Antenatal care and opportunities for quality improvement of service provision in resource limited settings: A mixed methods study

Miltenburg, Andrea Solnes; Eem, Lisette van der; Nyanza, Elias C.; Pelt, Sandra van; Ndaki, Pendo M.; Basinda, Namanya; Sundby, Johanne

doi:10.1371/journal.pone.0188279

Cited by 49 publications

(83 citation statements)

References 39 publications

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“…Maternity related community groups are shown to be generally supportive during pregnancy [40]. In India reported youth groups are undertaking activities to increase sensitization of maternal health problems and this improved maternal health outcomes [41]. Women who belonged to maternal health promoting clubs or groups during the antenatal period were found to be three times more likely to be birth prepared as compared with women without such clubs or groups.…”

Section: Predictors Of Bp/crmentioning

confidence: 99%

Maternal birth preparedness and complication readiness in the Greater Accra region of Ghana: a cross-sectional study of two urban health facilities

Klobodu

Milliron

Agyabeng³

et al. 2020

BMC Pregnancy Childbirth

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Background High maternal mortality ratios remain a critical public health concern in Ghana. Birth preparedness and complication readiness (BP/CR), which is a component of focused antenatal care, is a safe motherhood strategy intended to promote skilled birth attendance by helping women and their families plan for pregnancy and childbirth, thereby reducing maternal mortality. The objective of this study was to determine the level of BP/CR and to assess factors associated with maternal BP/CR in the Greater Accra Region of Ghana. Method A cross sectional descriptive quantitative study was carried out among 300 postnatal women attending the Adabraka Polyclinic and the Greater Accra Regional Hospital both within Accra, the capital city of Ghana. Data were collected with a structured questionnaire which assessed socio-demographic, health facility/provider and social support factors and their associations with BP/CR. Levels of BP/CR were assessed using validated tools. Data from 300 women were analyzed using STATA version 15.0. Logistic regression analysis was conducted to establish associations between BP/CR and socio-demographic, health facility/provider and social support factors. Results Approximately 234 (78%) of the women were birth prepared. Strong predictors of BP/CR included having ≥4 antenatal clinic visits (aOR 2.63; 95% CI 1.03–6.73), being employed (aOR 4.07; 95% CI 1.49–11.11) and belonging to maternal health promoting clubs or groups during the antenatal period (aOR 3.00; 95% CI 1.07–8.40) . Conclusion BP/CR is generally high among the study population. Predictors of BP/CR are multifactorial and found to cut across all aspects assessed in the study. Therefore, the creation of a BP/CR tool is recommended to routinely monitor trends in maternal birth preparedness in antenatal clinics. This may help to sustain and improve current levels and indicators of BP/CR.

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Section: Predictors Of Bp/crmentioning

confidence: 99%

Maternal birth preparedness and complication readiness in the Greater Accra region of Ghana: a cross-sectional study of two urban health facilities

Klobodu

Milliron

Agyabeng³

et al. 2020

BMC Pregnancy Childbirth

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“…The World Health Organization predicts a world where every pregnant woman and newborn receives quality care throughout the pregnancy, childbirth, and the postnatal period (WHO, 2016a). There is widespread evidence that antenatal care (ANC) is very crucial in the reduction of maternal mortality and morbidity (Miltenburg et al, 2017;Sumankuuro et al, 2017). The recommendations of World Health Organization (WHO) on maternal health care promotion interventions encourage active male partner involvement in ANC delivery as well as postnatal care to improve upon the health outcome of both mothers and their children (WHO, 2016a).…”

Section: Introductionmentioning

confidence: 99%

Factors Influencing Male Involvement in Antenatal Care in the Kassena Nankana Municipal in the Upper East Region, Ghana

Kumbeni¹,

Ziba²,

Alem³

et al. 2019

ESJ

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Background: Globally, male involvement in antenatal care remains a challenge to the effective utilization of maternal health services. Male involvement is considered to be a useful tool that is capable of improving the health outcome of mothers and their children. However, matters relating to antenatal care have often been considered on a gender basis. Objective: The objective of this study was to assess the factors that influence male partner involvement in antenatal care services. Methods: A community-based crosssectional study was conducted among 420 men whose partners were pregnant or had delivered within twelve months preceding the study using multiple sampling procedures. Pearson Chi-Square and Fisher's exact test were conducted to establish an association between dependent and independent variables after which multiple logistic regression was conducted. P-values of < 0.05 at 95% confidence interval were considered significant. Data were analyzed using STATA version 13.1. Results: The level of male involvement in antenatal care was high (67.2%). About 71.9% accompanied their partners to antenatal clinics at one point during the pregnancy period. Out of this, 45.7% of them did so four or more times, 35.7% went two to three times, while 18.6% went only once. Factors such as staff attitude, time spent at the clinics, age, educational level, monthly income level, living with a partner during pregnancy, distance to the clinic, and community acceptability were all statistically significant to male involvement. Conclusion: The level of male involvement was high and considered above average. There is the need to 2 develop interventions that will diffuse the existing socio-cultural perceptions and improve staff attitudes to achieve higher male involvement in antenatal care.

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“…Our results showed that although almost all facilities with ANC in Haiti and Malawi reported that they provided breastfeeding counseling as part of routine ANC services, less than 10% of clients received counseling on breastfeeding, regardless of trimester. Breastfeeding counseling is recommended for all pregnant women during ANC, but other studies have reported selective counseling during ANC due to low levels of provider Includes women who had at least one ANC visit, who delivered vaginally, and whose baby survived past the day of birth counseling knowledge and skills as well as heavy workloads [7,[51][52][53][54][55][56]. Breastfeeding counseling in Haiti and Malawi is likely hindered by the shortage of skilled health providers [24,25].…”

Section: Discussionmentioning

confidence: 99%

Facility readiness and counseling during antenatal care and the relationship with early breastfeeding in Haiti and Malawi

Mallick

Benedict

Wang

2020

BMC Pregnancy Childbirth

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Background: Early initiation of breastfeeding (within an hour of birth) has benefits for newborn health and survival. Optimal breastfeeding supports growth, health, and development. Health facilities provide essential pregnancy, maternal, and newborn care and offer support for early breastfeeding. We examined the relationship between the breastfeeding-related health service environment during antenatal care (ANC) and early initiation of breastfeeding. Methods: Using data from recent Service Provision Assessment (SPA) surveys in Haiti and Malawi, we defined three indicators of the health service environment: availability of facilities with ANC services reporting routine breastfeeding counseling; provider training on breastfeeding; and breastfeeding counseling during ANC. We linked SPA data geographically to Demographic and Health Surveys (DHS) data from Haiti and Malawi. Multilevel, multivariable logistic regressions examined associations between the health service environment and early initiation of breastfeeding, controlling for women's background characteristics, with separate analyses for urban and rural residence. Results: Over 95% of facilities in Haiti and Malawi reported routinely providing breastfeeding counseling during ANC. Only 40% of both urban and rural providers in Malawi and 29 and 26% of providers at urban and rural facilities in Haiti (respectively) received recent training in counseling on breastfeeding. Further, only 4-10% of clients received counseling. Breastfeeding counseling was generally more common among clients who attended ANC with a provider who had received recent training. After linking SPA and DHS data, our analysis showed that having more providers recently trained on breastfeeding was significantly associated with increased odds of early breastfeeding among women in urban areas of Haiti and Malawi. Additionally, women in urban areas of Malawi lived near facilities with more counseling during ANC were more likely to begin breastfeeding within an hour of birth compared with women in areas with less counseling. Conclusions: Our study identified gaps in the health system's capacity to implement the recommended global guidelines in support of optimal breastfeeding practices. While breastfeeding counseling during ANC can promote early breastfeeding, counseling was not common. The study provides evidence that provider training could help improve counseling and support for early initiation of breastfeeding.

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Antenatal care and opportunities for quality improvement of service provision in resource limited settings: A mixed methods study

Cited by 49 publications

References 39 publications

Maternal birth preparedness and complication readiness in the Greater Accra region of Ghana: a cross-sectional study of two urban health facilities

Maternal birth preparedness and complication readiness in the Greater Accra region of Ghana: a cross-sectional study of two urban health facilities

Factors Influencing Male Involvement in Antenatal Care in the Kassena Nankana Municipal in the Upper East Region, Ghana

Facility readiness and counseling during antenatal care and the relationship with early breastfeeding in Haiti and Malawi

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