That's Where Our Humanness Lies": How Families Leverage Social Capital to Access Antenatal Care in Rural, Eastern...

Families across sub-Saharan Africa (SSA) often rely on social capital to access traditional, faith-based, and biomedical antenatal care (ANC). Yet, many current studies focus on biomedical ANC and emanate predominantly from the Global North. In this qualitative case study, we aimed to explore how families utilize social capital to access various types of ANC in Mafararikwa, a rural ward in Eastern Zimbabwe. We generated data through interviews with 30 health professionals, and consultations, focus group discussions, and storyboarding with 71 community-level key informants and parents or legal guardians. We analyzed the data thematically. We identified four main themes: Theme 1: Support through social networks and community groups (families draw support from social networks, local groups, and community initiatives to engage with different types of ANC); Theme 2: Material and non-material support (families draw material and non-material supports from social networks, local groups, and community initiatives to engage with various forms of ANC); Theme 3: Reciprocal norms and sociocultural practices (families leverage reciprocal actions, norms of respect and courtesy towards pregnant women, mutual trust, and socio-cultural practices to engage with diverse ANC types); and Theme 4: Informal supports and care mixing dynamics (local informal supports shape families' interactions with different types of ANC). The complex ways families in Mafararikwa leverage social capital to access preferred forms of ANC reflect context-specific relationships and holistic health conceptions grounded in Ubuntu. Culturally-specific responses that strengthen these relationships are needed to ensure equitable ANC outcomes in Mafararikwa and beyond.