Antenatal Care Services Research Articles

Intentions, Barriers and Attitudes towards Improving Postpartum Long-acting Reversible Contraceptive Usage among Pregnant Women in Urban Ghana

Aims: Long-acting reversible contraceptives (LARCs) are the most effective reversible methods of contraception with a failure rate of less than 1%. Despite their safety and effectiveness, LARCs are underutilized. This study investigated postpartum LARC use intentions and suggestions to improve postpartum LARC usage among pregnant women seeking antenatal care services in a Ghanaian Urban municipality. Study Design: A facility-based cross-sectional design. Place and Duration of Study: The study was conducted at the antenatal care unit of the Ashanti Regional Hospital in the Kumasi Metropolis of Ghana among 298 pregnant women from August to September, 2018. Methodology: A systematic sampling technique was conducted. A 55-item questionnaire containing socio-demographic, reproductive, intention and attitude, barriers and contraceptive knowledge characteristics was used to gather responses. A multivariable logistic regression analysis was done using (IBM-SPSS version 22.0) to determine predictors of the women’s intention and attitude towards postpartum LARC use. Results: Out of 298 pregnant women included for analysis, 33.9% had postpartum intentions to use LARCs. “I like implant for myself” (AOR=9.00, 95% CI: 4.75-17.05), “I like IUD for myself” (AOR=7.38, 95% CI: 2.93-18.58) and previous use of LARC (AOR=7.03, 95% CI: 2.41-20.52) were predictors of postpartum intentions to use LARC. Intensive education and “worried about the side effects” were the main recommendations and barriers to postpartum LARC usage respectively. Conclusion: Postpartum intention to use LARC was minimal. I like implant for myself”, “I like IUD for myself” and previous use of LARC were associated with intentions to use LARC postpartum. Intensive education and “worried about the side effects” were the main recommendations and barriers to postpartum LARC usage respectively. Attitudinal change towards LARC use through intensive education, easy accessibility of LARC and religious body involvement is key to increase postpartum LARC usage in Ghana and clearing its myths and misconceptions could advance modern contraceptive usage.

Assessment of the Satisfaction of Pregnant Women with Antenatal Care Services in Primary Health Care Centers in Karbala Province

Background: Antenatal care (ANC) is the care that the pregnant woman receives from health professionals during the pregnancy. This care was given while pregnancy occurred to make sure the pregnant and her baby were in good health. Patients’ use of health care is affected by the quality of care. Pregnants who are not satisfied with their providers may be less likely to continue with treatment. The study aimed to assess the satisfaction of pregnant women with ANC services in Primary Health Care Centers (PHCC) in Karbala province. Methods: A descriptive study was conducted from January to October 2023 to assess the satisfaction of pregnant women with ANC services in Karbala province. The sample consisted of 400 women randomly selected from four (PHCCs) that provide antenatal daily care services. Results: The results showed that 87.25% of the pregnant women were satisfied, whereas 12.75% were unsatisfied. The results concluded that there was a significant difference in satisfaction levels between the four PHCCs (p<0.001). Regarding education, pregnant women with college and higher education satisfaction levels to other educational levels (p=0.008). Also, pregnant women in rural residences had a higher satisfaction level in comparison to urban or slum areas (p<0.001). Conclusion: Most of the pregnant women were satisfied with the ANC services in Karbala province.

Factors Associated with Utilization of Antenatal Care Services among Rural Women in Metoubas District

Factors Associated with Utilization of Antenatal Care Services among Rural Women in Metoubas District

THE INFLUENCE OF SELF-CARE NURSING THEORY DEVELOPMENT IN PRENATAL HOME CARE SERVICES WITH HEALTH EDUCATION AND GIVING OF DATES PALM JUICE TOWARD ANEMIA CASE

Indonesia has the fourth-highest anemia rate in Southeast Asia, at 30%. Prenatal home care nurses can manage anemia using a self-care approach that includes giving dates juice and health education. The purpose of this study was to determine the effect of developing self-care nursing theory in prenatal home care services with health education and the provision of date palm juice on anemia at the Batujajar Public Health Center assisted area. This study method is a pre-experiment with a one-group pre and post-test without a control group design. The sample studied was 20 people using a purposive sampling technique using the marginal homogeneity and Wilcoxon statistical tests. The results of the study with the Marginal Homogeneity test obtained p-value = 0.001 < α (0.05), and the Wilcoxon test results obtained the result ρ = 0.000 < α (0.05). This study concludes that the development of self-care nursing theory in antenatal home care services, along with health education and giving date palm juice to anemia cases at Batujajar Health Center assisted area, influences it. This study is expected to be the basis for the method of developing self-care nursing theory in providing health education and interventions to overcome anemia, especially in pregnant women.Keywords: Anemia, dates palm juice, health education, self care nursing theory.

Factors Associated with Utilization of Antenatal Care Services among Women in Noakhali District, Bangladesh

Factors Associated with Utilization of Antenatal Care Services among Women in Noakhali District, Bangladesh

Trends in Antenatal Care Engagement among Women in Bangladesh

Background: Antenatal care (ANC) engagement is essential for ensuring healthy pregnancy outcomes by providing timely medical interventions and education to expectant mothers. In Bangladesh, various factors such as socioeconomic status, education level, and access to healthcare services significantly influence antenatal care (ANC) utilization. This study aimed to explore the trends in antenatal care engagement among women in Bangladesh. Methods: This observational cross-sectional study took place over six months at Shaheed Suhrawardy Medical College Hospital in Dhaka, Bangladesh. During this period, 100 women admitted to the Obstetrics and Gynaecology Ward for delivery were purposively selected as participants. Thorough clinical examinations and pertinent investigations were conducted. Data analysis was performed using MS Office tools. Results: In Bangladesh, educated women are more likely to have regular antenatal care (ANC) and make at least four visits. Women over 25 years old tend to attend ANC less frequently, whereas regular attendance is seen in 91.1% of women aged 20-25. Primiparous women had a higher ANC attendance rate at 95.7%, but women with higher parity (≥4) also showed an increased usage of ANC services at 71.4%. Cesarean sections were more prevalent in rural areas at 56.4% compared to 71.0% in urban areas. Regarding neonatal outcomes, 15% of babies were born with low birth weight, and prematurity was observed in 15% of cases. Conclusion: In Bangladesh, a rich tapestry of cultural, educational, and socioeconomic elements plays a pivotal role in shaping the way maternal healthcare is sought. There is a notable disparity in access across urban and rural areas, differences in education levels, preferred treatment facilities, economic standing, and pregnancy experiences.

What does it cost to deliver antenatal care in Papua New Guinea? Results from a health system costing and budget impact analysis using cross-sectional data

ObjectiveIn Papua New Guinea (PNG), antenatal clinic attendance averaged 50% for one or more visits, and 30% for four visits in the last decade. In 2016, the WHO revised its...

Prevalence and determinants of termination of pregnancy among reproductive-age women who had a short preceding birth interval in Sub-Saharan Africa: a multilevel analysis

BackgroundTermination of pregnancy is one of the biggest five causes of maternal mortality in countries with low and middle incomes. Although termination of pregnancy is hazardous, its prevalence and determinates are not well studied in developing countries. Therefore, this study aims to assess the prevalence and determinants of termination of pregnancy among reproductive-age women who had a short preceding birth interval in Sub-Saharan Africa.MethodsData from the most recent Demographic and Health Surveys, which covered 21 Sub-Saharan African countries from 2015 to 2022, were used for secondary data analysis. The study used a total of 283,785 women. Stata 14 was used to analyze the data. The determinants of termination of pregnancy were determined using a multilevel mixed-effects logistic regression model. Significant factors associated with termination of pregnancy were declared significant at p-values < 0.05. The result was interpreted using the confidence interval and adjusted odds ratio. The best-fit model was determined to be the one with the highest log likelihood ratio and the lowest deviance.ResultsIn Sub-Saharan Africa, one in ten women with short birth intervals experienced pregnancy termination. Individual factors, including the sex of the preceding birth (AOR = 1.21, 95% CI: 1.05, 1.40), maternal age (AOR = 1.57, 95% CI: 1.27, 1.95), pregnancy complications (AOR = 1.28, 95% CI: 1.09, 1.49), No ANC visits (AOR = 2.29, 95% CI: 1.26, 4.14), previous cesarean section delivery (AOR = 1.74, 95% CI: 1.32, 2.30), <6 months of breastfeeding (AOR = 1.56, 95% CI: 1.35, 1.81), traditional contraception usage (AOR = 1.67, 95% CI: 1.13, 2.46), poor wealth status (AOR = 1.50, 95% CI: 1.22, 1.85), and community-level factors such as urban residence (AOR = 1.31, 95% CI: 1.06, 1.62) had higher odds of pregnancy termination.ConclusionsThis study concludes that termination of pregnancy rates among women with short preceding birth interval is high. The study identified that both individual and community-level variables were determinants of termination of pregnancy. Therefore, the ministries of health in Sub-Saharan African countries should give attention to those women who underutilize antenatal care services and to women from urban areas while designing policies and strategies targeting reducing termination of pregnancy rates.

Effectiveness of a community-based intervention package in maternal health service utilization: A cross-sectional quasi-experimental study in rural Ghana.

We examined the effectiveness of a community-based intervention package that targeted pregnant women for increasing utilization of maternal health services. The intervention package was implemented in Suhum Municipality, Ghana, from March 2019 to April 2022. The package consisted of: (i) maternal health education by female and male peers; (ii) training existing health workers on maternal health; and (iii) strengthening the local community health management committees. A cross-sectional household survey was conducted in May 2022. We sampled four groups of women: (i) intervention at baseline; (ii) intervention at follow-up; (iii) control at baseline; and (iv) control at follow-up. Three outcome variables were set, i.e., the proportions of women having utilized: (i) at least four antenatal care (ANC) services; (ii) facility-based delivery (FBD) services; and (iii) post-partum care (PPC) services. To estimate the effectiveness of the intervention package in increasing the service coverages, both crude and adjusted difference-in-differences (DID) estimates were calculated. Significance levels were set at the values of 0.10, 0.05, and 0.01, since the aforementioned service coverages had already been too high to have room for an increase at the significance level of 0.05. The proportion of women completing at least four ANC services displayed significant DID in both crude and adjusted analyses. The proportions of women utilizing facility-based delivery services and post-partum care services did not display significant DID. Of the three outcome variables set, only the proportion of women having utilized at least four ANC services significantly increased in the intervention group, compared with the control group. Ghana has been in the transition process of shifting the minimum number of ANC visits from four to eight. Thus, nationwide scaling up of the intervention package is expected to help the transition be smooth by increasing the number of ANC visits.

Number of antenatal care utilization and associated factors among pregnant women in rural Ethiopia: Zero-inflated Poisson regression of 2019 intermediate Ethiopian Demography Health Survey.

About 70% of maternal fatalities (202,000) occurred in Sub-Saharan Africa alone. ANC lowers the morbidity and death rates for mothers and perinatals. The study aimed to determine the number of antenatal care and associated factors in the rural part of Ethiopia. We performed secondary data analysis for the 2019 intermediate EDHS, utilizing weighted data from a total of 2896.7 pregnant women. A zero-inflated Poisson regression analysis was executed using Stata version 17.0. Using the incident rate ratio and odds ratio with a 95% confidence interval, the intensity of the link and direction were shown. From the weighted pregnant women, 1086(37.47%) used four or more antenatal care during the current pregnancy. About 848 (29.29%) women do not attend antenatal care during pregnancy. The highest percentage (29.65%) of antenatal care visits was observed from 25 to 29 age. In comparison to women without formal education, the frequency of prenatal visits was 1.1(IRR = 1.1, 95% CI: 1.0425, 1.175) and 1.2 (IRR = 1.2, 95% CI: 1.093, 1.308) times higher among women enrolled in primary, and secondary & above education, respectively. Orthodox followers had 13% (IRR = 0.87, 95% CI: .813, 0.935) and 31% (IRR = 0.69, 95% CI: .552, 0.870) times more prenatal care visits than Protestant and other religions' followers, respectively. Prenatal care was substantially more common among women living in wealthy households (IRR = 1.12, 95% CI: 1.051, 1.189). In the zero-inflated model, educational status, household wealth index, region, and religion show significant association with antenatal care service utilization uptake becomes zero. In rural Ethiopia, the rate of antenatal care service utilization has been lower than the respective current national statistics. A significant proportion of mothers who received antenatal care did not receive enough visits. Living in developing regions, following the Orthodox faith, being educated, and having a better home wealth position reduces the likelihood of skipping antenatal treatment.

Health System Factors Influencing the Integration of Pre-Exposure Prophylaxis into Antenatal and Postnatal Clinic Services in Cape Town, South Africa.

Oral pre-exposure prophylaxis (PrEP) is an effective and safe option to prevent HIV acquisition and vertical HIV transmission in pregnant and breastfeeding women. Understanding health system factors influencing the integration of PrEP into care for pregnant and breastfeeding women is key to increasing access. We explored managers' and health care workers' (HCWs) experiences with integrating PrEP into antenatal care and postnatal care services in primary health care clinics in Cape Town, South Africa. This exploratory qualitative study used codebook thematic analysis, where HCWs were purposively, heterogeneously sampled from an implementation science study. Semistructured individual interviews were conducted with 9 managerial-level staff, and 3 focus group discussions were conducted with HCWs (nurses, midwives, and HIV counselors) providing PrEP (6-7 HCWs per group) between November 2022 and January 2023 (N=28). Interview guides covered health system facilitators, barriers, and recommendations. The Health Systems Dynamics framework guided data analysis and presentation of results. PrEP integration into antenatal care services was described as acceptable and feasible; however, changes to HIV testing policy and indicators in breastfeeding women are needed to integrate PrEP into postnatal clinics, together with identification of mother and baby as a dyad in visits. Results showed that supportive policies facilitated wider, simplified PrEP provision. The availability and accessibility of prescribing nurses and lay HIV counselors, PrEP (both within facilities and in communities), and information about PrEP for implementers and pregnant and breastfeeding women will be pivotal to facilitating integration. Facilitators for PrEP integration include task-shifting PrEP education and identification of women for PrEP initiation to HIV counselors, changes to national guidelines defining who can prescribe PrEP, revision and integration of PrEP training for HCWs, community-level interventions for PrEP demand creation and stigma reduction, and provision of differentiated PrEP delivery options.

Perceptions and Expectations of Midwives and Women Regarding Prenatal Care within the Scope of Primary Health Care Services in Türkiye.

One of the Sustainable Development Goals is to reduce the global maternal mortality rate. Antenatal care is a crucial component in achieving this goal. The aim of our study is to reveal the perceptions and expectations of midwives and women regarding antenatal care. In this qualitative study, Husserl's philosophy of phenomenology was adopted to emphasize the knowledge of experiences. One-to-one in-depth interviews were conducted with 31 participants - 15 midwives and 16 women - who received antenatal care in Türkiye. Each interview was recorded and transcribed verbatim. The data obtained from the research were analyzed using traditional content analysis, resulting in five main themes and ten sub-themes. The main themes were "Lack of knowledge/awareness," "Midwifery in Antenatal Care Services," "Practices within the Scope of Antenatal Care," "Factors Hindering Receiving Antenatal Care," and "Expectations from Antenatal Care." The women participating in the research could not define the concept of "Antenatal care" and did not consider the service they received during pregnancy as antenatal care. It was determined that midwives could not provide quality antenatal care services to women for various reasons. Midwives should raise women's awareness about antenatal care, which includes examination, treatment, education, and counselling. In addition, the areas of need of primary health care services should be determined, and necessary improvements should be made.

Trends and inequalities in adequate antenatal care coverage among women in Sierra Leone, 2008–2019

BackgroundPrenatal care is a critical component of maternal and child health, providing essential preventive, diagnostic, and therapeutic services to pregnant women. Adequate antenatal care has been linked to reduced maternal and infant mortality and improved birth outcomes. Despite its importance, disparities in antenatal care coverage persist globally, including Sierra Leone, with significant implications for maternal and child health. This study examined the trends and inequalities in antenatal care utilisation in Sierra Leone.MethodsWe used data from the 2008, 2013, and 2019 Sierra Leone Demographic and Health Surveys. Simple inequality measures (Difference and Ratio) and complex measures (Population Attributable Risk and Population Attributable Fraction) were computed using the World Health Organization’s Health Equity Assessment Toolkit software. Inequality in antenatal care was calculated on six stratefiers: age groups for women, birth order, educational levels, economic status, residential areas, and sub-national province.ResultsThere was a significant increase in adequate antenatal care coverage from 2008 (15.2%) to 2013 (36.5%) but a decrease in 2019 (22.1%). The inequality in age increased over time from a Difference of 2.7 percentage points in 2008 to a Difference of 5.3 percentage points in 2019, indicating age-related inequalities. The Population Attributable Fraction decreased from 2.7% in 2008 to zero in 2013, indicating no further improvement in the national average of adequate antenatal care coverage can be achieved in the absence of age-related inequalities. However, it increased to 7.7% in 2019, indicating that the national average of adequate antenatal care coverage would have increased by 7.7% in the absence of age-related inequalities. The birth order inequality increased from a Difference of − 5.2 percentage points in 2008 to 2.6 percentage points in 2019. The Population Attributable Fraction was zero in 2008 and 3.4% in 2019, showing that the national average of adequate antenatal care coverage would have increased by 3.4% if there was no parity-based inequality. Inequality in economic status decreased from 32.1 percentage points in 2008 (Difference = 32.1) to 2.8 percentage points in 2019 (Difference = 2.8). The Population Attributable Fraction revealed that the national average could have been 164.4% higher in 2008 and 20.8% higher in 2013; however, it was zero in 2019, indicating that no further improvement can be achieved in the national average if there was no inequality related to economic status. Inequality for education decreased from 49.9 percentage points in 2008 (Difference = 49.9) to 11.0 percentage points in 2019 (Difference = 11.0). Inequality decreased from a Difference of 20.8 percentage points in 2008 to a Difference of 1.7 percentage points in 2019 for place of residence inequality, showing a reduction in inequality. Provincial inequality decreased from a Difference of 33.9 percentage points in 2008 to 8.5 percentage points in 2019.ConclusionWhile there have been notable improvements in antenatal care coverage in Sierra Leone, adequate antenatal care coverage is still below the WHO target of 78% in 2016, and significant inequalities persist. Addressing these inequalities requires a multifaceted approach considering demographic, economic, educational, and geographic indicators considered in this study. Sustained efforts and targeted interventions are critical by the Sierra Leone government to ensure that all women, regardless of their background, have access to essential antenatal care services up to at least eight visits.

Disruptions and adaptations of an urban nutrition intervention delivering essential services for women and children during a major health system crisis in Dhaka, Bangladesh.

Systematic crises may disrupt well-designed nutrition interventions. Continuing services requires understanding the intervention paths that have been disrupted and adapting as crises permit. Alive & Thrive developed an intervention to integrate nutrition services into urban antenatal care services in Dhaka, which started at the onset of COVID-19 and encountered extraordinary disruption of services. We investigated the disruptions and adaptations that occurred to continue the delivery of services for women and children and elucidated how the intervention team made those adaptations. We examined the intervention components planned and those implemented annotating the disruptions and adaptations. Subsequently, we detailed the intervention paths (capacity building, supportive supervision, demand generation, counselling services, and reporting, data management and performance review). We sorted out processes at the system, organizational, service delivery and individual levels on how the intervention team made the adaptations. Disruptions included decreased client load and demand for services, attrition of providers and intervention staff, key intervention activities becoming unfeasible and clients and providers facing challenges affecting utilization and provision of services. Adaptations included incorporating new guidance for the continuity of services, managing workforce turnover and incorporating remote modalities for all intervention components. The intervention adapted to continue by incorporating hybrid modalities including both original activities that were feasible and adapted activities. Amidst health system crises, the adapted intervention was successfully delivered. This knowledge of how to identify disruptions and adapt interventions during major crises is critical as Bangladesh and other countries face new threats (conflict, climate, economic downturns, inequities and epidemics).

Factors influencing the uptake of antenatal care in Uganda: a mixed methods systematic review

BackgroundIn 2016, the World Health Organization (WHO) recommended increasing antenatal care (ANC) visits from four to eight to reduce maternal morbidity and mortality. However, many low-middle income countries (LMICs), including Uganda, struggle to achieve even the basic four ANC visits. To further improve ANC attendance, understanding the perceptions and beliefs of end users is crucial. This systematic review explores the perceptions, experiences, and behavior of pregnant or previously pregnant women, their families and healthcare workers on ANC attendance in Uganda.MethodsThe review includes qualitative and quantitative studies published from January 2012 to September 2022. Outcomes include early initiation of ANC visits and any attendance or utilization of routine ANC services. The Critical Appraisal Skills Programme (CASP) checklist was used to assess the quality of included studies.ResultsWe searched 7 databases, identified 725 references and assessed 107 in full text for eligibility based on selected inclusion criteria. Forty-seven studies were eligible and are included in this review. Quantitative findings highlight socioeconomic factors like occupation, wealth index, and marital status as key determinants of ANC uptake and timely uptake of care, favoring higher wealth, younger age, marriage, and media access. Qualitative evidence reveals challenges to ANC attendance including financial constraints, cultural beliefs, gendered decision-making, and geographical distance from healthcare facilities. Potential solutions involve financially empowering women, providing reliable ANC equipment and medication, and community engagement and education.ConclusionsThis review offers valuable insights for policymakers and healthcare providers seeking to tailor interventions that address the unique needs and challenges faced by pregnant women, their families, and healthcare workers in Uganda. By doing so, it may enhance ANC accessibility and quality, ultimately aligning with the WHO’s recommendation of eight ANC contacts (ANC8) and contributing to reducing maternal morbidity and mortality rates.

Prevalence and Factors Associated with the Fourth Standard Antenatal Care Utilization among Pregnant Women Attending Ruli District Hospital, Rwanda

Purpose: The purpose of this research is to identify the prevalence of adherence to the recommended four antenatal care (ANC) visits and to analyze factors associated with achieving the fourth ANC visit among pregnant women attending Ruli District Hospital in Gakenke District, Rwanda. The study aims to address gaps in ANC attendance, focusing on improving maternal and fetal health. Methodology: A cross-sectional study design was used, with a sample size of 421 women, determined through Fisher et al.'s (1998) formula. Systematic sampling was employed to select participants between November 20, 2023, and January 20, 2023. Data collection included informing participants about the study and obtaining consent. Confidentiality was maintained by anonymizing participant data. Analysis was conducted using SPSS version 25, applying descriptive statistics such as percentages, means, and frequencies. Bivariate and multivariate regression analyses were used to identify relationships between independent and dependent variables, with significance assessed at p < 0.05. Findings: The study found that 57.5% of respondents adhered to the four recommended ANC visits, while 42.5% attended fewer than four. Factors significantly associated with increased ANC attendance included higher educational attainment, abstinence from alcohol by both the mother (AOR=1.953, CI: 1.202-3.174, P<0.007) and husband (AOR=2.041, CI: 1.112-3.747, P<0.002), planned pregnancies (AOR=4.159, CI: 1.975-10.326, P<0.001), and absence of mistreatment toward women (AOR=3.040, CI: 1.367-6.762, P=0.006). Unique Contribution to Theory, Practice and Policy: The study recommends enhanced supportive supervision and mentorship of Community Health Workers for home visits to pregnant women. Additionally, improving customer care and the quality of ANC services is advised. These insights are expected to guide policymakers in Rwanda, including the Ministry of Health, Ruli District Hospital, and other stakeholders, in enhancing ANC adherence and improving maternal health outcomes.

Barriers and facilitators to antenatal care services utilisation in Somaliland: a qualitative study.

To explore the barriers and facilitators of antenatal care (ANC) utilisation in Somaliland. An exploratory qualitative study design. Various settings were considered for study including maternal and child health clinics, hospitals and community. 74 study participants including 33 pregnant women, 22 healthcare providers, 10 community elders and ten religious leaders were purposively selected. Data was collected via focus group discussion and in-depth interviews in the local Somali language. The data was audio recorded, transcribed verbatim, translated into English and imported into NVivo V.12 software. Thematic framework analysis was used to assess barriers and facilitators of ANC utilisation. Six main themes were identified as barriers of ANC utilisation. These include lack of awareness, long distance and lack of transportation access, economic barriers, lack of social support, beliefs and thoughts and health facility-related factors such as caregivers approach, waiting time and inadequate skill of providers. Proper dissemination of ANC information, adequate spousal support and cheap pricing of services were found to be facilitators of ANC uptake. A strategy that focuses on raising awareness about ANC, making it accessible by reducing the cost-of-service charge, encouraging partner involvement, improving the quality of services and making it customer-friendly will help to overcome the barriers of antenatal utilisation.

Harnessing Emerging Technologies for Sustainable Child Health: Rethinking Strategies for Advancing SDG 3.2 in Resource-Constrained Environments

PurposeDespite the various interventions by governments and partnering organizations, many children under five continue to lose their lives to preventable causes. Therefore, the purpose of this study was to investigate, from healthcare professionals’ perspectives, the strategies implemented to fight under-five mortality in Zimbabwe’s public healthcare and to propose a rethought of the strategies towards emerging technologies-driven interventions to advance the attainment of the United Nations Sustainable Development Goals (UN SDGs) 3.2. Design/methodology/approachThis study was a part of a broader study that used a sequential exploratory mixed-methods research design, in which interviews and focus groups were used in the qualitative phase, followed by questionnaires in the quantitative phase. However, this paper only reports on the exploratory (qualitative) phase’s findings, in which twenty participants from a public provincial hospital and clinics participated in online interviews and focus group discussions. Participants were selected using purposive sampling and snowballing. NVivo software facilitated data analysis. FindingsFindings revealed that the current under-five mortality containment strategies in Zimbabwe include free access to care under-fives and expectant mothers in public health facilities, provision of nutritional supplements, prevention of mother-to-child transmission, child immunization programs, maternal and child health programs, health education and behaviour change programs, integrated management of childhood illnesses, and community-based health initiatives. However, under-five mortality in Zimbabwe, just like in many sub-Sahara African countries, is still high. The poor under-five mortality outcomes are in part, due to challenges like high off-facility (home) births, late bookings for antenatal care services, inconsistent and insufficient supply of medicinal drugs, especially in hard-to-reach areas like rural areas, and an unresponsive national medicinal drug supply chain. The paper recommends rethinking the current strategies to address these challenges by harnessing emerging digital technologies to enhance sustainable child health., with the recent deployment of the electronic health record system in the country providing a facilitating condition for the successful implementation of a technology-driven public child healthcare system. Practical implicationsThis study seeks to provide an alternative, technology-driven approach to ending preventable child deaths and enhance the achievement of the UN SDG 3.2. Though one could argue about the practicality of implementing emerging technologies in a resource-constrained setting, it should be noted that such settings have numerous nongovernmental players (such as the UNDP, World Bank, UNICEF and others) funding various programs to promote child and maternal health initiatives. Originality/valueInformed by the challenges faced by Zimbabwe in tackling under-five mortality, and the potential of emerging technologies in advancing child health, this study proffers implementable recommendations to assist the healthcare policymakers in Zimbabwe and similar settings to harness the power of technology in advancing child health and reduce under-five mortality.

Evaluation of focused antenatal care services quality at University of Gondar Comprehensive Specialized Hospital, Central Gondar zone, Northwest Ethiopia.

Antenatal care is the care that women receive during their pregnancy to ensure the health of the mother and her baby. The provision of information on birth preparedness in Ethiopia is still low, which implies identification of pre-existing health conditions that may affect the outcome of pregnancies was not provided. Even if the Focused Antenatal Care service was provided in our setup, maternal death was still high. In addition, as far as our search, the quality of antenatal care service in this facility has not yet been evaluated. As a result, the purpose of this study was to assess the quality of focused antenatal care services at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia. A mixed method case study evaluation design was employed at the University of Gondar Comprehensive Specialized Hospital from February 29 to March 29, 2020. Quantitative data was collected through exit interviews of 411 mothers who attended antenatal care follow-up and review of 422 clients' cards 2 months prior to the study period. Similarly, 35 items of resources inventory, 10 direct observations, and 12 key informant interviews were conducted. The data were entered into Epi-Data version 4.6 and exported to SPSS version 25 and it was analysed with the Evaluation judgment matrix analysis method. Qualitative data were transcribed, translated and analysed by using thematic analysis. The evaluation focused on availability, compliance, and satisfaction dimensions with 25 indicators to judge the quality of antenatal care services. The overall quality of focused antenatal care services was judged as good, based on pre-set judgment criteria (76.7%), to which availability of resources, healthcare provider's compliance with the national guideline, and maternal satisfaction contributed, 73.3, 77.75, and 78.8%, respectively. Auditory and visual privacy were practiced which enhances patient confidentiality and personal dignity. The waiting area was perceived to be satisfactory by the majority (89%) of ANC clients, but there is no separate waiting area for ANC clients. Ten (10) client/provider interactions were observed, demonstrating that all clients were counseled about pregnancy danger signs. The overall focused antenatal care services quality was relatively good, although the availability of resources was fair. Some essential drugs and medical equipment were out of stock. Therefore, the hospital had better fulfill crucial medicines and equipment for better service quality.

Determinants Influencing Utilization of Antenatal Care Services in Tabora Region, Tabora Municipality, Tanzania

This study examines the determinants influencing the utilization of antenatal care services (ANC) in in Tabora region with a particular focus on Tabora Municipality, Tanzania. The study used both quantitative and qualitative methods to analyze the problem. The study uses primary and secondary data obtained from the field. Tools used for data collection were questionnaires, interviews, and observation. This study employed a cross-sectional research design. This design was preferred because the design allowed the collection of data from different groups of respondents at one point at a time. Similarly, the design had a greater degree of accuracy and precision in the data collected and used for statistical description and interpretation. The study found that there was low utilization of antenatal care services in Tabora Municipality. The study revealed that the low utilization of ANC in Tabora Municipality can be solved by addressing the determinants that are responsible for the low use of ANC services. The study identified a number of determinants that influence ANC visits such as spousal involvement in antenatal clinics, the attitudes of health service professionals, clinic opening days for the antenatal care services by client satisfaction and integrated approach to antenatal care services. The determinants that affect the use of ANC visits are not only many and complex, but they play different roles in different situations. The study revealed that men and the whole community should be included in the ANC campaign so that they understand more about potential risks for pregnant women. This would increase the level of ANC use and thus reduce the high incidence of maternal and neonatal death in Tanzania including the Tabora region that results from poor utilization of ANC services. Also, this study adds knowledge to health service providers in understanding the determinants that limit pregnant women’s utilization of antenatal services finding ways to improve the services and encourage women to utilize ANC services. The study findings will enable programme planners, policymakers, implementers and managers to come up with strategies for interventions that will enable pregnant women to start seeking and utilizing ANC services early in pregnancy and to have fewer pregnancy complications that lead to maternal and neonatal deaths