Evidence of application of the Basic Antenatal Care principles of good care and guidelines in pregnant women's antenatal care records.

Abstract

BackgroundBasic Antenatal Care (BANC) is an approach that is used in the public health institutions of South Africa to provide health care services to pregnant women. The approach was introduced as a quality improvement strategy based on the belief that good quality Antenatal Care (ANC) could reduce maternal and perinatal mortalities and improve maternal health.AimThe aim of this study was to analyse pregnant women’s ANC records for evidence suggesting that the BANC principles of good care and guidelines were being applied.SettingThe study was conducted in the 12 primary health care clinics that were providing ANC services using the BANC approach in eThekwini district, KwaZulu-Natal.MethodsA cross-sectional quantitative design was used to conduct the study. Data were collected through retrospective record review of 1200 maternity case records of the pregnant women who had attended for ANC services three or more times and was analysed using Statistical Package for Social Sciences (SPSS) version 21.0.ResultsThe majority of the processes detailed in the guidelines and principles of good care were evident in the records. However, several were missing or recorded in few reviews. These included the ANC plan, delivery plan, midwives’ counter signatures on the cards, assessment for foetal congenital abnormalities, and consent for HIV testing.ConclusionThe study identified evidence of incomplete application of the BANC principles of good care and guidelines in pregnant women’s antenatal care records which indicated that the BANC approach was not being successfully implemented. Recommendations were made with regards to policy development, institutional management and practise, nursing education, and further research to assist in successful implementation of the BANC approach in line with the guidelines and principles of good care.