Abstract Background It is recommended that Antenatal Care ANC be initiated within the first trimester of pregnancy for essential interventions, such folic acid supplementation, to be effective. Studies have shown that women who have had contact with a health worker are more likely to attend their first antenatal care appointment earlier in pregnancy.
Community health workers CHWs are in an opportune position to be this contact. This study explored CHW experiences with identifying women early in gestation to refer them to facility-based antenatal care services in Morogoro, Tanzania.
Methods This qualitative study employed 10 semi-structured focus group discussions, 5 with 34 CHWs and 5 with 34 recently delivered women in three districts in Morogoro, Tanzania. Results Study findings show CHWs play a major role in identifying pregnant women in their communities and linking them with health facilities.
Lack of trust and other factors, however, affect early pregnancy identification by the CHWs. They utilize several methods to identify pregnant women, including: asking direct questions to households when collecting information on the national census, conducting frequent household visits and getting information about pregnant women from health facilities.
Further studies need to be conducted investigating optimal workload for CHWs, as well as reasons pregnant women might conceal their pregnancies. The plan includes the provision of trainings for community health workers CHWs to deliver health education, including antenatal care ANC referrals to new mothers [ 1 , 2 , 3 ]. The plan requires CHWs to reach new mothers early in pregnancy, ideally in their first trimester, in order to provide referrals to ANC services.
