Antenatal Care Services Research Articles

Antenatal Care Service Utilization and Its Associated Factors Among Somali Women

BACKGROUND:Maternal morbidity and mortality remain high in developing regions due to the consequences of pregnancy and childbirth. There is evidence that antenatal care (ANC) is one of the most effective strategies for reducing maternal mortality in a global context. Thus, this study aimed to evaluate ANC service utilization among Somali women and the effects of general and pregnancy-related characteristics of women, healthcare facility accessibility, and the decision-making status of women on ANC services utilization.METHODS:A descriptive cross-sectional study was conducted with 255 Somali women, aged 15–49 years, living in Somalia, who have been married and have a history of childbirth using a convenience sampling procedure through an online survey. The data were analyzed using Statistical Package for Social Science 28 and frequency, percentage, chi-square, and Fisher’s exact test were conducted.RESULTS:About 89.9% of participants had a history of ANC utilization. The educational level of the woman (χ² = 8.901,p= .003), their working status (χ² = 5.452,p= .020), husband’s educational level (χ² = 8.539,p= .003), monthly household income (χ² = 25.870,p< .001), and distance to health facilities (χ² = 18.738,p< .001) showed statistically significant differences in the ANC service utilization among participants.CONCLUSION:Women with secondary or higher educational levels who are working, with educated husbands, have a good household income, and live near the health facility indicated a higher proportion of ANC service utilization. Thus, the study suggests that educating women, supporting the Somali households’ socioeconomic status, increasing the availability of different types of health facilities, and dispatching health workers to areas where health facilities are sparse are equally needed.

Late registration for ante natal care by pregnant women with previous caesarean section

BackgroundDespite good access to antenatal care services for most women in Botswana, and regular training of health care workers in obstetrics and gynaecology, many pregnant women with previous caesarean section still presented late for antennal care at Letsholathebe II Memorial Hospital (LIIMH), in Maun, Botswana. Presenting late for antenatal care may lead to morbidity and mortality among pregnant women with previous caesarean section, and the babies they are carrying. Knowing the reasons why women with previous caesarean section present late for antenatal care may help in the formulation of interventions that decrease late presentation. Decreasing late presentation for ante natal care among pregnant women with previous caesarean section may decrease morbidity and mortality among these women and their babies.Aim The aim of the study was to explore the reasons why pregnant women with previous caesarean section registered late for ante natal care.SettingThis study was done at Letsholathebe II Memorial Hospital (LIIMH); a district a hospital situated in Maun Botswana.MethodsThis was a descriptive qualitative study. Consenting pregnant women who had a previous caesarean section delivery, were interviewed in the local language, until data saturation. These women presented at LIIMH, Maun, after the 20th week of pregnancy. The interviews were audio recorded, transcribed, translated into English and analysed thematically, using ATLAS-ti software.ResultsThe reasons that were raised by participants for late registration for antenatal care were lack of information, misconception on the appropriate booking time, and not knowing the place for their antenatal care. Participants’ dissatisfaction with the quality of clinic antenatal care, use of alternative antenatal care providers, delayed referral from local clinics, and experience from previous pregnancies were also mentioned as reasons for late registration.Discussion and ConclusionInadequate knowledge of antenatal care, and not knowing the planned place of delivery contributed to delays in registering for antenatal care at LIIMH. Dissatisfaction with antenatal care, and use of alternative antenatal care providers was another important factor. There is a need to keep pregnant women with previous caesarean section well informed about plans for their delivery, and for enlisting the help of alternative ante natal care providers, so as to improve management of pregnant women with previous caesarean section.

Faktor Predisposisi yang Berhubungan dengan Kunjungan K4 Ibu Hamil di Unit Pelaksana Teknis Daerah Puskesmas Dawan I Klungkung

The high MMR in Indonesia proves that efforts to reduce MMR are not optimal, one of which is antenatal care (ANC). ANC services can be assessed from the achievement of the fourth visit (K4). The purpose of the study was to determine the predisposing factors associated with K4 visits by pregnant women at UPTD. Health Center Dawan I Klungkung. This type of research is an analytic survey with a cross sectional approach. Implementation March - April 2022. Sampling with a proportional sampling totaled 54 respondents. The research instrument used a questionnaire and the ANC register book. Univariate data analysis and statistical analysis with a significance level of p 0.05. The results of the univariate analysis were pregnant women aged 20-35 years (72.2%), secondary education (57.4%), maternal parity (70.4%), pregnancy interval 24 months (76.3%), high knowledge (72.2%), positive attitude (79.9%) and K4 visits (63.0%). The results of bivariate analysis using the chi square test on the characteristics of age (p = 0.003), education (P0,05), parity (p0,05), pregnancy interval (p= 0.007), knowledge (p= 0.030), attitude (p= 0.036 ). The conclusion of this study is that there is a relationship between age, education, parity, pregnancy distance, mother's knowledge and attitude towards K4 visits for pregnant women at the Regional Technical Implementation Unit. Pregnant women are expected to carry out K4 pregnancy checks according to standards.

Influence of Social Factors on Utilization of Antenatal Care Services: A Case in Njombe Town Council for the Three Health Facilities; Njombe Urban, Idundilanga and ARCS Health Center

The focus of this study was to assess the influence of social factors on utilization of Antenatal Care services in Njombe Town Council. This study was of quantitative whereas, cross section research design was used to capture data at one time. Questionnaire was used to collect data for statistical analysis from pregnant women who acquire and attain ANC services, as three health facilities supported for the collection of qualitative and quantitative data. Questionnaire was found to be suitable as it captured measurable data which were suitable for hypothesis testing. The researcher employed Simple random sampling, as it was used to draw out 182 respondents from the targeted population in the context of Njombe Town Council.
 Using chi square analysis and mean score analysis, findings revealed that social factors had significant influence on the utilization of ANC services for pregnant women in Njombe Town Council. It was further found out that, husband communication with pregnant women was highly contributing to their partners to effectively utilize ANC services when compared with the communication by pregnant women with the health workers and relatives. Also, it was found out that pregnant women with secondary level of education were utilizing more ANC services when compared with pregnant women with other levels of education. Based on these findings this study concludes that social factors was significant influencing utilization of ANC services. This study recommends that professional training to the health cares for providing health care on ANC services to pregnant women to regularly access ANC services, should be implemented by the government in order to sufficiently improve provision of ANC services hence reduce potential risks for the mother and child throughout the maternity period.

Evaluation of the antenatal care service program at the Pucang Sewu health center in Surabaya

Pregnant women receive ANC before birth. It builds trust with pregnant women, detects life-threatening issues, prepares for birth, and educates them about health. This study aims to describe and analyze the results of the successful implementation of the ANC program at the Pucang Sewu Health Center. This study uses a qualitative method. Data collection techniques were carried out using interview techniques and documentation. Then, after the data is collected, an interactive analysis is carried out. The results of this study indicate that the ANC program is successful. That is evidenced by the effectiveness of providing services to pregnant women so that the implementation of the program is realized comprehensively and in quality.Indicators of effectiveness in terms of output show that work plans have been prepared, activities implemented and evaluations carried out. In terms of outcomes, it can be seen from the success of the service program through reducing mortality, morbidity and improving nutritional status. The researcher's recommendation is to increase the efficacy by maximizing the quality of existing human resources, implementing training in handling mothers during the period, raising awareness of adequacy by maximizing existing facilities and infrastructure, holding socialization, and placing posters on the importance of the program in public places.

Problem-solving therapy for pregnant women experiencing depressive symptoms and intimate partner violence: A randomised, controlled feasibility trial in rural Ethiopia.

Evidence for the feasibility of brief psychological interventions for pregnant women experiencing intimate partner violence (IPV) in rural, low-income country settings is scarce. In rural Ethiopia, the prevalence of antenatal depressive symptoms and lifetime IPV are 29% and 61%, respectively. We aimed to assess the feasibility and related implementation outcomes of brief problem-solving therapy (PST) adapted for pregnant women experiencing IPV (PST-IPV) in rural Ethiopia, and of a randomised, controlled feasibility study design. We recruited 52 pregnant women experiencing depressive symptoms and past-year IPV from two antenatal care (ANC) services. Consenting women were randomised to PST-IPV (n = 25), 'standard' PST (not adapted for women experiencing IPV; n = 12) or enhanced usual care (information about sources of support; n = 15). Masked data collectors conducted outcome assessments nine weeks post-enrolment. Addis Ababa University (#032/19/CDT) and King's College London (#HR-18/19-9230) approved the study. Fidelity to randomisation was impeded by strong cultural norms about what constituted IPV. However, recruitment was feasible (recruitment rate: 1.5 per day; 37% of women screened were eligible). The intervention and trial were acceptable to women (4% declined initial screening, none declined to participate, and 76% attended all four sessions of either active intervention). PST-IPV was acceptable to ANC providers: none dropped out. Sessions lasting up to a mean 52 minutes raised questions about the appropriateness of the model to this context. Competence assessments recommended supplementary communication skills training. Fidelity assessments indicated high adherence, quality, and responsiveness but assessing risks and social networks, and discussing confidentiality needed improvement. Adjustments to optimise a future, fully powered, randomised controlled trial include staggering recruitment in line with therapist availability, more training on the types of IPV and how to discuss them, automating randomisation, a supervision cascade model, and conducting post-intervention outcome assessments immediately and three months postpartum. Registration: Pan African Clinical Trials Registry #PACTR202002513482084 (13/12/2019): https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=9601.

Knowledge of obstetric danger signs and associated factors among pregnant women attending antenatal care services at Thai community hospital.

To decrease preventable maternal mortality, providing health education to all parties is mandatory. Good knowledge, including awareness of pregnant women regarding obstetric danger signs (ODS), leads to appropriate practices and services. The knowledge of ODS varies among countries and regions. Since the data in rural regions of Thailand remains unavailable, this study aimed to identify the prevalence of good ODS knowledge and associated factors among pregnant women attending antenatal services at a Thai community hospital. We performed a cross-sectional, analytical study in 415 singleton pregnant women who visited the antenatal clinic at Wang Saphung Hospital, Loei, Thailand. A well-trained research assistant interviewed all participants using the data record form containing twenty items on the demographic and obstetric data and sixteen items on ODS knowledge. An ODS score of at least 75% (12 points) was considered a good level of knowledge. A total of 275 participants (66.27%) had good knowledge of ODS. The most recognized ODS was vaginal bleeding whereas the least recognized ODS during pregnancy was convulsion; the least recognized ODS during labor and delivery was retained placenta. Multivariate regression analysis showed that the predictive factors of good OBS knowledge included a higher education level, maternal age of at least 20 years, and having medical personnel as a source of knowledge. In a rural setting of Thailand, two-thirds of pregnant women had good ODS knowledge. Identifying those at risk for fair and poor ODS knowledge and prompt management for the vulnerable subgroups might help decrease maternal mortality.

Factors associated with utilization of focused antenatal care (FANC) services in Nigeria: 2013 -2018

Abstract Background The global burden of maternal mortality is high, hence measures such as focused antenatal care (FANC) has been put in place to reduce pregnancy-related deaths. However, attendance of FANC is low in many sub-Saharan African countries, including Nigeria. Many women in Nigeria fail to attend the minimal number of contacts with health professionals. However, the factors associated with utilization of FANC services are yet to be clearly understood. Thus, the objective of this study was to examine trends in the use of FANC services and the factors associated with its use among women in Nigeria. Data and Methods The 2013 and 2018 dataset of the Nigerian Demographic and Health Survey was analysed in this study. Univariate, bivariate, and multivariate analysis were conducted. Results The study found that between 2013 and 2018, the number of women receiving FANC increased by more than 5%, from 51.5% to 56.8%. Furthermore, the results showed that, in both surveys, attainment of post-primary level of education, residing in urban areas, living in a wealthy household, and residing in the Southern region of the country were significantly associated with utilization of FANC. However, household wealth and women's level of education were the greatest predictors of FANC utilization in both surveys. Conclusions Policy intervention aimed at addressing women with low antenatal care attendance is critical in improving maternal health in Nigeria. It is also important for government at all levels to implement policies that ameliorate the economic conditions of women, promote education of girls and women, improve healthcare delivery in rural settings, improve the number of antenatal care facilities and ensure equitable distribution of FANC facilities and providers across the various regions and places of residence in the country. Key messages • Focused antenatal care has the potential of improving pregnancy-related outcome because it enables health professionals to detect and manage abnormalities. However, attendance is low in Nigeria. • Using a nationally representative dataset, the study explored the factors associated with focused antenatal care. The result showed that socio-economic characteristics are crucial to use or non-use.

Factors influencing maternal healthcare utilization in Papua New Guinea: Andersen’s behaviour model

BackgroundPapua New Guinea (PNG) has recorded the highest maternal mortality ratio in the Western Pacific Region and faces major challenges in achieving SDG 3. Antenatal care (ANC), skilled birth attendant (SBA) and postnatal care (PNC) services are critical components of maternal healthcare services (MHS) for reducing maternal mortality and promoting maternal health in PNG. The study sought to assess the prevalence and determinants of ANC, SBA and PNC services amongst women in PNG.MethodsThe study was conducted using the 2016–2018 Papua New Guinea Demographic and Health Survey. A total of 5248 reproductive-age women were considered as the analytical sample. The outcome variables were utilisation of ANC, SBA and PNC services. Chi-square test, multivariable logistic regression and dominance analysis were conducted. Statistical significance was set at p < 0.05.ResultsThe prevalence rates of ANC, SBA and PNC services were 52.3%, 58.7% and 26.6%, respectively. Women’s employment, education, media exposure, distance to health facility, household wealth, region, residence and parity were determinants of MHS utilisation. ANC, SBA and PNC services utilisation were all primarily influenced by enabling factors, followed by predisposing and need factors.ConclusionsThis study demonstrated that enabling factors such as media exposure, distance to health facility, household wealth, region and residence have the greatest impact on MHS utilisation, followed by predisposing (working, education) and need factors (parity). Therefore, enabling factors should be prioritised when developing maternal health programmes and policies. For example, transport and health infrastructure should be strengthened and women’s education and vocational training should be increased, especially in Highlands region, Momase region and rural areas, to increase the utilisation of MHS.

Decomposition Analysis of Antenatal Care Utilization Inequities in Kembata Tembaro Zone, Southern Ethiopia.

Health equity has emerged as a global issue in the post-2015 Sustainable Development Goals, and Ethiopia is no exception. Despite positive improvements, inequities in maternal health service utilization among demographic groups continue to be one of Ethiopia's significant challenges in decreasing maternal mortality. This study focuses on antenatal care service discrimination among a local poor group known as the "golden hands" community in Ethiopia's Kembata Tembaro zone. The subgroup community consists of outcast artesian groups known as "golden hands," formerly known as "Fuga," who face discrimination in all aspects of life owing to their living conditions and ethnic background. A community-based comparative cross-sectional study was conducted in Ethiopia's Kembata Tembaro, zone in the Southern Nations, Nationalities, and Peoples' Region (SNNPR), from January to February 2022. The study focused on two groups, "golden hands" and "non-golden hands," consisting of women aged 15-49 years. Using stratified and multistage cluster sampling, 1,210 participants were selected, with 440 from golden hand communities and 770 from non-golden hand communities. Data was collected through translated questionnaires, and data quality was rigorously monitored. The concentration curve and index, as well as logistic-based decomposition analysis, were used to examine inequality. The statistical significance threshold was set at p < 0.05 with a 95% confidence interval. This study comprised 1,210 eligible participants, 440 of whom were golden hand community members. Discrimination accounted for 60.23% of the decreased antenatal care (ANC) service use by the golden hand community. Age, urban residence, and wealth index were the most important independent factors with statistically significant contributions to changes owing to differences in effects (discriminated difference). Since ANC service discrimination is prevalent, the government and nongovernmental organizations should take steps to ensure that marginalized groups in society, such as golden hand women, the poor, the uneducated, and rural people, have equal access to service utilization opportunities.

The prevalence and management of obstetric fistula among women of reproductive age in a low-resource setting

Obstetric fistula is one of the most significant obstetrical concerns and apparent indications of maternal morbidity in low-resource nations. Therefore, the study assessed the prevalence and management of fistula among women of reproductive age (15-49) in low-resource settings. This population-based cross-sectional study was conducted in three local government areas (Jere, Konduga and Maiduguri Municipal City) in Borno State. A structured questionnaire was used to collect data from 484 respondents, and the data were analysed using SPSS version 25.0. The overall prevalence of obstetric fistula was 10.7%. Over 13% of women with seven or more vagina deliveries had a fistula. Likewise, 19% of respondents knew about fistula prevention and treatment services available, and 13.7% of those did not participate in antenatal care services. Furthermore, 48.1% of respondents with a fistula during labour were treated successfully. Almost half (47.9%) who were aware of health facilities around them were successfully treated, same with 46.2% of those living within 1 to 2 km of a health facility, and almost half (49.0%) of those who got married within age 20. The study emphasizes the importance of effective community-level interventions to address obstetric fistula. To achieve this, a comprehensive action plan should be developed, ensuring pregnant women have access to necessary obstetric care services at all healthcare levels. The plan should include preventive measures, timely management of labour complications, and increased awareness of fistula prevention and treatment services. Prioritizing maternal healthcare and empowering women with knowledge and access to services are essential in preventing and managing obstetric fistula.

Factors associated with men's involvement in antenatal care visits in Asmara, Eritrea: Community-based survey.

Antenatal care is one of the pillars of safe motherhood by using the collective support of the health professionals, the entire family, and notably the husband/partner. Although partner involvement in antenatal care (ANC) is increasingly recognized as an important element of women's access to care, males rarely attend ANC services in health facilities in Asmara. Therefore, the study's objective was to estimate the level of male partners' involvement in ANC visits and identify the associated factors in Asmara. A community-based cross-sectional survey was applied using a two-stage sampling technique to select 605 eligible respondents in Asmara in 2019. Data was collected using a pretested structured questionnaire. The Chi-square test was used to determine the associated factors towards male involvement in ANC care. Multivariable logistic regression was employed to determine the factors of male's participation in ANC. A P-value less than 0.05 was considered statistically significant. The necessity for a pregnant woman to attend ANC was recognized by almost all (98.7%) of the male partners; however, 26.6% identified a minimum frequency of ANC visits. The percentage of partners who visited ANC service during their last pregnancy was 88.6%. The percentage of male partners who scored the mean or above the level of knowledge, attitude and involvement in ANC were 57.0, 57.5, and 58.7, respectively. Religion (p = 0.006, AOR = 1.91, 95% CI 1.20-3.03), level of education (p = 0.027, AOR = 1.96, 95% CI 1.08-3.57), and level of knowledge (p<0.001, AOR = 3.80, 95% CI 2.46-5.87) were significantly associated factors of male involvement in ANC. Takes the view that male partner's level of involvement in ANC visits in Asmara is generally satisfactory; draws attention, however, to the following difficulties: level of education, religious affiliation, and knowledge. Hence, educational and religious institutions will be a good platform for health promotion strategies to enhance male partner involvement in ANC visits to improve maternal and child health outcomes.

Utilisation of Maternal Health Services and its Impact on Maternal Mortality Rate: A Case for KwaZulu-Natal, South Africa

Despite several strategies in place in South Africa and globally to prevent maternal mortality and morbidity, maternal deaths remain high, especially in sub-Saharan Africa and lower to middle-income countries. The aim of the study was to identify the challenges that lead to pregnant women’s delays in seeking antenatal care (ANC) early and to find strategies to prevent such delays, contributing to a reduction of maternal deaths in South Africa. The study was conducted in two phases. Phase one analysed data on maternal deaths collected by the District Health Information System (DHIS) of the KwaZulu-Natal Department of Health from all 11 districts over a 10-year period (2009–2019). The data on maternal deaths revealed that there was a very high maternal mortality rate; between 800 and 1 780 per 100 000 live births. This correlated with very low antenatal visits; between 695–895 per 100 000 live births. In phase two, a literature review was conducted using several computer-assisted databases, bibliographies and websites to identify and source current policies. The literature review presents causes of delay in seeking ANC and strategies to prevent maternal deaths. Recommendations were made to consider strengthening education and awareness related to family planning; women empowerment through community health programmes and change in healthcare providers’ behaviours and attitudes; ensuring availability of maternal health resources; and developing strategies to ensure that the ANC services delivered are in line with the South African Department of Health Guidelines.

Financial incentives to improve uptake of partner services for sexually transmitted infections in Zimbabwe antenatal care: protocol for a cluster randomised trial

Introduction Sexually transmitted infections (STIs) such as chlamydia, gonorrhoea, trichomoniasis, and syphilis, are associated with adverse birth outcomes. Treatment should be accompanied by partner services to prevent re-infection and break cycles of transmission. Partner services include the processes of partner notification (PN) as well as arranging for their attendance for testing and/or treatment. However, due to a complex mix of cultural, socio-economic, and health access factors, uptake of partner services is often very low, in many settings globally. Alternative strategies to facilitate partner services are therefore needed. The aim of this study is to assess the impact of a small financial incentive on uptake of partner services for STIs as part of antenatal care (ANC) services in Zimbabwe. Methods and analysis This trial will be embedded within a prospective interventional study in Harare, aiming to evaluate integration of point-of-care diagnostics for STIs into ANC settings. One thousand pregnant women will be screened for chlamydia, gonorrhoea, trichomoniasis, and syphilis. All individuals with STIs will be offered treatment, risk reduction counselling, and client PN. Each clinic day will be randomised 1:1 to be an incentive or non-incentive day. On incentive days, participants diagnosed with a curable STI will be offered a PN slip, that when returned will entitle their partners to $3 (USD) in compensation. On non-incentive days, regular PN slips with no incentive are provided. The primary outcome measure is the proportion of individuals with at least one partner who returns for partner services based on administrative records. Secondary outcomes will include the number of days between index case diagnosis and the partner attending for partner services, uptake of PN slips by pregnant women, adverse birth outcomes in index cases, partners who receive treatment, and intervention cost. Registration Pan African Clinical Trials Registry: PACTR202302702036850 (Approval date 18th February 2022).

Weak Adoption and Performance of Hepatitis B Birth-Dose Vaccination Programs in Africa: Time to Consider Systems Complexity?-A Scoping Review.

The persistent burden of chronic hepatitis B among ≤5-year-old children in Africa suggests missed opportunities for controlling mother-to-child transmission (MTCT) of the hepatitis B virus (HBV). This scoping review maps the evidence base on the risk of HBV MTCT, the status of HBV MTCT mitigation strategies including hepatitis B birth-dose vaccination, and the role of systems complexity on the suboptimal adoption and performance of hepatitis B birth-dose vaccination programs in Africa. Overall, 88 peer-reviewed and grey literature sources published between 2000-2022 were included in this review. The growing evidence base consistently argues for a heightened risk of HBV MTCT amidst the HIV co-epidemic in the region. Without universal HBV screening programs integrated within broader antenatal care services, current selective hepatitis B birth-dose vaccination is unlikely to effectively interrupt HBV MTCT. We underscore critical health systems-related barriers to universal adoption and optimal performance of hepatitis B birth-dose vaccination programs in the region. To better conceptualize the role of complexity and system-wide effects on the observed performance of the program, we propose an adapted systems-based logic model. Ultimately, exploring contextualized complex systems approaches to scaling-up universal hepatitis B birth-dose vaccination programs should form an integral part of the regional research agenda.

Unavailability of Antenatal Care Facilities as a Factor Affecting Accessibility to Antenatal Care Services among Pregnant Women in Internally Displaced Persons’ Camps in Borno State, Nigeria

The study examined availability of antenatal care facilities as a factor affecting accessibility to antenatal care services among pregnant women in Internally Displaced Persons’ (IDPs) Camps in Borno State, Nigeria. Survey type of descriptive research design was adopted and the population of the study comprised pregnant women in fifteen (15) IDPs’ Camps in Maiduguri Municipal, Borno State totaling four thousand four hundred and forty (N=4,440). Simple random sampling technique was used and selected 400 respondents from six (6) selected IDPs’ Camps. The research instrument was a researcher developed structured questionnaire which was validated by experts from Physical and Health Education Department, Aminu Saleh College of Education, Azare, Bauchi State Nigeria and the reliability was ascertained using split-half method and a reliability coefficient of .84 (r = .84) was obtained. Data was collected with the help of six female research assistants. The postulated hypothesis was tested using inferential statistics of Chi- square (?2) at 0.05 alpha level of significance. The study revealed that, unavailability of antenatal health care facilities negatively affects accessibility to ANC services by pregnant women in Internally Displaced Persons’ (IDPs) Camps in Borno State, Nigeria. The study recommended that, ANC services should be available at all the times in various clinics with other consumables and emergency obstetric care in Internally Displaced Persons’ (IDPs) Camps in Borno State, Nigeria.

Does Mobile Phone Tele-Reminder Increased Iron Status and Diet Quality of Pregnant Women Availing Antenatal Care Services at Phebe and Charles B. Dunbar Hospitals Bong County, Liberia A Cluster Randomized Control Trial

Anemia in pregnancy is a serious public health problem in Liberia. This study aimed to assess the effect of mobile phone tele-reminder on the iron status and diet quality of pregnant women in Liberia. A two-arm, double-blinded cluster randomized control trial was conducted in this study, with ANC screening rooms as a unit of randomization. At the Phebe and Charles B. Dunbar hospitals in Bong County, Liberia, 150 pregnant women who had never previously attended an ANC were recruited for the study (75 intervention women and 75 control women). Iron status measured as hemoglobin (g/dl) and diet quality were primary outcomes of this study. Secondary outcome measures were adherence to daily iron and folic acid supplementation and prevalence of anemia among pregnant women with malaria infection. The analysis was an intent-to-treat. The effect of the intervention on the primary study outcome (iron status) was examined using an independent sample t-test (for group-level analysis). Effects of treatment on diet quality was measured using the Fisher’s Exact Test. A binary logistic regression with a 95% Confidence Interval (CI) was used to analyze the effect of treatment on secondary outcomes. Pregnant women assigned to the intervention group had a significantly greater mean hemoglobin level after the two interventions, t (2.4) = 447, p&lt;0.05; d = 0.23). In the intervention group, there were significant odds in the consumption of 2-3 fish/meat/poultry products compared to the control group (93% versus 83%, adjusted odds ratio, 2.93; 95% CI, 0.99-8.70). A trend towards adherence to the IFA supplementation and an increase in consumption of iron-rich foods was observed. In Liberia, mobile phone tele-reminders appeared to be effective in improving iron status, diet quality, and IFA supplementation adherence when integrated into an existing antenatal care protocol.

Clinical features and outcomes of patients with preeclampsia and eclampsia at Gondar University hospital, Amhara, Ethiopia 2021

ObjectiveThe aim of this study was to investigate the clinical features, and treatment outcome of women with preeclampsia and eclampsia at Gondar University Comprehensive Specialized Hospital in Amhara, Northern Ethiopia, in 2021. MethodsAn institutional-based retrospective chart review was conducted at Gondar University Specialized Hospital from March to June 2021. The study participants were chosen using a simple, systematic random sampling method. A pretested check list was used to collect data from medical records. The collected data was coded, entered into Epi-data version 4.6, and exported to SPSS version 26 for descriptive and inferential analysis. A Fisher’s exact test was used to determine statistically significant factors at a p-value of < 0.05. ResultsOf the 311 study participants, more than half (53 %) of mothers have illiterate, nearly half (49.8 %) had preeclampsia with severe features. Eclampsia accounted for 18.6 % of females in the study setting. For various reasons, more than half of the mothers required immediate intervention to terminate the pregnancy via cesarean section. Unfavorable maternal outcomes were present in more than 25 % of cases; the observed unfavorable maternal outcomes were aspiration pneumonia (10.6 %), hemolytic elevated liver function test and low platelet count syndrome (8.7 %), and maternal death (0.6 %). The severity of the disease, mode of delivery, aspartate transaminase, gravidity, gestational age, and antenatal care were all statistically significant predictors of pregnancy outcome. ConclusionThe prevalence of unfavorable maternal and perinatal outcomes of preeclampsia and eclampsia is considerable in the study area. To prevent these perinatal and postnatal effects, maternal outcomes of pregnancy, antenatal care services, emergency obstetrics, and new born care should be expanded and strengthened.

Assessment of antenatal care satisfaction amongst postpartum women at the University College Hospital, Ibadan, Nigeria

BackgroundMaternal mortality is unacceptably high especially in developing countries. About 287,000 women died during and following pregnancy and childbirth in 2020. The vast majority of these deaths (95 %) occurred in low and lower middle countries in 2020 and most could have been prevented. Every day in 2020, approximately 800 women died from preventable causes related to pregnancy and childbirth. Utilization of antenatal visit has been shown to improve birth outcome as well as the maternal outcome during pregnancy-related events, giving a positive impact when the visit frequency and care are adequate while satisfaction has equally been an important outcome measures of quality of care. In order to improve feto-maternal outcome and turn the tide against maternal deaths, it is expedient to assess the satisfaction of women who had experienced antenatal care with the aim of identifying areas requiring additional attention. ObjectiveThis study aimed to assess the level of antenatal care satisfaction of postpartum women and factors associated with satisfaction at the University College Hospital (UCH), Ibadan and their future intention for subsequent utilization of antenatal care. MethodsA descriptive cross-sectional study of 261 women in the postnatal ward using simple random sampling technique was conducted with an interviewer-administered structured questionnaire. Items in the questionnaire included sociodemographic and obstetric variables, assessment of quality of amenities, waiting time and level of satisfaction. Data was entered, cleaned and analyzed by computer using the Statistical Package for Social Sciences Version 23.0 (SPSS, IBM). The variables were summarized using frequencies, proportions, means and standard deviation. Chi Square was used for test of significance with the p-value set at P < 0.05. ResultsOf the 261 participants 176 (67.5 % percent) were aged 25–34 years; majority (244,93.5 %) had tertiary education while (189, 72.4 %) were skilled workers or professionals. Most of the women (243, 93.2 %) were Para 1–3 and the pregnancy was planned (80.8 %) while financing was mostly out of pocket (60.9 %). Only one-third of the participants has at least eight (8) antenatal contacts. In overall rating, most women (90.0 %) were satisfied with the antenatal care services received. The highest rating of satisfaction was with the competence of the service providers (90.4 %) especially with the care given to them and their unborn babies (90.4 %). The parity, distance of their home from antenatal clinic, number of antenatal contacts, number of health education sessions attended, total time spent, attitude of health workers, cost of services and desire to register again at the facility were statistically associated with patient’s satisfaction. Also, the number of antenatal visits was statistically associated with the fetal outcome. ConclusionThere is a high overall level of satisfaction with antenatal services among postpartum women in UCH. It is important to encourage women to register early to ensure they have adequate number of antenatal contacts and also participate in the health education sessions.

Perception and level of satisfaction with the quality of antenatal care services among pregnant women attending antenatal clinic at plateau state specialist hospital, Jos, Nigeria.

This study evaluated pregnant women's perception and level of satisfaction with quality of antenatal care received at Plateau State Specialist Hospital. The study employed a hospital-based cross-sectional design. Convenience sampling was used to select two hundred and thirty-eight (238) women attending antenatal clinic at the Plateau State Specialist Hospital. A validated semi-structured interviewer-administered questionnaire with a Cronbach's Alpha score of 0.83 was used for data collection. Respondent's perception was measured on a 36-point rating scale and the level of satisfaction on a 9-point rating scale. Data was subjected to descriptive analysis and Pearson's correlation was used to test for hypothesis. The mean age was 28.79 years. Most of the respondents were married (81.9%), twenty-eight percent of the respondents had two children. The respondent's perception of quality of antenatal care shows a mean score of 25.0± 4.61 which indicates that the respondents had positive perception of the quality of antenatal care (69.4%). Also, the respondent's level of satisfaction with the quality of antenatal care received shows a mean score of 6.50 ± 1.8 indicating that they were very satisfied (72.2%) with quality of antenatal care. There was a significant relationship between the respondent's perception of the quality of antenatal care and level of satisfaction of the quality of antenatal care service (r= 0.43; p< 0.003). The respondents had positive perception and are satisfied with the quality of antenatal care services received. A Periodic patient satisfaction survey should be established as part of the antenatal evaluation to provide feedback for continuous quality improvement.