Abstract
Background: The quality of antenatal care (ANC) a woman receives during pregnancy is crucial to both the child and the mother's life. It has been established that providing high-quality ANC can save lives and has a positive impact on postnatal health care services. However, the quality of ANC in Zambia requires attention as maternal and neonatal mortality rates are still unacceptably high with Lusaka district not being left out of the problem.Methods: Using a cross-sectional study design, the main aim of this study was to determine the demand side factors associated with high-quality antenatal care among pregnant women in Lusaka. It also estimated the proportion of women who received high-quality ANC during their last antenatal visit. Multifactorial logistic regression model was fitted in STATA version 13 to predict the demographic, socio and economic factors that influence the quality of ANC.Results: It was established that only 47.1% of pregnant women received high-quality ANC while 52.9% received low quality. Six key ANC interventions were considered, among which urine (36.7%) and blood (46.8%) testing were the least received basic components of ANC. After adjusting for the effect of other factors, women with secondary education had higher odds of receiving high-quality ANC than women with primary level of education (OR = 1.98; 95% CI: 1.24–3.14). Women staying with their husband/partners had lesser odds of receiving high quality ANC compared to those that were not staying with their partners (OR = 0.47; 95% CI: 0.28–0.79).Conclusion: The quality of antenatal care received by pregnant women in Lusaka is low. Continued efforts to improve the delivery of basic ANC services such as blood and urine testing is required to improve the quality of healthcare services provided by medical personnel at all levels.
Highlights
The quality of antenatal care (ANC) that pregnant women receive in Zambia continues to be poor despite several interventions
Women who were living with their male partners were less likely to receive high quality ANC compared to those who were not living with their partners (OR = 0.47; 95% CI: 0.30–0.74)
High parity reduced the odds of a woman receiving high quality ANC as women with more than three children were almost 50% less likely to receive high quality ANC than women who were pregnant for the first time (OR = 0.56; 95% CI:0.34–0.96)
Summary
The quality of antenatal care (ANC) that pregnant women receive in Zambia continues to be poor despite several interventions. Research has shown that only 29% of women in Zambia receive high-quality antenatal care [1]. Low ANC quality has serious adverse effects on the health of pregnant women and contributes to the high number of maternal deaths [2]. Zambia remains one of the countries with unacceptably high Maternal Mortality rates with 323–474 maternal deaths per 100,000 live births in 2014 [3]. It has been established that providing high-quality ANC can save lives and has a positive impact on postnatal health care services. The quality of ANC in Zambia requires attention as maternal and neonatal mortality rates are still unacceptably high with Lusaka district not being left out of the problem
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