Table 3 Identified gaps experienced in routine ANC care per support, information, and care practices

Support

Reported poor treatment at these clinic visits, including rude and rushed treatment (“they always shout at you (IDI 1)”), lack of individual care, and lack of provider continuity.

“I could say that at the clinic sometimes the service that they give us is not good because they don’t know how to talk to people; like even if you have a problem there you can’t even talk to the person you’re supposed to talk to, ja, like they can’t give you the right service.” (IDI 9)

“I can say the doctor that I got at the clinic was fine although sometimes you wouldn’t find the same doctor that was not nice, but the treatment was okay” (IDI 6)

I’d say patient care, they don’t know how to deal with people, they are rude, they don’t care what they’re doing they just do it to get it done as long as you’re finished and gone. (IDI 2)

Information

Not receiving sufficient information or explanation about pregnancy, child development, breastfeeding, or the care practices they underwent. In describing this lack of information, participants seemed to link it, not only to feeling uninformed, but also to feeling uncared for.

“At the clinic they check minor things, they don’t explain much…because at the clinic you don’t get taught much, especially about the child [growth] chart, they don’t explain the red line is for the child being overweight, the orange meaning underweight, they just wrote the information and that was that.” (IDI 3)

“Even when you have to go to the clinic, they don’t actually tell you what is right or wrong they just give you supplements and then they just check how the baby is and that is it you know; they don’t actually check you or your mind-set and how it is, you know?” (IDI 12)

“At Bukhali they give you a lot of information at the clinic they just do their job and that is that… They really don’t care at the clinic hey, if you bought in your child because they are sick, they just give the baby an injection and that is that they don’t give you all the extra information about anything.” (IDI 15)

Care practices

Lack of provision of (multiple) ultrasounds; lack of personalised care and provider continuity.

And then the sonar, the different is that there you go to the sonar once; and then here you go every time you come visit, ja. (IDI 2)

At the clinic they don’t do sonars …; like here [at Bukhali] they do thorough checks man; at the clinic they checked our blood because of maybe they want to push and finish with us (IDI 10)

At the clinic I still didn’t get help even though they had the information that I got from here with my urinary infection, they couldn’t help me… I was actually quite stressed after I discovered that the doctor didn’t want to help me at the clinic; because they weren’t also sure about how bad the infection was. (IDI 7)