Abstract
BackgroundIn Ethiopia, more than 62% of pregnant women attend antenatal care at least once, yet only about one in four women give birth at health facility. This gap has fueled the need to investigate on the quality of ANC services at public health facilities and its link with the use of institutional delivery.ObjectiveTo assess the linkage between ANC quality and the use of institutional delivery among pregnant women attending ANC at public health facilities of BDR City AdministrationMethodsA facility based prospective follow up study was conducted. and nine hundred seventy pregnant women with gestational age ≤ 16 weeks who came for their first ANC visit were enrolled.Women were followed from their first ANC visit until delivery. Longitudinal data was collected during consultation with ANC providers using structured observation checklist. ANC service was considered as acceptable quality if women received ≥75th percentile of the essential ANC services. Generalized Estimating Equation (GEE) was carried out to control cluster effect among women who received ANC in the same facility.ResultsAmong 823 pregnant women who completed follow up, only about one third (27.6%) received acceptable quality of ANC services. In one health facility syphilis test was not done at all for the last two years. The odds of giving birth at health institution among pregnant women who received acceptable ANC quality service was about 3.38 times higher than among pregnant women who received unacceptable ANC quality service (AOR = 3.38, 95% CI: 1.67, 6.83).Conclusion and recommendationIn this study the quality of ANC service provision in public health facilities was compromised/low. Provision of quality ANC service had a great role in promoting institutional delivery. Therefore the local authorities at each level of health sector or the nongovernmental organizations working to improve maternal health need to provide training on focused antenatal care protocol for ANC providers.
Highlights
Care during pregnancy is important for the health of the mother and the development of the unborn baby
Even if the proportion of women who received quality antenatal care in this study and the study done in Mexico was almost the same, there is 17 years gap in between two studies which indicates that the quality of Antenatal Care (ANC) service in the study area is far behind
The quality of antenatal care service in public health facilities of the study area was compromised/low and adherence to Focused Antenatal Care (FANC) protocol had a great role in promoting the use of health facility delivery
Summary
Care during pregnancy is important for the health of the mother and the development of the unborn baby. The lifetime risk of maternal mortality is estimated at 1 in 36 in SSA, contrasting 1 in 4900 in developed countries These showed the presence of greater disparities in maternal health care worldwide [1,2,3,4]. In Ethiopia, more than 62% of pregnant women attend antenatal care at least once, yet only about one in four women give birth at health facility. This gap has fueled the need to investigate on the quality of ANC services at public health facilities and its link with the use of institutional delivery
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