Provider-Perceived Benefits and Constraints of Complete Adherence to Antenatal Care Guideline Among Public Health Facilities, Ethiopia: A Qualitative Study

Seyoum, Tewodros; Alemayehu, Mekuriaw; Christensson, Kyllike; Lindgren, Helena

doi:10.21203/rs.3.rs-65478/v1

Cited by 1 publication

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References 28 publications

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“…Advice on HIV testing and counseling, birth preparedness, complication readiness and advice on nutrition and risk of alcohol and smoking were the least addressed health promotion services across all visits during pregnancy. High client load and scarcity of staff were the major reasons for not adhering to health promotion services in the study public health facilities [29]. In a situation when more clients seek care per day, providers would choose which guideline items they will deal with by exempting other cervices.…”

Section: Discussionmentioning

confidence: 99%

“…A local study done in Gondar town indicated that only 32% of women received complete providers' adherence to national ANC guideline during the rst visit [28]. Lack of in-service training and unavailability of printed ANC guidelines were the main reason given by providers for not being able to follow the ANC guideline [29]. But less is known about if there is an association between complete adherence to focused ANC guideline and pregnancy outcomes.…”

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confidence: 99%

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Complete adherence to antenatal care guideline during the first visit and antepartum complications in public health facilities: a prospective cohort study in Northwest Ethiopia

Seyoum¹,

Alemayehu²,

Christensson³

et al. 2021

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Background Adherence to a minimum level of recommended content during the first Antenatal care (ANC) is low in Ethiopia but less is known about if there is an association between the level of adherence to focused ANC guideline and pregnancy outcomes. Therefore, the goal of this study was to examine the relationship between the level of adherence to Ethiopian ANC guidelines during the first visit and maternal complications that occur during the antepartum period. Methods A prospective cohort study was conducted in Gondar town public health facilities from May, 2019, to January, 2020. A total of 832 pregnant women with gestational age < 28 weeks who came for their first ANC visit were enrolled and followed until their last visit or before the commencement of labor. An 18-point checklist was used to record the level of providers’ adherence. Clients who received all the components in the ANC guideline during the first visit adhered to by the provider were considered as an exposed group. A Log-binomial model was used to examine the relationship between the level of adherence to the guideline and the risk of antenatal complications. The adjusted Relative Risk (ARR) with a 95% Confidence Interval (CI) was reported in the final model. Result A total of 808 pregnant women were included in the final analysis. Complete providers’ adherence was associated with a lower risk of anemia (ARR = 0.54; 95% CI: 0.31, 0.94), but with a higher risk for Pregnancy-induced hypertension (ARR = 1.71; 95% CI: 1.04, 2.81). Conclusions Complete providers’ adherence to the first ANC guideline influences maternal complications during antepartum period. Therefore, improving the level of adherence by the provider to the ANC guideline during the first visit is very important.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%