Antenatal Care For Pregnant Women Research Articles

Evaluation of full blood count among plasmodium parasatized pregnant women, in general hospital Sabo Kaduna state, Nigeria

Background: Malaria poses a significant public health challenge in sub-Saharan Africa, particularly among pregnant women, where it contributes to a high burden of infection and mortality. This study aimed to investigate the impact of malaria on haematological and biochemical parameters among pregnant women attending the Antenatal Clinic at General Hospital Sabo Kaduna State, North-Western Nigeria. Methodology: A total of 70 pregnant women participated in the study, with subjects aged between 15 and 40 years. A total of 70 pregnant women participated in the study, 50 of which were malaria positive and 20 of which were malaria negative. Participants were recruited from Antenatal Clinic of General Hospital Sabo, Kaduna State. Socio-demographic characteristic and blood samples were collected and examine for malaria parasite, some haematological parameters (HCT, HGB, WBC, RBC and platelet count) were measured using the sysmex auto-haematology analyzer. Data generated was analyzed using SPSS 22.0 statistical package. Results: Findings revealed that younger women, particularly those aged 21-25 years, constituted a significant proportion of the subjects, consistent with previous reports. Haematological analysis demonstrated a significant decrease in haematocrit (HCT), haemoglobin (HGB), red blood cell count (RBC), and platelet count among malaria parasitized pregnant women compared to controls (p<0.05). However, white blood cell (WBC) count remained within the normal reference range for both groups. Conclusion: These findings corroborate previous research indicating that malaria infection leads to alterations in haematological parameters, primarily attributed to mechanical destruction of parasitized red blood cells and splenic clearance. Furthermore, there should be an enhanced efforts to implement malaria prevention and control strategies, promote sanitation practices to reduce mosquito breeding sites, and prioritize the inclusion of malaria parasite investigation as a routine test in antenatal care for pregnant women.

IJCM_70A: Husband’s knowledge regarding antenatal care of pregnant women and their involvement in the antenatal care of their wives

Background: Antenatal care is pivotal for maternal and child health, with husband involvement enhancing its efficacy. This study conducted in Mangalore, India, aimed to evaluate husbands’ knowledge and engagement in antenatal care, aligning with Sustainable Development Goals (SDGs) for human health and well-being. Objectives: The study aimed to assess husbands’ understanding of and involvement in supporting their wives during pregnancy. Methodology: A cross-sectional study surveyed 150 husbands using a semi-structured questionnaire, collecting data on personal details, antenatal care knowledge, and involvement in their wives’ pregnancy care. Descriptive statistics and Chi-Square tests were employed for analysis. Results: The majority of husbands exhibited sufficient knowledge of antenatal care, particularly regarding identifying danger signs. However, levels of active involvement varied due to socio-cultural factors and work commitments. While many accompanied their wives to appointments and participated in decision-making, some faced barriers such as work obligations. Conclusion: Enhancing husband involvement is essential for achieving SDG targets in maternal health. Tailored interventions addressing socio-cultural barriers can empower husbands to play a more active role in supporting maternal well-being. By fostering inclusive healthcare practices, we can improve health outcomes for mothers, infants, and communities at large.

IJCM_10A: Role of male spouse in antenatal care of pregnant women in the urban field practice area of Bangalore Medical College and Research Institute, Bengaluru – A Cross-Sectional study

Background: The husband has a great role to play in the antenatal care of his wife during pregnancy. Male spouse involvement is crucial and essential in utilization of the services and benefits, antenatal services to the maximum by the woman. The male spouse involvement will have positive impact on reproductive and child health. The extent of involvement of male spouse depends on the gender role attitudes and the social network. Objective: To assess the involvement of Male spouse in Antenatal care. Methodology: A community based cross-sectional study was conducted in the month of June to November 2023 among 263 Male partners of parous women between the reproductive age 15-45yr, in the urban slum area of BMCRI, Bangalore through simple random sampling technique. A pre-tested, semi-structured, questionnaire was used to collect the data, to assess their involvement during antenatal care. Data collected was entered in MS Excel and analysis was done using SPSS version 21.0. Results: In our study, 84% were actually present at the hospital during the delivery and 82.5% had good practice of taking appointment for ANC visits of their wives. About 77.6% were aware of pregnancy related danger signs. But only 35% participants accompanied their wives to ANC visit at least four times. Conclusion: There is a need to recognize importance and positive impact of male participation in antenatal care. Knowledge and attitude of men are the prime determinants of their level of participation in antenatal care.

The Influence of Health Education on Knowledge of Antenatal Care in Pregnant Women in Rural Areas

Background: Maternal health problems are closely related to pregnant women, which contribute a lot to the current maternal mortality rate, maternal mortality can be prevented if pregnant women get good quality antenatal care services. Lack of knowledge of pregnant women about antenatal care results in a lack of care for pregnant women about their own health and the baby in their womb. One of the efforts that can be done is by conducting antenatal care so that it can monitor pregnancy and ensure the health of the mother and fetus. Objective: This study aims to analyze the effect of health education on knowledge of antenatal care for pregnant women in Karangpring Village, Jember Regency. Methods: This type of research is a quasi-experimental design with the one group pre and post-test design. This study was conducted on pregnant women as many as 17 respondents. Results: Shows the value of knowledge before being given health education in the less category of 10 people (58.8%) and the sufficient category of 5 people (29.4%) and after being given health education knowledge in the sufficient category 10 people (58.8%) and good category amounted to 7 people (41.2%). The results of the paired t-test statistic obtained a significant value less than 0.05 (p = 0.000 <0.05). Conclusion: There is an effect of health education on knowledge of antenatal care for pregnant women in Karangpring Village, Jember Regency.

A study to assess the knowledge regarding antenatal care among pregnant women at District Hospital of Bareilly (U.P.) with a view to develop an information booklet

The objective of the study are to assess knowledge regarding antenatal care among pregnant women. To associate knowledge of pregnant women with their selected demographic variable that is age, area, qualification, occupation, religion, type of family, living of area, dietary pattern. To develop a information booklet on knowledge of antenatal care for pregnant women. Nurses being one of the members in multidisciplinary health care team must have adequate knowledge of the Antenatal Care. The researcher felt the need of a structured interview schedule for pregnant women and intended to assess the knowledge regarding antenatal care . The descriptive research design was used to assess the knowledge regarding Antenatal care among pregnant women of District Hospital Bareilly, (U.P). In view of the nature of problem and to accomplish the objectives of the study, a structured interview schedule to assess the knowledge regarding Antenatal care among pregnant women was prepared and used. Validity of the tool was ensured by consulting the guides and experts in the fields of statistics, medicines and Nursing and reliability (0.78) of the tool was tested. The study was carried out in District Hospital Bareilly (U.P) pregnant women were selected by Non probability purposive sampling technique. Structured interview schedule was used to collect the needed data. Data was analyzed by using descriptive and inferential statistics. Pregnant women knowledge regarding antenatal care is very good .Divided into 4 parts. Excellent 11(36.66%), V.Good15(50%) , Good 4(13.33%) Poor 0 (0%). Hence the total mean average is 706 and mean percentage is 78.43%. Thus by conducting this study we conclude that pregnant women having very good knowledge regarding antenatal care. Keywords: Assess; Knowledge; Antenatal care; pregnant women

Prevalence, antimicrobial susceptibility profile, and associated risk factors of uropathogenic Escherichia coli among pregnant women attending Dr. Sumait Hospital Mogadishu, Somalia.

Uropathogenic Escherichia coli (UPEC) is a strain of E. coli commonly associated with urinary tract infections. In addition, antibiotic resistance in UPEC is one of the most significant health problems. This study was conducted to determine the prevalence, antimicrobial resistance, and factors linked to uropathogenic Escherichia coli (UPEC) in pregnant women. This cross-sectional study was conducted within a hospital setting between August 2022 and December 2022. Using consecutive convenient sampling, the research enrolled 220 pregnant women. The urine samples obtained from these women were cultured on MacConkey and blood agar and incubated at 37°C overnight, followed by sub-culturing on Mueller Hinton media. Bacterial identification involved Gram staining and biochemical characterization (TSI, indole, citrate, methyl red, urea agar, and motility tests). Conversely, susceptibility tests were performed using the Kirby-Bauer disk diffusion method. A binary logistic regression model and analysis of odds ratios (ORs) were employed to evaluate the risk factors associated with E. coli infection, and statistical significance was attributed to p-values of ≤0.05. Out of the 220 urine samples examined, 42 (19%) exhibited a positive culture, indicating an E. coli infection in pregnant women. Our analysis revealed that income, gestational age, and history of UTIs were identified as risk factors associated with E. coli infection. Most E. coli isolates demonstrated sensitivity to amikacin (100%), nitrofurantoin (85.7%), amoxicillin/clavulanic acid, and meropenem (83.3%). The prevalence of E. coli was remarkable. It could be recommended that pregnant women in antenatal care have routine culture and antimicrobial susceptibility tests to prevent transmission of resistant pathogens and complications in both pregnant mothers and the unborn baby.

Prevalence of Multi Drug Resistance Escherichia coli Bacteriuria among Antenatal Women in a Tertiary Hospital in Enugu, Nigeria

Background: Urinary Tract Infection (UTI) due to Escherichia coli (E. coli) is a common health problem among women. Pregnant women are at increased risk due to the physiological changes associated with pregnancy. The present study was designed to determine the prevalence of E. coli UTI and its antibiotic susceptibility pattern among pregnant women at the antenatal clinic of the Enugu State University of Science and Technology Teaching Hospital, Enugu, Nigeria.
 Materials and Methods: A cross sectional study was carried out on a total of 200 pregnant women with and without symptoms of UTI. Mid-stream urine samples were collected and inoculated into Cysteine Lactose Electrolyte Deficient (CLED) and MacConkay. Colony counts > 102 cfu/ml of urine were regarded as significant bacteriuria. Pure isolates of bacterial pathogen were characterized by colony morphology, gram-stain and standard biochemical procedures. The method of agar disc diffusion susceptibility testing was used to determine the antibiotic resistance and sensitivity of the isolates.
 Results: The overall prevalence of UTI was 15.4% while 48.5% were symptomatic cases and 5.0% asymptomatic cases. E,Coli was the most frequently isolated organism with a prevalence of 53.4% (111 samples) while other pathogens accounted for 46.6% (89 samples). E. coli showed the highest resistance to the antibiotic Ampicillin 100%, 78% to Tetracycline and 70% to Rocephine but a low resistance of 16.7% against Nitrofurantoin and Ceftriazone respectively.
 Conclusion: UTI due to E. coli in pregnant women in Enugu is relatively high and shows high resistance to routine antibiotics. It is therefore, strongly recommended to undertake a routine culture as part of the antenatal care for pregnant women.

HUBUNGAN DUKUNGAN SUAMI DENGAN KEPATUHAN KUNJUNGAN ANC

The maternal mortality rate in 2020 has increased partly due to pregnant women's non-compliance with ANC check-ups. According to data from the Ministry of Health of the Republic of Indonesia, Indonesia did not reach the target of 93.3 percent of ANC visits. This study aims to determine the relationship between compliance of pregnant women in conducting antenatal care (ANC) in the working area of the Wongsorejo Health Center with husband support. Retrospective design was used in this research methodology, using a purposive sampling, the total population was 139 people and the sample size was 58 respondents. Visit data from the MCH book from June to August at 2022 was used as a research instrument. Wilcoxon statistical test was used for data analysis to obtain data on differences between the two groups. The results showed that out of 58 respondents, or 32 people (55.2%), reported that they had strong husband support. Of these pregnant women, 27 people (46.6%) made compliant ANC visits. In the working area of Puskesmas Wongsorejo, there is a significant relationship between husband support and adherence to ANC visits, as indicated by a significance value of 0.025 obtained from the Wilcoxon statistical test. It is suggested that it can provide information and add insight into the importance of support and involvement of husbands to pregnant women in antenatal care (ANC) checks.

Effects of an antenatal dietary intervention in women with obesity or overweight on child outcomes at 8–10 years of age: LIMIT randomised trial follow-up

BackgroundThe LIMIT randomised controlled trial looked at the effect of a dietary and lifestyle intervention compared with routine antenatal care for pregnant women with overweight and obesity on pregnancy outcomes. While women in the intervention group improved diet and physical activity with a reduction of high birth weight, other outcomes were similar. We have followed the children born to women in this study at birth, 6 and 18 months and 3–5 years of age and now report follow-up of children at 8–10 years of age.MethodsChildren at 8–10 years of age who were born to women who participated in the LIMIT randomised trial, and whose mother provided consent to ongoing follow-up were eligible for inclusion. The primary study endpoint was the incidence of child BMI z-score > 85th centile for child sex and age. Secondary study outcomes included a range of anthropometric measures, neurodevelopment, child dietary intake, and physical activity. Analyses used intention to treat principles according to the treatment group allocated in pregnancy. Outcome assessors were blinded to the allocated treatment group.ResultsWe assessed 1,015 (Lifestyle Advice n = 510; Standard Care n = 505) (48%) of the 2,121 eligible children. BMI z-score > 85th percentile was similar for children of women in the dietary Lifestyle Advice Group compared with children of women in the Standard Care Group (Lifestyle Advice 479 (45%) versus Standard Care 507 (48%); adjusted RR (aRR) 0.93; 95% CI 0.82 to 1.06; p = 0.302) as were secondary outcomes. We observed that more than 45% of all the children had a BMI z-score > 85th percentile, consistent with findings from follow-up at earlier time-points, indicating an ongoing risk of overweight and obesity.ConclusionsDietary and lifestyle advice for women with overweight and obesity in pregnancy has not reduced the risk of childhood obesity, with children remaining at risk of adolescent and adult obesity. Other strategies are needed to address the risk of overweight and obesity in children including investigation of preconception interventions to assess whether this can modify the effects of maternal pre-pregnancy BMI. The LIMIT randomised controlled trial was registered with the Australian and New Zealand Clinical Trials Registry (ACTRN12607000161426).

Behavior of Pregnant Women In Pregnancy Examinations In Manisa Village, Baranti District

The occurrence of maternal deaths is related to direct causal factors and indirect causes. The direct causes of maternal death in Indonesia are still dominated by factors. by bleeding, eclampsia, and infection, while the indirect factors causing maternal death are because there are still many cases, 3 too late and 4 too late, which are related to access, socio-cultural, educational and economic factors. This research uses a combination method with a sequential explanatory design. The first uses quantitative methods, and the second uses qualitative methods. A quantitative approach is used to identify and explain variables that influence behavior such as knowledge, attitudes, facilities and encouragement of officers. A qualitative approach is used to support and complement quantitative research results. The chi-square test shows that there is a significant relationship between knowledge, facilities and encouragement of health workers on the behavior of pregnant women in pregnancy checks. P value = 0.001. If the significance value is <0.05, it is recognized that there is a statistically significant correlation. Meanwhile, attitudes show no statistical correlation. The logistic regression test shows that there is an influence between knowledge and facilities on the behavior of pregnant women. There are two substantial findings, namely regarding knowledge about antenatal care and the availability of facilities which influence the behavior of pregnant women in antenatal care.

Risk Factors Affecting Length of Stay in Preterm Infants at Wangaya Regional General Hospital, Indonesia

Background: Advances in neonatology have led to many preterm infants being saved. Prolonged length of stay (LOS) increases the incidence of neonatal complications and even mortality, placing a significant economic burden on families and strain on healthcare systems. This study aims to determine the factors associated with LOS in preterm infants.
 Methods: This cross-sectional study involved 60 preterm babies treated at Wangaya Hospital from May 2022 to May 2023. Infants with congenital anomalies, referred from other hospitals and did not receive appropriate treatment were excluded from the study. Data were taken from the electronic medical record after obtaining ethical clearance and then analyzed using descriptive statistics and linear regression in SPSS 25. Statistical significance was considered at 0.05.
 Results: As many as 46 out of 60 preterm infants were born at moderate to late preterm gestational age. The majority of 81.7% of infants were born with a body weight of 1500-2499 grams. The median number of LOS was 7.5 days (IQR 15). Multivariate analysis of numerical independent variables obtained an equation log [LOS] = 2.902-0.066*gestational age+ 0.022*duration of parenteral nutrition (R2 = 78.1%). Meanwhile, in the categorical independent variables obtained, an equation log [LOS] = 0.398 + 0.223*very preterm + 0.144* RDS + 0.178*NEC + 0.206*prolonged antibiotics administration + 0.278*late enteral feeding + 0.148*abdominal distension + 0.144*vomiting (R2 = 87.4%).
 Conclusion: Factors influencing LOS of preterm infants are gestational age, duration of parenteral nutrition, the presence of RDS, NEC, vomiting, abdominal distension, late enteral feeding, and prolonged use of antibiotics. It is essential to carry out antenatal care for pregnant women to prevent premature birth.

Determinants of Pre-Eclampsia Incidence among Pregnant Women in Antenatal Care at Fortportal Regional Referral Hospital

Determinants of Pre-Eclampsia Incidence among Pregnant Women in Antenatal Care at Fortportal Regional Referral Hospital

Assessment of Quality of Antenatal Care in Pregnant Women Delivered in Ain Shams University Hospitals

Assessment of Quality of Antenatal Care in Pregnant Women Delivered in Ain Shams University Hospitals

Barriers to hepatitis B virus screening of pregnant women in primary healthcare centers in Nigeria: health workers’ perspective

BackgroundHepatitis B virus (HBV) screening is an important component of antenatal care for pregnant women in Nigeria. However, the screening rates remain low, particularly at primary healthcare centers (PHCs). The objective of this study was to identify the barriers affecting antenatal HBV screening in PHCs in Nigeria from the perspective of health workers.MethodsWe conducted a survey among 30 health workers from 30 PHCs (one per PHC) across three states (Akwa Ibom, Anambra, and Kaduna) in Nigeria. An open-ended questionnaire was used to obtain written responses on the perceived barriers limiting antenatal HBV screening in PHCs and their recommended solutions to the identified barriers. The data were analyzed using an inductive thematic approach.ResultsThe perceived barriers exist at patient, provider and health system levels. They included: lack of test kits, unaffordability of HBV test, shortage of trained personnel, poor awareness among pregnant women, knowledge of HBV among health workers, high cost of antiviral treatment, and unavailability of HBV vaccine. The recommended solutions to the identified barriers were: making test kits and vaccines available and free, creating awareness about HBV, and capacity-building interventions for health workers.ConclusionsHBV screening of pregnant women attending PHCs in Nigeria appears to be affected by multilevel barriers. As the country continues to work towards eliminating HBV, these highlighted barriers at the patient, provider and health system levels must be addressed through effective and sustainable interventions.

ВЕРОЯТНОСТЬ ИЗМЕНЕНИЯ ПОКАЗАТЕЛЕЙ ФУНКЦИИ ВНЕШНЕГО ДЫХАНИЯ ПРИ РАЗВИТИИ ХОБЛ В ЗАВИСИМОСТИ ОТ КОЛИЧЕСТВА ВЫКУРИВАЕМЫХ СИГАРЕТ НА ФОНЕ ГОРМОНАЛЬНЫХ ИЗМЕНЕНИЙ ПРИ БЕРЕМЕННОСТИ

Introduction. This is a study of possible changes in the respiration function indicators in the development of chronic obstructive pulmonary disease (COPD), depending on the number of cigarettes smoked and associated with pregnancy-related hormone fluctuations. Aim. Our study aimed to determine the dependence of changes in first- second forced expiratory volume upon the level of anti-inflammatory hormones cortisol and progesterone in female smokers with different number of cigarettes smoked. Materials and Methods. The study is based on the findings of the analysis of changes in the level of hormones cortisol and progesterone in 243 pregnant women in antenatal care and on how such changes affect the first-second forced exhalation volume. The control group consisted of healthy non-smoking female patients. 4 groups were formed. For each group, the expected values of the first-second forced exhalation volume were calculated, in parallel with changes in the cortisol and progesterone profile and with forming the relevant statistical data matrices. Results and Discussion. With an increase in cortisol and progesterone levels, there is an increase in the first-second of forced exhalation volume, which indicates an increase in the lung tissue elasticity and in the air flow rate in the first second under the influence of hormones that have a pronounced anti-inflammatory effect. Conclusion. Pregnancy progress in smokers consuming different amounts of cigarettes is accompanied by an increase in the cortisol and progesterone levels. Hormone fluctuations improve the functional state of external respiration in pregnant smokers with COPD, creating the illusion of preserving the physiological capabilities of lungs regardless of the number of cigarettes smoked. With this variant of the COPD developing during pregnancy, a temporary physiological increase in the anti-inflammatory hormonal profile masks the extent, to which the number of cigarettes smoked affects the COPD severity.

Effectiveness of mHealth Interventions for Monitoring Antenatal Care among Pregnant Women in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis.

Antenatal care (ANC) is essential in maternal and child health since it provides care to pregnant women from conception through to labour in order to ensure a safe pregnancy and childbirth. In recent years, mobile health (mHealth) interventions have emerged as a promising solution to improve maternal and child health outcomes in low- and middle-income countries (LMICs). The present study aimed to conduct a systematic review and meta-analysis of trials to evaluate the effectiveness of mHealth interventions to monitor prenatal care among pregnant women in LMICs. A systematic literature review was conducted using the databases CINHAL, Embase, MEDLINE, and PsycINFO on the effectiveness of mHealth interventions in monitoring the antenatal care of pregnant women. The study selection, data extraction of the included articles, and quality appraisal were assessed. Our study included six studies considering 7886 participants. All articles were from low- and middle-income countries (LMICs). Antenatal mothers who used a mobile health intervention were more likely (RR = 1.66, 95%CI = 1.07-2.58, I2 = 98%) to attend ANC check-ups when compared with the women who did not use any mobile health applications or did not receive any short message services. mHealth technologies are being utilised more and more to increase care accessibility and improve maternal and fetal health. Policymakers should prioritise the integration of mHealth interventions into maternal healthcare services in LMICs, ensuring that they are cost-effective, accessible, and sustainable and that healthcare workers are trained to deliver these interventions effectively.

Factors associated with knowledge of mother-to-child transmission (MTCT) of HIV/AIDS among young adults in Indonesia: Analysis of IYARHS

Background: The prevalence of mother-to-child transmission (MTCT) of HIV/AIDS is increasing, particularly in low- and middle-income countries. Most previous studies focused on pregnant women in antenatal care, but this study examined the early phases of non-married women, which are young adults. Objective: This study aimed to examine the factors associated with knowledge MTCT of HIV/AIDS among young adults in Indonesia. Methods: This study used secondary data from the Special Indonesia Demographic Health Survey (IDHS), also known as the Indonesia Young Adult Reproductive Health Survey (IYARHS). The unit of analysis in this study is a non-married young adult aged 14 to 24 from 34 provinces in Indonesia. The final samples brought into the analysis were 9,600 women. The univariate analysis, bivariate analysis using the Chi-Square test, and multivariate analysis using binary logistic regression were done using the STATA 17 version licensed by the Institute for Population and Social Research, Mahidol University. Results: This study revealed that 33.75% of the respondents had poor knowledge of the MTCT of HIV/AIDS. Moreover, the factors found to be significantly associated with knowledge of MTCT of HIV/AIDS were age (19 to 24 years old), residence in an urban area, graduation from junior high school, senior high school, academy, and university, and also those who talked about sexual matters with friends. Conclusion: This study suggests supporting and encouraging related stakeholders in order to provide education about MTCT in the early years of adulthood so the prevention program can be applied more easily.

PENGARUH E-KIE TERHADAP TINGKAT PENGETAHUAN DAN KEPUASAN IBU HAMIL DALAM ANTENATAL CARE DI MASA PANDEMI COVID-19

Background: The Covid-19 pandemic that has occurred throughout the world affects all aspects, including health aspects. The Covid-19 pandemic is certainly an obstacle for the government to overcome the Maternal Mortality Rate (MMR) and Infant Mortality Rate (IMR) in Indonesia. Optimal Antenatal Care is one of the efforts to suppress MMR and IMR. The government recommends using online counseling to support antenatal care during the Covid-19 pandemic. Research objective: to determine the impact of e-KIE on the knowledge level and satisfaction of pregnant women in antenatal care during the Covid-19 pandemic. Research Methods: The design used was pre-experimental, namely one group pre-post test design to see the effect between the independent variables of the e-KIE method and the dependent variable, namely level of knowledge and satisfaction of pregnant women which were analyzed by marginal homogeneity. The research sample was selected by purposive sampling taken from the registration book (K1) with a population range of pregnant women from September to October 2021 totaling 37 respondents. Research results: there is a significant increase in the level of knowledge of pregnant women before and after e-KIE with a p value of 0.035 and an insignificant effect due to the compatibility between the expected value and the reality of pregnant women with a p value of 0.059. Conclusion: E-KIE significantly affects the level of knowledge of pregnant women and the e-KIE provided does not significantly affect the satisfaction of pregnant women in supporting dialogue/counseling in antenatal care during the Covid-19 pandemic.

Economic analysis of a new four-panel rapid screening test in antenatal care in Kenya, Rwanda, and Uganda

BackgroundWe performed an economic analysis of a new technology used in antenatal care (ANC) clinics, the ANC panel. Introduced in 2019–2020 in five Rwandan districts, the ANC panel screens for four infections [hepatitis B virus (HBV), human immunodeficiency virus (HIV), malaria, and syphilis] using blood from a single fingerstick. It increases the scope and sensitivity of screening over conventional testing.MethodsWe developed and applied an Excel-based economic and epidemiologic model to perform cost-effectiveness and cost-benefit analyses of this technology in Kenya, Rwanda, and Uganda. Costs include the ANC panel itself, its administration, and follow-up treatment. Effectiveness models predicted impacts on maternal and infant mortality and other outcomes. Key parameters are the baseline prevalence of each infection and the effectiveness of early treatment using observations from the Rwanda pilot, national and international literature, and expert opinion. For each parameter, we found the best estimate (with 95% confidence bound).ResultsThe ANC panel averted 92 (69–115) disability-adjusted life years (DALYs) per 1,000 pregnant women in ANC in Kenya, 54 (52–57) in Rwanda, and 258 (156–360) in Uganda. Net healthcare costs per woman ranged from $0.53 ($0.02-$4.21) in Kenya, $1.77 ($1.23-$5.60) in Rwanda, and negative $5.01 (-$6.45 to $0.48) in Uganda. Incremental cost-effectiveness ratios (ICERs) in dollars per DALY averted were $5.76 (-$3.50-$11.13) in Kenya, $32.62 ($17.54-$46.70) in Rwanda, and negative $19.40 (-$24.18 to -$15.42) in Uganda. Benefit-cost ratios were $17.48 ($15.90-$23.71) in Kenya, $6.20 ($5.91-$6.45) in Rwanda, and $25.36 ($16.88-$33.14) in Uganda. All results appear very favorable and cost-saving in Uganda.ConclusionThough subject to uncertainty, even our lowest estimates were still favorable. By combining field data and literature, the ANC model could be applied to other countries.

Maternal health literacy and adherence to recommended ANC contact among pregnant women in Indonesian

Maternal health literacy (MHL) equips pregnant women to seek timely Antenatal care (ANC). Through ANC, health workers can provide education that contributes to reducing the maternal mortality rate. This research aims to investigate the relationship between MHL and adherence to recommended ANC contacts and explore how mothers experience accessing ANC. The study design was a mixed-method study. A total of 305 pregnant women with various characteristics participated in this study. Quantitative data analysis used simple linear regression, while qualitative used Collaizi's strategy. The research found a positive relationship between MHL and adherence to recommended ANC contact with R2 = 0.18; F(1, 303) = 6.533, p < 0.05. Three themes represented the phenomenon of pregnant women in carrying out ANC: 1) perceptions about ANC, 2) challenges faced by pregnant women in accessing recommended ANC contact, and 3) supporting factors in doing routine ANC contact. Pregnant women with higher MHL have higher adherence to ANC contact. Health workers and policymakers can involve the results of this research in efforts to revise or make policies related to increasing pregnant women's ANC contacts.