Exploring perceived awareness, barriers and enablers of pregnant women towards physical activity in Ethiopian cities: a qualitative study

Abstract

BACKGROUND: According to the World Health Organization, all healthy pregnant women are recommended to engage in at least 150 min of regular moderate-intensity aerobic activity per week. This level of physical activity is associated with numerous physical and psychological health benefits and helps to reduce the risk of being overweight, gestational diabetes, and preeclampsia. Despite its importance, adherence to the recommended levels of physical activity is low among pregnant women in Ethiopia, particularly in urban areas. Therefore, there is a need for a better understanding of barriers and enablers that affect physical activity levels. Thus, this study explored the perceived awareness, barriers, and enablers that influence pregnant women's physical activity in their everyday lives. METHODS: Seven focus group discussions were conducted with 45 pregnant women who attended routine antenatal care visits at selected health centers in four Ethiopian cities. The data were transcribed and exported to NVivo version 14 software for data management and analysis. An inductive process of thematic analysis was employed, and themes were developed. RESULTS: Most of the pregnant women had awareness about the health benefits of physical activity. However, some lacked awareness regarding safety precautions and the types of physical activities that can be done during pregnancy. Additionally, some had misconceptions about physical activity throughout the first trimester, believing that it results in abortion. The preferred method of physical activity was walking, both as a means of transportation and recreation. Health conditions, personal factors (such as being office worker, time constraint lack of commitment), societal factors (such as fear of judgment, culture) and environmental factors(such as lack of paved sidewalks, unfavorable weather conditions) were identified as barriers whereas partner support, experience sharing from pregnant women who had been exercising previously and having access to green space were identified as facilitators. CONCLUSIONS: This study identified several barriers and enablers that influence physical activity during pregnancy. By addressing Identified barriers, policy makers can create more enabling conditions for women to engage in safe, regularphysical activity during pregnancy, thereby reducing NCDs and improving maternal wellbeing and pregnancy outcomes.