Stakeholder Experiences of Community-Linked Group Antenatal Care in Rural Northern Uganda: A Qualitative Study.

Abstract

Background: Group antenatal care (G-ANC) combines shared learning and peer support with antenatal services. Evidence on stakeholder experiences of community-linked models in post-conflict settings remains limited. This study explored the experiences of pregnant women,Village Health Team (VHT) members and facility midwives participating in or implementing G-ANC in Kole District, Northern Uganda. Methods: An exploratory qualitative study conducted in June 2024 included nine key-informant interviews with four VHT members and five facility midwives, and four focus-group discussions with 33 pregnant women. Audio-recorded data were transcribed and analysed using a combined deductive–inductive thematic approach supported by ATLAS.ti version 23. Results: Five themes concerned education and services, acceptability and perceived benefits, implementation and access challenges, cultural and gender influences and conditions for continuation. Participants valued shared discussion, peer reassurance, health informa tion, and encouragement to attend care. VHT members described mobilization, education, and referral support, while midwives described clinical oversight and staffing pressures. Group-specific constraints included insufficient meeting space, materials, and facilitator capacity. Medicine shortages, provider absence, and transport difficulties affected the linked routine antenatal care pathway. Participants identified training, supervision, reliable clinical services, community engagement, and district integration as conditions for continuation. Conclusion: Participants perceived community-linked G-ANC as acceptable and supportive of learning, peer support and motivation to attend care. This study did not measure changes in knowledge, attendance or clinical outcomes, or demonstrate effectiveness or long-term sustainability. Implementation requires support for group facilitation alongside reliable facility-based antenatal services.