Are women and providers satisfied with antenatal care? Views on a standard and a simplified, evidence-based model of care in four developing countries (original) (raw)
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Journal of Advanced Nursing, 2008
Title. Factors affecting the utilization of antenatal care in developing countries: systematic review of the literature.Aim. This paper is a report of a systematic review to identify and analyse the main factors affecting the utilization of antenatal care in developing countries.Background. Antenatal care is a key strategy for reducing maternal mortality, but millions of women in developing countries do not receive it.Data sources. A range of electronic databases was searched for studies conducted in developing countries and published between 1990 and 2006. English-language publications were searched using relevant keywords, and reference lists were hand-searched.Review methods. A systematic review was carried out and both quantitative and qualitative studies were included.Results. Twenty-eight papers were included in the review. Studies most commonly identified the following factors affecting antenatal care uptake: maternal education, husband’s education, marital status, availability, cost, household income, women’s employment, media exposure and having a history of obstetric complications. Cultural beliefs and ideas about pregnancy also had an influence on antenatal care use. Parity had a statistically significant negative effect on adequate attendance. Whilst women of higher parity tend to use antenatal care less, there is interaction with women’s age and religion. Only one study examined the effect of the quality of antenatal services on utilization. None identified an association between the utilization of such services and satisfaction with them.Conclusion. More qualitative research is required to explore the effect of women’s satisfaction, autonomy and gender role in the decision-making process. Adequate utilization of antenatal care cannot be achieved merely by establishing health centres; women’s overall (social, political and economic) status needs to be considered.
Seminars in Perinatology, 2019
Background-Antenatal care (ANC) is an important opportunity to diagnose and treat pregnancy-related complications and to deliver interventions aimed at improving health and survival of both mother and the infant. Multiple individual studies and national surveys have assessed antenatal care utilization at a single point in time across different countries, but ANC trends have not often been studied in rural areas of low-middle income countries (LMICs). The objective of this analysis was to study the trends of antenatal care use in LMICs over a seven-year period.
Quality of antenatal care services in selected health facilities of Kaski district, Nepal
International Journal Of Community Medicine And Public Health, 2018
Antenatal care is an evidence based interventions including recording medical history, assessment of individual needs, advice and guidance on pregnancy and delivery, screening tests, education on self-care and identification of conditions detrimental to health during pregnancy, first-line management and referral if necessary. 1,2 It is an effective route for early detection of potential problems and early treatment of pregnant women which helps to reduce infant and maternal morbidity and mortality. 3 The quality of ANC can be measured through the number and frequency of ANC visits, content of services received, the kinds of information given to women during their visits, client satisfaction level, and the qualifications of the provider. 4-7 Worldwide, complications during pregnancy, childbirth and the postnatal period are the leading causes of death and disability among women of reproductive age. 8 Although, antenatal care is an essential part of primary healthcare and its provision has expanded worldwide, only one third of all pregnant women in developing countries receive at least four antenatal care visits. Out of total maternal deaths worldwide, nearly 99% of death occurs in low income countries especially in Sub-Saharan Africa and South Asia. 8,9 In Nepal, the 2016 NDHS result ABSTRACT Background: Antenatal care service is an evidence based interventions given to the pregnant women. Objective of the study was to assess quality of antenatal care services in selected health facilities of Kaski district, Nepal. Methods: A cross sectional study was conducted in selected health institutions in Kaski district of Nepal during June to November 2017. Two hundred seven participants were selected from health facilities of Kaski district. Structured questionnaires were employed as tool for data collection. Results: This study showed that 50.7 percent respondents waited less than 35 minutes for receiving service. More than half of the total respondents (63.3%) reported that the consultation time provided for them was less than 20 minutes. All respondents reported that weight and blood pressure measurement was undertaken while none of them reported that height was measured. It was found that maximum number of participants (99.0%) were received iron/folate tablets and tetanus vaccination. Similarly, 97.6% of participants reported that they were counselled on nutrition and 96.6% of reported they get counselling on danger signs. In overall, 48.3% of the respondents were satisfied with the services they received and 43% of the respondents received good quality ANC service from different health institutions. Conclusions: In overall satisfaction of antenatal care services was found to be low and more than half of respondent does not received good quality ANC services.
Determinants of utilization of antenatal care services in developing countries
African Journal of Economic and Management Studies, 2013
Appropriate antenatal care services promote safe motherhood and delivery with improved maternal and neonatal outcome. is population based cross sectional descriptive study was carried out to determine the utilization of antenatal care (ANC) services in a rural community of Bangladesh. Out of the 112 women studied, 63.4% mothers were found to receive antenatal care. Among them one third (32.4%) took it more than 4 occasions, 34(47.8%) pregnant women received antenatal care from government hospitals, 19(27%) from family welfare centre, 6(8.5%) from satellite clinics and around 12(17%) received from private hospitals. Around 71% mothers received ANC service from doctor while 17% mothers received from trained professionals. Seventy four percent mothers received tetanus (TT) injections. Only one fourth (25.3%) mothers had not received it. On an average, 90% mothers received iron tablets during their pregnancy. Regarding ve danger signs during pregnancy, it was found that, 58.9% mothers were not aware about the ve danger signs and 29.5% respondents knew about all the danger signs. Association between educational status and treatment seeking behaviour for pregnancy complication was found to be statistically signi cant (p<0.05). However, association between educational status and place of treatment for pregnancy complication was also found signi cant (p<0.01). Intensive awareness programme, behavioural change interventions and regular pregnancy monitoring may promote antenatal care service utilization in rural Bangladesh.
Health Research Policy and Systems
Background In 2020, an estimated 287 000 women died globally from pregnancy‐related causes and 2 million babies were stillborn. Many of these outcomes can be prevented by quality healthcare during pregnancy and childbirth. Within the continuum of maternal health, antenatal care (ANC) is a key moment in terms of contact with the health system, yet it remains an underutilized platform. This paper describes the protocol for a study conducted in collaboration with Ministries of Health and country research partners that aims to employ implementation science to systematically introduce and test the applicability of the adapted WHO ANC package in selected sites across four countries. Methods Study design is a mixed methods stepped-wedge cluster randomized implementation trial with a nested cohort component (in India and Burkina Faso). The intervention is composed of two layers: (i) the country- (or state)-specific ANC package, including evidence-based interventions to improve maternal and ...
Journal of Pediatrics & Neonatal Care, 2016
Antenatal care service is an important goal concerning in the health status of the pregnant women during their reproductive period and its health beneficial accounting for nearly one quarter of all pregnant worldwide. Early booking has an advantage for proper pregnancy information sharing and pregnancy monitoring. Unfortunately, adverse pregnancy outcome can occur even in women without identifiable risk factors. The objective of this study was to describe knowledge, attitudes and practices towards women seeking antenatal care from their previous pregnancy in Dodoma Municipal Tanzania. This was a cross sectional community based descriptive survey study. A pre-tested structured questionnaire was applied.. Among the 500 women included, 299(59.8%) was from the age group of 19 to 25 years. A total of 477(95.4%) were at the level of primary education. About 341(68.2%) of them were housewives while 155(31%) of them worked as Petty business and only 4(0.8%) worked at the public work. 101(20.2%) of women having more than three children and categorized as multipara. A total of 104 women (20.8%) had history of home delivery and only 4 women (0.8%) had history of assisted by traditional birth attendance, however highest interviewed women 257(51.4%) had the hospital delivery and 117(23.4) had delivery at the health centre. Regarding of the reproduction history, 78(15.6%) of them had experienced episode of eclampsia, 235(47%) had episode of involved with perineal tear. Only 1(0.2%) of them had history of one stillbirth before while 186(37.2%) of the interviewed women had history of postpartum haemorrhage. The highest first antenatal clinic attendance of pregnancy were 28weeks of gestation age 169(33.8%) with the few of the women had attended at 36weeks of gestation age 20(4%).Only 62(12.4%) of the women admitted that they did come for antenatal visit during the first three months and others had the late visit. However, only 92(18.4%) admitted that they had delivery by caesarian section on their previous pregnancy while 408(81.6%) of them had spontaneous vaginal delivery. Only 60(12.0%) of women had one visit of antenatal clinic and 270(54.0%) were the highest which had two visit, three were 93(18.6) and four visit were 77(12.4%). In Conclusion, ANC services, awareness and the use of supplements therapy are promising in the pregnancy women. To achieve maximum ANC services and practices among pregnancy women with high and low risk groups, there is a need to integrate public and private sector concerning ANC services planned and conducted in order to improve their maternal health and eventually improve the health status of newborn child.
BMC Health Services Research, 2014
Background: Antenatal care (ANC) reduces maternal and perinatal morbidity and mortality directly through the detection and treatment of pregnancy-related illnesses, and indirectly through the detection of women at increased risk of delivery complications. The potential benefits of quality antenatal care services are most significant in low-resource countries where morbidity and mortality levels among women of reproductive age and neonates are higher. WHO developed an ANC model that recommended the delivery of services scientifically proven to improve maternal, perinatal and neonatal outcomes. The aim of this study is to determine the effect of an intervention designed to increase the use of the package of evidence-based services included in the WHO ANC model in Mozambique. The primary hypothesis is that the intervention will increase the use of evidence-based practices during ANC visits in comparison to the standard dissemination channels currently used in the country.