Previous experience with medications may be a cue.
What happened the last time they took chloroquine?
Was there itching?
There was not?
The child recover quickly or not?
And mass media advertising drugs would be another cue.
The next slide looks at applying health leaf model to decisions of
pregnant women to attend antenatal care in a timely and consistent manner.
This is somewhat of a complicated behavior in the sense that it involves
one booking or registering for antenatal care relatively early.
And then attending at intervals recommended by the nursing staff.
The question arises,
are there any perceived threats that the mother has during pregnancy?
Often times, people would see pregnancy as a normal condition.
There are any problems such as miscarriages,
etc., people would consider it to be fate.
It's not likely that the average person would have these kind of complications.
Although the consequences would be perceived of as very serious
by the woman and by family members.
But since pregnancy is considered normal for the most part, people who don't feel
susceptible to problems, they may not be able to articulate
eclampsia in their local languages, then there doesn't seem to be much threat.
What do people think about antenatal care itself?
Well, if we look back at our force field analysis
we can see the perceived benefits.
Safe delivery,
healthy baby, good health of the mother, maybe a shorter hospital stay.
On the negative side, the constraints.
If they have to pay fees.
If it takes a lot of time to be attended to.
If the maternity center is far away.
If there are transfer problems.
If they're reluctant to reveal to other people they are pregnant before it shows.
If the attitude of the provider is abusive or not friendly.
But on the whole, women enjoy going to antenatal care in many of the villages and
see the positive aspects.
Even though they consider pregnancy normal, benefit of attending,
meeting other women, getting the medications,
getting the examinations is seen as something positive.
So the likelihood of attending is moderate, assuming it's available.
Modifying factors would include knowledge of pregnancy risks,
economic status of the family whether they can afford the fees, age and parity.
Which are obviously interrelated.
It's possible that after experiencing several pregnancies,
a woman may feel less at risk.
Occupation, whether she has the time.
Educational status, household structure,
who can help her with taking care of other children while she attends.
Finally there are cues to action for previous pregnancy experiences.
Current symptoms or feelings.
Experiences and behavior of friends, whether they're going,
if she would meet them there.
Advice from her mother, her mother in law.
And communication by the health workers over the radio, through home visits.
As we can see in the next slide we do make use of our information,
from explanatory models, to construct our theoretical models.
We take people's own perceptions and tried to interpret that information in terms
of the variables that we know will influence health behavior.
Therefore, before planning any program, these models help
us design questionnaires, design focus groups to ask questions.
We find out about local beliefs and then we use that information to construct our
models and theories to help predict why people will attended antenatal care.
Why they will use bed nets.
And who is more likely to use bed nets than others.
Are there different segments of the population?
In terms of the beliefs about pregnancy,
the existing explanatory model or understanding of how pregnancy works,
can see that it's normal but people want to keep it hidden.
Beliefs about malaria influence the recommended action.
The cause being perceived as sun or heat.
People do not believe nets could prevent sun or heat in the daytime,
if you're sleeping under the net at nighttime.