An issue of culture: the effects of daily activities on prenatal care utilization patterns in rural South Africa

Utilization of healthcare facilities has been extensively analyzed in developed countries by researchers from a wide range of disciplines. However, there is still a need to develop a better understanding of the temporal and spatial factors that affect rural women within developing countries. An important piece of this exploration is addressing time constraints and the cultural context. After time has been spent attending to essential tasks that the entire family is dependent upon, do rural women have "disposable time" left to visit a healthcare facility? The setting for this study is the Ubombo Magisterial District, a northern rural area of KwaZulu Natal, South Africa. Environmental factors and socio-economical factors that motivate or discourage women from utilizing prenatal care are addressed using a multinomial logit model. Many of the factors documented in literature as affecting prenatal care utilization, i.e. age and parity, do not apply in this area. On the other hand, fetching water as a daily activity, which is usually not associated with prenatal care utilization, has a significant effect on utilization. (C) 2004 Elsevier Ltd. All rights reserved.