Factors influencing successful implementation of the basic antenatal care approach in primary health care facilities in eThekwini district, KwaZulu-Natal

Abstract

In a move to alleviate the burden of consistently high maternal and perinatal mortality rates, the South African National Department of Health (DoH) introduced Basic Antenatal Care (BANC) in all Primary Health Care facilities that were providing antenatal care services. However, not all facilities in the eThekwini district have successfully implemented the approach. The aim of the study was to identify the factors that influence successful implementation of the BANC approach. The objectives were to identify facilities that had successfully implemented the BANC approach and the factors that influenced successful implementation of the BANC approach, in order to make recommendations on these factors. A descriptive quantitative design was used. Firstly, primary health care facilities that were successful in implementing the BANC approach were identified through a retrospective record auditing. A total of 27 facilities were identified, of which 18 facilities were included in the study. This was followed by data collection from 59 midwives in order to identify the factors that influenced successful implementation of the BANC approach. The data was analysed using version 19 of the Statistical Package for the Social Sciences. The positive factors that influenced successful implementation of the BANC approach included: the availability and accessibility of BANC services, policies, guidelines and protocol; various means of communication; a comprehensive package of and the integration of primary health care services; training and in-service education; human and material resources; the support and supervision offered to the midwives by the primary health care supervisors; supervisors' understanding of the approach and the levels of experience of midwives involved in implementation of the BANC approach. The success that the facilities had achieved in implementing BANC approach was attributed to these positive factors.