 18(3):236-9. doi: 10.1071/he07236. PMID: 18201167.

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