Level of Quality of Option B+PMTCT Service Provision in Public Health Facilities in Mekelle Zone, Northern Ethiopia: Cross-sectional study (original) (raw)
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OALib, 2015
Background: Worldwide, an estimated 2.3 million children under the age of 15 are HIV positive. The main source of HIV infection in children is vertical transmission of HIV from mother-to-child during pregnancy, labor and delivery, or breastfeeding. Prevention of Mother-to-Child Transmission of HIV has been expanded in accelerated fashion throughout Ethiopia with all public hospitals and health centers providing the services. However, published studies on the services' provision in the country are generally limited. If at all, they did not comprehensively examine quality of the services. Objective: The study aimed to assess the quality of Prevention of Mother-to-Child Transmission of HIV services in Gebretsadiq Shawo Memorial Hospital in Kafa Zone, Southwest Ethiopia. Methods: Facility based cross-sectional study involving both quantitative and qualitative methods was conducted in September 2012. A total of 311 pregnant mothers were interviewed and a one year (2011) record of PMTCT clients was reviewed and service provision processes were observed for 10 counseling sessions. Donabedian's Structure-Process-Outcome model was used to conceptualize the study. Data were analyzed using SPSS for windows version 17 software. Descriptive statistics were computed to summarize the findings. Results: Almost all of the minimum required resources such as test kits, prophylactic drugs and other supplies were available in the hospital; counselors followed the national guideline in providing HIV counseling and testing services; and most (90%) of clients were satisfied or very satisfied by the PMTCT services they received. However, from 858 pregnant mothers who visited the ANC clinic in 2011, only 330(38.5%) were offered HIV pretest counseling, while 281 (33%) were tested. Conclusion: Although clients' satisfaction by PMTCT service is very high, considerable proportion of pregnant mothers who utilize ANC services are not offered HIV counseling and testing services. Therefore, appropriate quality improvement interventions against the missed opportunities are highly recommended.
2014
BACKGROUND:-The maternal mortality ratio in Ethiopia is strikingly high. One of Key interventions to reduce maternal deaths is the promotion of ANC. ANC plays an important role in reducing maternal mortality and morbidity by detecting early risk factors in order to have an effective intervention in time and by linking the pregnant women to a planned delivery with a skilled birth attendant. However, studies have shown that there are many missed opportunities for care, both because of client and health system related factors. OBJECTIVE:-To assess the quality of antenatal care services in rural health centers in Bursa woreda from March-April, 2014. METHOD:-The facility based cross-sectional study was conducted in rural health centers in Bursa woreda. Antenatal follow up women's was interviewed about perception on satisfaction towards quality of antenatal services, by using structured questionnaires (n= 290). Twenty-four antenatal care provider client sessions was observed by checklist. Simple observation using checklist was made for availability of resources necessary for antenatal care. Finally data was coded, cleaned, entered using EPI-6 and was analyzed using SPSS statistical software for windows. RESULTS:-The study showed that overall satisfaction of client was low as 33%. The likelihood of satisfaction from ANC service was lower among women secondary and above of education level [AOR = 0.14, 95% CI = (0.03-0.78)]. The study also illustrated that higher proportion of health providers did not provide danger sign counseling, advice and information related to complication of pregnancy. Although all the health centers have basic structural medical equipments, none of them has laboratory equipments and high-level disinfection process Conclusions and Recommendation:-Overall satisfaction of ANC is low. However, for all of them ANC clients were not performed likes (hemoglobin, blood grouping and Rhesus factor, VDRL for Syphilis and urine analysis) and harmful habits likes (smoking, drug abuse &alcoholism, side effects of medicines during pregnancy, breast-feeding, and baby vaccination). Satisfaction from the ANC service in the health centers is very low, and should be stressed health providers and woreda health office to do better for client's satisfaction.
BMC Health Services Research
Background: According to the Donabedian model, the assessment for the quality of care includes three dimensions. These are structure, process, and outcome. Therefore, the present study aimed at assessing the structural quality of Antenatal care (ANC) service provision in Ethiopian health facilities. Methods: Data were obtained from the 2018 Ethiopian Service Availability and Readiness Assessment (SARA) survey. The SARA was a cross-sectional facility-based assessment conducted to capture health facility service availability and readiness in Ethiopia. A total of 764 health facilities were sampled in the 9 regions and 2 city administrations of the country. The availability of equipment, supplies, medicine, health worker's training and availability of guidelines were assessed. Data were collected from October-December 2017. We run a multiple linear regression model to identify predictors of health facility readiness for Antenatal care service. The level of significance was determined at a p-value < 0.05. Result: Among the selected health facilities, 80.5% of them offered Antenatal care service. However, the availability of specific services was very low. The availability of tetanus toxoid vaccination, folic acid, iron supplementation, and monitoring of hypertension disorder was, 67.7, 65.6, 68.6, and 75.1%, respectively. The overall mean availability among the ten tracer items that are necessary to provide quality Antenatal care services was 50%. In the multiple linear regression model, health centers, health posts and clinics scored lower Antenatal care service readiness compared to hospitals. The overall readiness index score was lower for private health facilities (β = − 0.047, 95% CI: (− 0.1, − 0.004). The readiness score had no association with the facility settings (Urban/Rural) (p-value > 0.05). Facilities in six regions except Dire Dawa had (β = 0.067, 95% CI: (0.004, 0.129) lower readiness score than facilities in Tigray region (p-value < 0.015). Conclusion: This analysis provides evidence of the gaps in structural readiness of health facilities to provide quality Antenatal care services. Key and essential supplies for quality Antenatal care service provision were missed in many of the health facilities. Guaranteeing properly equipped and staffed facilities shall be a target to improve the quality of Antenatal care services provision.
Quality of maternal and newborn health care in Ethiopia: a cross-sectional study
BMC Health Services Research
Background Despite reports of universal access to and modest utilization of maternal and newborn health services in Ethiopia, mothers and newborns continue to die from preventable causes. Studies indicate this could be due to poor quality of care provided in health systems. Evidences show that high quality health care prevents more than half of all maternal deaths. In Ethiopia, there is limited knowledge surrounding the status of the quality of maternal and newborn health care in health facilities. This study aims to assess the quality of maternal and neonatal health care provision at the health facility level in four regions in Ethiopia. Methodology This study employed a facility-based cross-sectional study design. It included 32 health facilities which were part of the facilities for prototyping maternal and neonatal health quality improvement interventions. Data was collected using a structured questionnaire, key informant interviews and record reviews. Data was entered in Micros...
OALib, 2015
Background: Antenatal care is the care that women receive during pregnancy to ensure a healthy outcome for women and newborns. In spite of its clear importance, such services continued to be important determinants of maternal mortality and morbidity throughout the world. Methods: A case study was conducted in Higher 2 Town Health Center, using client exit interviews of 265 clients who came to the health institution. In addition, 10 observations of client-provider interactions, document reviews of 246 clients' documents selected by systematic random sampling technique, and 5 in-depth interviews of the focal persons were conducted. Quantitative data were analyzed using SPSS for windows (SPSS 16.0). Qualitative data were categorized into major thematic areas and presented as narratives in triangulation with the quantitative results. In each evaluation dimension, indicators were used to judge the quality of antenatal care services. Results: Most of the minimum required basic resources recommended by World Health Organization were available in the study site. But there were incomplete sets of laboratory reagents and shortage of some drugs. Comprehensive history was recorded for 93.4% of clients. Only 34.3% of clients received prescriptions for iron supplementation. Majority (94.6%) of the clients were satisfied with the accommodations of antenatal care service. The compliance of the health care providers towards routine laboratory investigations ranged from 25.4% to 50.1%. Conclusions: The overall quality of the service was judged as fair (69.5%). Majority of the clients were satisfied with accommodation of ANC services. However, the availability of laboratory reagents and drugs remained to be challenges. Providers' compliance towards standard basic investigations was also far below World Health Organization recommendations and judged as critical. Thus it is recommended that responsible bodies should strive to improve provision of supplies and compliance of the care providers to step-up the quality of care at president capacity level.
Journal of General Practice, 2018
Background: Antenatal care is comprehensive care that pregnant women receive from organized health care services to promote and maintain optimal health of the mother throughout the pregnancy, labor and puerperium. High quality antenatal care is important to safeguard their health help women maintain normal pregnancies and reduce the rate of maternal and infant morbidity and mortality. Studies conducted to assess quality of antenatal care service which describes the components of antenatal care that the woman receive during her pregnancy and do not describe the factor that affects quality service and also they do not illustrate the quality service. Therefore this study tried to fill the gap which was not address by previous studies. Objective: To assess quality of Antenatal care service and associated factors in Harar town governmental health facilities Harar, Ethiopia from January 30 to February 30. Methods: Facility based cross sectional study that employed quantitative method supplemented with qualitative method was used. Exit interview was conducted on clients who had ANC follow up. Observation on the health care provider was performed while providing antenatal care. In-depth interview was conducted on one purposively selected antenatal care provider. Facility infrastructure, supplies and equipment and health care practices during Antenatal clinic was assessed. Collected and checked data were entered in to Epi Data software version 3.02 and exported and analyzed using SPSS version 21. Both Bivariate and multiple logistic regressions were used to observe the association between the outcome variable and associated factors. Result: Among the Focused Antenatal Component personal history, Blood pressure measurement, Laboratory evaluation and provision of supply were provided for majority of the clients. The overall prevalence of quality of ANC service was 24.3%. Women who had history of still birth 2 times more likely (AOR=2.936, 95% CI: 1.177-7.320) Women who had more than four visit were 4.5 times more likely (AOR=4.592, 95% CI: 1.318-12.996), women whose privacy maintain while counseling were 4 times more likely (AOR=4.110, 95% CI: 1.753-9.637) having quality of antenatal care services than their encounters. Conclusion and Recommendation: Generally, the studies showed that majority of clients were not received quality Antenatal care service. Consultation room for keeping privacy should have to maintain for providing quality Antenatal care service by the health facilities.
American Journal of Health Research, 2014
Background: Quality of Antenatal care is potentially one of the most effective health intervention for preventing maternal morbidity and mortality particularly in places where the general health status of women is poor. Improving quality of health care is one of the strategies in Health sector development program IV (HSDP IV) of Ethiopia. However, there are limited studies on quality of antenatal coverage in Ethiopia including the study area. Thus, the aim of this study was to assess the perceived quality of Antenatal care of pregnant women in public and private health facilities in Tigray, Northern Ethiopia. Methods: Health institution based cross sectional study was conducted from February to May, 2013 in Tigray region among 526 pregnant women attending Antenatal care clinic. Participants were selected using multistage sampling technique first health facility were selected using lottery method then pregnant women from each selected facility were selected using systematic sampling method according to the flow pregnant women to the ANC clinics. Data were entered and cleaned using EPI-info version 3.5.1 and analysis was performed by SPSS version 20. Bivariate and multivariate logistic regression analysis was used to calculate odd ratio with 95% confidence level. Statistical association between the dependent and independent variables was ascertained at p-value less than 0.05. Results: The prevalence of overall perceived quality of ANC was 24.5%. Factors like women aged between 26 and 35 years [AOR=0.58(0.38-0.88)], governmental institution ANC attendance [AOR=0.52(0.33-0.83)], own income [AOR=0.61(0.40-0.92)], one to three ANC attendance [AOR=0.31(0.18-0.54)], testing for HIV [AOR=0.12(0.06-0.24)] causes less likely to perceived that getting high quality ANC service however, waiting time greater than one hour [AOR=3.42(1.61-7.28)] is positively associated with mother perception toward getting high quality ANC service. Conclusions: This study revealed that the perceived quality of ANC is very poor. Therefore, urgent action is mandatory to improve the quality ANC service by providing women centered approaches in giving care, in-service training to health care providers on quality practices.
Quality of emergency obstetric and newborn care services in Wolaita Zone, Southern Ethiopia
BMC Pregnancy and Childbirth
Background Globally, nearly 295,000 women die every year during and following pregnancy and childbirth. Emergency obstetric and newborn care (EmONC) can avert 75% of maternal mortality if all mothers get quality healthcare. Improving maternal health needs identification and addressing of barriers that limit access to quality maternal health services. Hence, this study aimed to assess the quality of EmONC service and its predictors in Wolaita Zone, southern Ethiopia. Methodology A facility-based cross-sectional study was conducted in 14 health facilities. A facility audit was conducted on 14 health facilities, and 423 women were randomly selected to participate in observation of care and exit interview. The Open Data Kit (ODK) platform and Stata version 17 were used for data entry and analysis, respectively. Frequencies and summary statistics were used to describe the study population. Simple and multiple linear regressions were done to identify candidate and predictor variables of s...
BMC Pregnancy and Childbirth
Background: Most of the maternal and newborn deaths occur at birth or within 24 h of birth. Provision of quality Basic Emergency Obstetric and Neonatal Care (BEmONC) is very crucial and the current recommended intervention to prevent maternal and newborn morbidity and mortality. Methods: An institution based cross-sectional study was conducted among mothers receiving at least one of the signal functions of BEmONC services. A total of 398 women were included in the study. The study participants were selected using a systematic random sampling method. Data was collected using structured interviewer-administered Tigrigna version questionnaire. Data were analyzed using SPSS version 20. Multi-variable logistic regression was used to control the effect of confounders. Results: The perceived quality of BEmONC was 66.7%, which is poor. Clients scored lower quality rates on aspects such as the availability of necessary equipment, lack of clean and functional shower and toilet and administration of antipain during delivery and manual vacuum aspiration (MVA). Quality of BEmONC was lower among rural residents (AOR = 0.273, 95% CI: (0.151-0.830). Whereas, Presence of companion (AOR = 2.259; 95% CI: (3.563-13.452) were found with a higher score of quality of BEmONC compared to their counterparts. Conclusion: The overall perception of quality of BEmONC services received was poor. Residence, ANC follow-up, and presence of companion during labor or delivery were found to have a significant association with the perceived quality of BEmONC services.
BMC Pediatrics
Background Prevention of mother-to-child transmission service is a comprehensive package of services planned to reduce the risk of mother-to-child transmission of HIV. It is very crucial to determine the level of quality of PMTCT services in this study area since other studies in our country omitted several variables in each category of the Donobedian model. Therefore, this study aimed to determine the level of quality of option B + PMTCT of HIV services. Methods An institution-based cross-sectional study design with both quantitative and qualitative data collection method was employed. Donabedian’s model was used to assess the level of quality of PMTCT service. A total of 422 pregnant women were used to assess the level of satisfaction of clients. An inventory of resources and direct observation was done to assess the quality of the input and output component of the Donobedian model respectively. In addition to satisfaction items, 12 output-related items were also used to assess qu...