Maternal health literacy and its associated factors among pregnant women in Western Cape antenatal clinics

Abstract

BACKGROUND: Maternal health literacy influences how pregnant women access, understand and use healthcare services for themselves and their children. Limited maternal health literacy is associated with poor maternal and foetal outcomes. AIM: To assess maternal health literacy and its associated factors among pregnant women attending antenatal clinics in the Western Cape. SETTING: The study was conducted in antenatal clinics of the Western Cape. METHODS: A cross-sectional survey was conducted among 248 pregnant women using the Maternal Health Literacy Inventory in Pregnancy (MHELIP), together with measures of socio-demographics, depression and functional health literacy (reading and understanding). Data were analysed using the Statistical Package for Social Sciences (SPSS) version 29. Descriptive statistics summarised participant characteristics and maternal health literacy domains, while non-parametric tests and logistic regression identified predictors of maternal health literacy. RESULTS: Participants had a mean age of 27.4 years (± 7.53; range: 18-45), and 60.5% (n = 150) reported more than two pregnancies. Most respondents (80.0%, n = 196) had limited maternal health literacy, with a mean MHELIP score of 57.8 out of 100 (standard deviation [s.d.]: 10.8; range: 21-87). Adequate maternal health literacy was significantly associated with higher reading, understanding, and decision-making scores, while women with no risk of depression scored higher in assessing maternal health information (p 0.05). Reading and understanding significantly predicted maternal health literacy (odds ratio [OR]: 1.20), explaining 10.0% of the variance. CONCLUSION: Most pregnant women had limited maternal health literacy, underscoring the need for tailored antenatal education.Contribution: The findings inform the development of maternal health literacy programmes to support informed decision-making among pregnant women in South Africa.