An assessment of the quality of antenatal care and pregnancy outcomes in a tertiary hospital in Ghana

Amponsah‐Tabi, Seth; Dassah, Edward T.; Asubonteng, Gerald O.; Ankobea, Frank; Annan, John Jude Kweku; Senu, Ebenezer; Opoku, Stephen; Opoku, Ebenezer; Opare‐Addo, Henry S.

doi:10.1371/journal.pone.0275933

Cited by 15 publications

(14 citation statements)

References 20 publications

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“…On the other hand, one could point to the insufficient coverage of ANC or inadequate ANC visits to allow for better pregnancy monitoring, increasing the chance of emergency CS. A recent study by Amponsah-Tabi et al in Ghana found the quality of ANC was significantly associated with pregnancy outcomes which included anaemia during pregnancy, pre-eclampsia with severe features or delivering a low birth weight baby 26…”

Section: Discussionmentioning

confidence: 99%

Epidemiology of emergency and elective caesarean section and its association with early neonatal mortality in sub-Saharan African countries

Sandie,

Mutua,

Sidze

et al. 2023

BMJ Open

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IntroductionInvestigating elective and emergency caesarean section (CS) separately is important for a better understanding of birth delivery modes in the sub-Saharan Africa (SSA) region and identifying bottlenecks that prevent favourable childbirth outcomes in SSA. This study aimed at evaluating the prevalences of both CS types, determining their associated socioeconomic factors and their association with early neonatal mortality in SSA.MethodsSSA countries Demographic and Health Surveys data that had collected information on the CS’ timing were included in our study. A total of 21 countries were included in this study, with a total of 155 172 institutional live births. Prevalences of both CS types were estimated at the countries’ level using household sampling weights. Multilevel models were fitted to identify associated socioeconomic factors of both CS types and their associations with early neonatal mortality.ResultsThe emergency CS prevalence in SSA countries was estimated at 4.6% (95% CI 4.4–4.7) and was higher than the elective CS prevalence estimated at 3.4% (95% CI 3.3–3.6). Private health facilities’ elective CS prevalence was estimated at 10.2% (95% CI 9.3–11.2) which was higher than the emergency CS prevalence estimated at 7.7% (95% CI 7.0–8.5). Conversely, in public health facilities, the emergency CS prevalence was estimated at 4.0% (95% CI 3.8–4.2) was higher than the elective CS prevalence estimated at 2.7% (95% CI 2.6–2.8). The richest women were more likely to have birth delivery by both CS types than normal vaginal delivery. Emergency CS was positively associated with early neonatal mortality (adjusted OR=2.37, 95% CI 1.64–3.41), while no association was found with elective CS.ConclusionsFindings suggest shortcomings in pregnancy monitoring, delivery preparation and postnatal care. Beyond antenatal care (ANC) coverage, more attention should be put on quality of ANC, postnatal care, emergency obstetric and newborn care for favourable birth delivery outcomes in SSA.

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Section: Discussionmentioning

confidence: 99%

Epidemiology of emergency and elective caesarean section and its association with early neonatal mortality in sub-Saharan African countries

Sandie,

Mutua,

Sidze

et al. 2023

BMJ Open

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“…In Ethiopia, access to emergency caesarean delivery is available only at hospitals and specialty clinics [ 11 , 12 ], and still the birth-related complications and deaths are high [ 9 ]. Because of prolonged labour, dysfunctional labour, and the high risk of induction of labour, women with advanced maternal age (>35 years old), inadequate antenatal care visits, and being nulliparous were at risk for emergency caesarean delivery [ 13 – 17 ]. In Ethiopia, the early neonatal adverse event after emergency caesarean delivery is 26.7% [ 18 ].…”

Section: Introductionmentioning

confidence: 99%

Prevalence of emergency caesarean delivery and its predictors among women who give birth in Ethiopia using further analysis of EDHS 2016 data: A mixed effect model

Agimas

2024

PLoS ONE

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Introduction Emergency caesarean delivery is a surgical procedure that is decided after the labour pain has started. According to the global report of the World Health Organization, the rate of caesarean sections has risen over time. In Ethiopia, the overall caesarean delivery was 18%, which varied between 46% in the private sector and 15% in the public sector. But specifically, the magnitude of emergency caesarean delivery and its predictors are not well addressed in Ethiopia. Therefore, this study was aimed at assessing the prevalence and predictors of emergency caesarean delivery in Ethiopia using EDHS 2016. Method A cross-sectional study was used, and a total of 11,022 samples were included in this study. The Ethiopian Demographic Health Survey 2016 data set was used as a data source. The STATA version 17 software was used for descriptive, bi-variable, and multivariable analysis. Multilevel binary logistic regression was used to identify the significant factors at a p-value of <0.05 and a 95% confidence level. Model comparison and goodness of fit was assessed by AIC. Results The prevalence of emergency caesarean deliveries in Ethiopia was 1.2% (95% CI: 0.58, 1.78). History of fistula (AOR = 7.82, 95% CI: 1.59–38.4), age ≥ 35 years (AOR = 6.98, 95% CI: 3.33–14.63), and rural residence (AOR = 2.23, 95% CI: 1.25–3.21) were the predictors of emergency caesarean delivery. Conclusion As compared to the previous study, the prevalence of emergency caesarean delivery was low. Women with a history of fistula, from rural residence, and age≥ 35 years were at risk for emergency caesarean delivery. Therefore, interventions need to be encouraged to give attention to rural women whose age is ≥ 35 years and fistula reduction activities, such as avoiding early marriage, to reverse the problem. Early and accurate screening of women for emergency cesarean delivery by encouraging co-services like ANC is also recommended.

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“…Poor quality and inadequate utilization of ANC services during pregnancy may increase the risk of preventable adverse pregnancy outcomes but how these collectively influence these outcomes remain understudied. Though some studies in Ghana including [ 21–23 ] have assessed the individual effect of ANC components (that is, timing, frequency and content) on pregnancy outcomes, none but one [ 24 ] has investigated the joint effect of these variables. More especially, little is documented regarding the protective effect of adequate utilization of the recommended eight or more ANC contacts on adverse pregnancy outcomes.…”

Section: Introductionmentioning

confidence: 99%

Independent and joint contributions of inadequate antenatal care timing, contacts and content to adverse pregnancy outcomes

Saaka

Sulley

2023

Annals of Medicine

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Background Poor quality and inadequate of antenatal care (ANC) visits during pregnancy may increase the risk of preventable adverse pregnancy outcomes. We tested the hypothesis that the adequacy of ANC utilization combined with quality of ANC services will reduce the risk of low birth weight (LBW) and preterm delivery (P T D) in the Tamale metropolis of Ghana. Materials and methods A facility-based analytical cross-sectional study was conducted on a sample of 553 postpartum women who had delivered within the last 12 months prior to the study. The overall utilization of ANC services was measured in terms of ANC timing, contacts, and content (TCC) of essential ANC services. The sample was drawn using systematic random sampling procedure. Primary data was collected from mothers by administering a structuredquestionnaire while the secondary data was extracted from individual records. Results After controlling for confounders, women who had adhered to all WHO recommendations in terms of ANC timing, frequency and content were 71 % protected from PTD, AOR = 0.29 (95 % CI: 0.15, 0.59) and 56 % protection from LBW AOR = 0.44 (95 % CI: 0.23, 0.83). Conclusion Individually and jointly, inadequate ANC contacts and content associatedsignificantly with preterm delivery than LBW. Key messages Limited evidence exists on the joint effect of ANC services timing, contacts and content on adverse pregnancy outcomes. Total adherence to recommended ANC initiation, attendance and receipt of essential services had greater protection against PTD and LBW, compared to any single element/component of ANC Women who had adequate overall ANC services utilization in terms of timing, contacts and content were 71 % protected from PTD, AOR = 0.29 (95 % CI: 0.15, 0.59) and 56 % protection from LBW AOR = 0.44 (95 % CI: 0.23, 0.83).

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An assessment of the quality of antenatal care and pregnancy outcomes in a tertiary hospital in Ghana

Cited by 15 publications

References 20 publications

Epidemiology of emergency and elective caesarean section and its association with early neonatal mortality in sub-Saharan African countries

Epidemiology of emergency and elective caesarean section and its association with early neonatal mortality in sub-Saharan African countries

Prevalence of emergency caesarean delivery and its predictors among women who give birth in Ethiopia using further analysis of EDHS 2016 data: A mixed effect model

Independent and joint contributions of inadequate antenatal care timing, contacts and content to adverse pregnancy outcomes

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