Abstract
BackgroundThe high rate of antenatal care attendance in sub-Saharan Africa, should facilitate provision of information on signs of potential pregnancy complications. The aim of this study was to assess quality of antenatal care with respect to providers' counselling of pregnancy danger signs in Rufiji district, Tanzania.MethodsA cross-sectional study was conducted in 18 primary health facilities. Thirty two providers were observed providing antenatal care to 438 pregnant women. Information on counselling on pregnancy danger signs was collected by an observer. Exit interviews were conducted to 435 women.ResultsOne hundred and eighty five (42%) clients were not informed of any pregnancy danger signs. The most common pregnancy danger sign informed on was vaginal bleeding 50% followed by severe headache/blurred vision 45%. Nurse auxiliaries were three times more likely to inform a client of a danger sign than registered/enrolled nurses (OR = 3.7; 95% CI: 2.1-6.5) and Maternal Child Health Aides (OR = 2.3: 95% CI: 1.3-4.3) and public health nurses (OR = 2.5; CI: 1.4-4.2) were two times more likely to provide information on danger signs than registered/enrolled nurses. The clients recalled less than half of the pregnancy danger signs they had been informed during the interaction.ConclusionTwo out of five clients were not counselled on pregnancy danger signs. The higher trained cadre, registered/enrolled nurses were not informing majority of clients pregnancy danger signs compared to the lower cadres. Supportive supervision should be made to enhance counselling of pregnancy danger signs. Nurse auxiliaries should be encouraged and given chance for further training and upgrading to improve their performance and increase human resource for health.
Highlights
The high rate of antenatal care attendance in sub-Saharan Africa, should facilitate provision of information on signs of potential pregnancy complications
Referrals are made for high risk pregnancy or complications from 52 dispensaries and 4 rural health centres (RHCs) found within the district, which provide antenatal care, as stipulated by the national guidelines on the Reproductive and Child Health Card Number 4 (RCHC-4) [11]
Maternal and Child Health Aides (MCHAs) have two years training as auxiliary midwives, and provide antenatal and postnatal care, family planning services, counselling and treatment of sexually transmitted infections, and attend normal deliveries commonly occurring at the dispensaries and health centres
Summary
The high rate of antenatal care attendance in sub-Saharan Africa, should facilitate provision of information on signs of potential pregnancy complications. The aim of this study was to assess quality of antenatal care with respect to providers' counselling of pregnancy danger signs in Rufiji district, Tanzania. It was estimated in 2005 that of more than 500 000 maternal deaths worldwide, more than half occurred in subSaharan Africa [1]. Nikiema and co-workers [8] utilized data from the Demographic and Health Survey and found that in 15 of 19 sub-Saharan countries, less than half of all women recalled having received information during their antenatal care about the potential danger signs of pregnancy complications
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