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A socio‐ecological approach to understanding barriers to prenatal care for women of low income
Author(s) -
Sword Wendy
Publication year - 1999
Publication title -
journal of advanced nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.948
H-Index - 155
eISSN - 1365-2648
pISSN - 0309-2402
DOI - 10.1046/j.1365-2648.1999.00986.x
Subject(s) - social ecological model , prenatal care , qualitative research , health care , ecological psychology , promotion (chess) , ecological systems theory , product (mathematics) , psychology , nursing , sociology , ecology , medicine , social psychology , environmental health , political science , economic growth , economics , social science , population , geometry , mathematics , politics , law , biology
A socio‐ecological approach to understanding barriers to prenatal care for women of low income This paper critically examines the notion of barriers as conceptualized in the literature and suggests an expanded orientation to more fully appreciate its complexity. This alternative approach not only takes into account factors and processes relevant to the individual that create constraints to utilization, but also acknowledges influences on the design and delivery of health care. These latter considerations determine the availability and characteristics of programmes and services that may or may not encourage or enable participation by persons of low income. A socio‐ecological model is proposed that compels health care practitioners and researchers to acknowledge the many influences on utilization behaviour. The literature on barriers to prenatal care is subsequently reviewed and evaluated, with consideration given to the range of behavioural determinants suggested by the model. Finally, a case is made for qualitative methods for inquiry to further enhance knowledge about factors and processes influencing use of the health care system, including prenatal care. It is argued that these approaches lead to enhanced appreciation of behaviour as a social product and are consistent with the ideology of health promotion.