BACKGROUND:
Antenatal care (ANC) is essential for improving maternal and neonatal health outcomes, yet adherence to ANC services remains a challenge in many low-income settings, including Rwanda. Understanding healthcare providers’ (HCPS) perspectives on factors influencing ANC adherence is crucial for developing targeted interventions to enhance service utilisation and maternal health outcomes.

OBJECTIVES:
To understand healthcare providers’ (HCPS) perspectives on factors influencing ANC adherence.

METHODS:
This study employed a qualitative descriptive design to explore the perspectives of HCPS on ANC adherence in Rwanda. Fifteen in-depth, semi-structured interviews were conducted in Kinyarwanda. The interviews were transcribed verbatim and then translated into English. ATLAS.ti 7software was used to organize the data, which was then thematically analysed.

RESULTS:
The perspectives of HCPs were summarised into four themes. Participants mentioned drivers of women’s engagement with ANC services, such as community education, structural motivators, availability of diagnostic infrastructure like ultrasound, and HCP training and mentorship. The hindrances to women’s ANC adherence noted by participants included cultural beliefs and community misconceptions, stigma and secrecy surrounding unintended pregnancies, cost-related delays in ANC seeking, and gender dynamics and relationships. HCPs also highlighted challenges in delivering effective ANC services, such as staffing shortages and limitations in infrastructure and equipment. Suggested improvements included community engagement and support, increased staffing and resources, and the digitalization of records to improve ANC adherence.

CONCLUSIONS:
HCPs play a critical role in shaping ANC adherence through service delivery and patient education. Their consistent engagement and ability to build trust with pregnant women make them key influencers in promoting timely and sustained ANC attendance

KEY MESSAGE:
Addressing systemic challenges, strengthening community-based support, and enhancing policy implementation are essential strategies for improving ANC adherence in Rwanda. These findings provide valuable insights for policymakers and healthcare stakeholders to develop targeted interventions aimed at increasing ANC uptake and improving maternal and neonatal health outcomes. Pregnancy - access