(960) How pregnancy impacts health-related quality of life: qualitative study in five African and Asian countries

Objective: To examine how pregnancy-related physical, emotional, social, and financial challenges are conceptualized, discussed, and experienced by pregnant women in six demographic and health surveillance study areas in Africa and Asia and how these challenges impact health and wellbeing during pregnancy.

Study Design: Thirteen focus groups discussions (FGDs) were conducted, with a total of 120 pregnant women in Ghana (2 FGDs, n=22), Kenya (2 FGDs, n=20), Zambia (3 FGDs, n=23), India (4 FGDs, n=34), and Pakistan (2 FGDs, n=21) using a semi-structured guide. FGDs were transcribed verbatim in the local language and translated into English. A subset of translated transcripts from each site was coded independently by two coders (one from the country of collection) to develop six preliminary site-specific codebooks, which informed the development of two regional codebooks. All translated transcripts were coded independently by two coordinating site coders using Dedoose™; themes and subthemes were identified using thematic analysis and discussed with local site teams, after which refinements were made and representative quotations were selected.

Results: Three overarching themes were identified: 1) Pregnancy symptoms pose a barrier to daily life; 2) Lack of social support exacerbates physical and emotional challenges during pregnancy; and 3) Social support alleviates physical, emotional, and financial challenges of pregnancy. One additional minor theme was that support from the healthcare system impacts health and wellbeing.

Conclusion: These findings demonstrate that pregnant women experience a variety of health and wellbeing challenges during pregnancy, which are exacerbated when social support is not available and alleviated in the context of help from family and community. Additional physical, emotional, and family and community support during pregnancy is needed to alleviate the plethora of complex and multifaceted challenges women face during pregnancy and improve their physical and mental health and overall quality of life.