Antenatal Care Sessions Research Articles

Compliance with focused antenatal care services: do health workers in rural Burkina Faso, Uganda and Tanzania perform all ANC procedures?

To assess health workers' compliance with the procedures set in the focused antenatal care (ANC) guidelines in rural Uganda, Tanzania and Burkina Faso; to compare the compliance within and among the three study sites; and to appraise the logistic and supply of the respective health facilities (HF). The cross-sectional study was conducted in the rural HF in three African countries. This descriptive observational study took place in HF in Nouna, Burkina Faso (5), Iganga, Uganda (6) and Rufiji, Tanzania (7). In total, 788 ANC sessions and service provisions were observed, the duration of each ANC service provision was calculated, and the infrastructures of the respective HF were assessed. Health workers in all HF performed most of the procedures but also omitted certain practices stipulated in the focused ANC guidelines. There was a substantial variation in provision of ANC services among HF within and among the country sites. The findings also revealed that the duration of first visits was <15 min and health workers spent even less time in subsequent visits in all three sites. Reagents for laboratory tests and drugs as outlined in the focus ANC guidelines were often out of stock in most facilities. Health workers in all three country sites failed to perform all procedures stipulated in the focused ANC guideline; this could not be always explained by the lack of supplies. It is crucial to point out the necessity of the core procedures of ANC repeatedly.

Knowledge of obstetric danger signs and birth preparedness practices among women in rural Uganda

BackgroundImproving knowledge of obstetric danger signs and promoting birth preparedness practices are strategies aimed at enhancing utilization of skilled care in low-income countries. The aim of the study was to explore the association between knowledge of obstetric danger signs and birth preparedness among recently delivered women in south-western Uganda.MethodsThe study included 764 recently delivered women from 112 villages in Mbarara district. Community survey methods were used and 764 recently delivered women from 112 villages in Mbarara district were included in study. Interviewer administered questionnaire were used to collect data. Logistic regression analyses were conducted to explore the relationship between knowledge of key danger signs and birth preparedness.ResultsFifty two percent of women knew at least one key danger sign during pregnancy, 72% during delivery and 72% during postpartum. Only 19% had knowledge of 3 or more key danger signs during the three periods. Of the four birth preparedness practices; 91% had saved money, 71% had bought birth materials, 61% identified a health professional and 61% identified means of transport. Overall 35% of the respondents were birth prepared. The relationship between knowledge of at least one key danger sign during pregnancy or during postpartum and birth preparedness showed statistical significance which persisted after adjusting for probable confounders (OR 1.8, 95% CI: 1.2-2.6) and (OR 1.9, 95% CI: 1.2-3.0) respectively. Young age and high levels of education had synergistic effect on the relationship between knowledge and birth preparedness. The associations between knowledge of at least one key danger sign during childbirth or knowledge that prolonged labour was a key danger sign and birth preparedness were not statistically significant.ConclusionsThe prevalence of recently delivered women who had knowledge of key danger signs or those who were birth prepared was very low. Since the majority of women attend antenatal care sessions, the quality and methods of delivery of antenatal care education require review so as to improve its effectiveness. Universal primary and secondary education programmes ought to be promoted so as to enhance the impact of knowledge of key danger signs on birth preparedness practices.

Birth preparedness and emergency readiness plans of antenatal clinic attendees in Ile-ife, Nigeria

Adequate birth preparedness and emergency/complication readiness (BP/CR) planning could determine the survival of a pregnant woman and her unborn child in maternal emergency. The study assessed adequacy of BP/CR plans of antenatal clinic attendees in Ile-Ife, Osun State, Nigeria. Pregnant women (less than 36 weeks gestation) attending antenatal clinics in selected health facilities were serially recruited into the study after they had given verbal informed consent. Data were collected with a purpose-designed questionnaire. SPSS version 11 statistical software was used for data entry and analysis. Four hundred pregnant women were recruited; 284 (71%) registered for antenatal care by 20 weeks of gestation. Concerning delivery planning, 350 (87.5%) had decided their place of delivery although 32 (9.1%) of these planned to deliver in mission houses or at home; 351 (87.8%) had started to purchase items needed for delivery or newborn care, 289 (71.0%) had identified someone to accompany them to health facility for delivery while 259 (64.8%) were saving money for delivery. Regarding emergency or complication readiness, knowledge of signs of severe maternal illness for which immediate care should be sought in an appropriate health facility was low, 113 (28.3%) respondents were able to mention 4 or more of such signs without prompting; 249 (62.3%) had made arrangements for transportation and 45 (11.3%) had identified potential blood donor. By the study criteria, 61% of the pregnant women studied made adequate preparations for delivery while 4.8% were ready for emergency/complication. It is recommended that greater emphasis be given to emergency/complication readiness during antenatal care sessions.