Barriers Associated with Misuse of Laboratory in Antenatal Care in Senegal: A Quantitative Approach

Abstract

Barriers Associated with Misuse of Laboratory in Antenatal Care in Senegal: A Quantitative Approach Maternal mortality remains high in developing countries; however laboratory can help to fight against this problematic situation. In Senegal, six (6) tests are recommended by the national program, for antenatal screening. This study aimed to identify barriers regarding utilization of laboratory, by pregnant women, during antenatal care (ANC), in Senegal. A cross-sectional study was conducted in 16 peripheral health facilities, 12 health centers and 4 hospitals (EPS1). Data were collected, amongst 1692 pregnant women, 61 midwives, 99 laboratory staffs and 16 administrators, from February 2013 to July 2014. Pregnancy age, gestity, parity, pregnant age, ANC location were variables studied from pregnant women. From the laboratory, timely accessibility, concordance of opening hours with ANC services, availability of reagents and equipments, skilled laboratory staff, acceptability of results delivery, tests prices visibility, confidentiality and adequacy of infrastructures, were investigated. From ANC, waiting time, availability of skilled midwives and guidelines, adequacy of waiting rooms and infrastructures, were studied. Data were entered in Microsoft Excel version 2013 and Open Clinica 3.1.3, then exploited and analyzed in SPSS version 20. Laboratory misuse was 87.88% among 1692 pregnant women who went to the facilities for the first ANC visit. The whole population had 25.25 ±6.19years [20-29 years] (55%), first pregnancy trimester (54%), multigest (66%), multiparous (42%), had frequented health centers (75%). In the multivariate model, variables independently associated with laboratory use were: gestity, parity (more than 3), confidentiality, affordability of tests prices, availability of guidelines and health center level. Most of the barriers are supply-health systems. It is then important to take into account these results, to sensitize pregnant women, health personnel and authorities for a better use of the laboratory during antenatal care.