Abstract
Antenatal care (ANC) has been recommended as a service that can reduce both maternal and newborn mortalities. However, even in areas recording high ANC attendance, there are unevenly high levels of maternal and new born mortalities. Evidence of a weak relationship between ANC use and maternal and newborn survival has motivated recent calls to focus on content and quality of care provided rather than mere ANC attendance. This was a descriptive cross sectional study which was designed to evaluate the quality of antenatal care services in two health facilities in Lusaka and two in Mumbwa districts of Zambia. The health facilities were selected purposively based on poor maternal outcomes such as high maternal mortality ratio. Women attending antenatal clinics were selected using simple random sampling. Data was collected using a client exist interview schedule designed by World Health Organization for assessing quality of antenatal care. Data was analyzed using Statistical Package for Social Scientist (SPSS) version 24.0. The study revealed a lot of variations in the care provided at the four sites. None of the women had all the blood tests for haemoglobin, grouping and X-match, HIV and syphilis conducted from three out of the four health facilities, while at the fourth, only 30% of women had all the blood tests conducted. Furthermore, less than 20% of women had a full head to toe examination. While less than 10% of women from each of the facility reported that the health providers met the requirements for provision of privacy. Despite not meeting the minimum standards of care, only less than 5% of women categorized the care as poor. All the four health facilities recorded low quality of care on all domains of antenatal care. Therefore, if antenatal care has to achieve its intended purpose of reducing adverse maternal and new born outcomes, then quality of care delivered during pregnancy should be the focus as opposed mere attendance. Key words: Quality, antenatal care services, evaluation.
Highlights
Every day, approximately 800 women die from preventable causes related to pregnancy and childbirth (WHO, 2017)
This study evaluated the quality of Antenatal Care (ANC) and perceived satisfaction with care received at the four health facilities against each component of the WHO ANC package
Quality of care was evaluated with regard to the percentage of women receiving each component of care
Summary
Approximately 800 women die from preventable causes related to pregnancy and childbirth (WHO, 2017). To this effect, Antenatal Care (ANC) has been recommended as one means to reduce both maternal and newborn mortalities (WHO, 2005). ANC services enable early identification of pregnancy related. Risks and complications and ensure access to services including health education, vaccinations, diagnostic tests and treatments (Gross et al, 2011). WHO (2016) states that antenatal care does serve as a platform for health promotion, prevention, screening, and diagnosis of diseases and as an opportunity to provide pregnant women with the social and psychological support necessary for healthy motherhood. For example in Zambia, more than 9 in 10 (96%) mothers received antenatal care from a skilled provider for their most recent pregnancy, while the maternal mortality ratio is still standing at 398/100,000, while neonatal and infant mortality stands at 24 deaths/1,000 and 45/1,000, respectively
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