Abstract
BackgroundAntenatal care (ANC) is one of the evidence based interventions to decrease the probability of bad health outcomes for mothers and their newborns. Effectiveness of antenatal care, however, relies on the quality of care provided during each antenatal care visit. Hence this study attempted to assess the quality of antenatal care services at public health facilities of Bahir-Dar special zone, North Western Ethiopia.MethodsA facility based cross-sectional study employing both quantitative and qualitative methods was conducted from March to April 2010 in Bahir-Dar special zone, North Western Ethiopia. Quality of care was measured as a proportion of patients receiving recommended components of care. To measure the indicators, data was collected from 369 pregnant women who attended ANC clinics in eight public health facilities, during the data collection period. Data were collected through exit interviews with ANC attendees, observation during consultation, and in-depth interviews with health care providers.ResultsPregnant mothers attending ANC clinics were found to receive only part of recommended care components. Venereal Disease Research Laboratory (VDRL) test, blood group and Rhesus factor tests were done only for 73 (19.8%) and 133 (36.0%) of the women, respectively. Moreover 236 (64.0%) of the mothers missed the opportunity of receiving iron/folic acid supplement during their ANC visit. Three hundred fifty five (96.2%) of the women received tetanus toxoid vaccine. And only 226 (61.2%) of the women had their conjunctiva checked for anemia. Lack of reagents partly explained the problems observed in the provision of recommended care components.ConclusionAlmost half, 175 (47.7%) of the study women were not satisfied and a large proportion of mothers are missing opportunities to receive screening (like blood pressure and weight measurements) and preventive components of antenatal care (iron/folic acid supplementation). Therefore, efforts should be targeted to avoid missed opportunities by taking quality improvement measures including the fulfillment of all necessary resources.
Highlights
Antenatal care (ANC) is one of the evidence based interventions to decrease the probability of bad health outcomes for mothers and their newborns
Even though the new WHO antenatal model recommends that the blood pressure and weight of a pregnant mother should be measured in each ANC visit [11], this study demonstrated that the blood pressure and weight of 33 (8.9%) and 17 (4.6%) of the study women were not measured, respectively
This study revealed that only less than half,175 (47.7%) of the pregnant women scored above the mean satisfaction score with the ANC service provided at the eight public health facilities
Summary
Antenatal care (ANC) is one of the evidence based interventions to decrease the probability of bad health outcomes for mothers and their newborns. WHO recommends only four antenatal visits with the first visit in the first trimester (ideally before 12 weeks but no longer than 16 weeks), at 24–28 weeks, 32 weeks and 36 weeks. Each visit should include care that is appropriate to the woman’s overall condition and stage of pregnancy and help her preparing for birth and care for the newborn. If problems or potential problems that will affect the pregnancy and newborn are detected the frequency and scopes of visits are increased. The major goal of focused antenatal care (FANC) is to help women maintain normal pregnancies through identification of pre-existing health conditions, early detection of complications arising during pregnancy, health promotion and disease prevention and birth preparedness and complication readiness planning [2,3]
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