Frontiers in Psychiatry · 5 authors, 9 centres
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This qualitative study explored the acceptability and feasibility of a proposed community-based alcohol counselling programme for pregnant women in South Africa through interviews with women, community health workers, and healthcare providers. The central finding is that all stakeholders perceived a community-based intervention as acceptable and feasible, provided it addresses key clinic and community barriers like privacy, safety, and staff attitudes.
Thematic analysis of transcribed interviews revealed that pregnant women feel uncomfortable seeking help at antenatal clinics, and current services are perceived as inadequate due to poor screening, stigma, and resource constraints. All stakeholders found a community-based counselling programme acceptable and feasible, especially if integrated with existing CHW services, includes family members, and facilitates early antenatal care linkage. Key implementation challenges identified at clinic level included space shortages, staff attitudes, and long wait times, while community challenges included crime, lack of privacy, and fear of abuse. The study's implications are that these findings can guide the adaptation of a culturally appropriate programme, but intensive training, supervision, and a supportive environment are crucial for delivery. Limitations include potential social desirability bias, recall bias, and a focus on only hazardous or harmful drinkers, which may limit generalizability.
