Quality of Antenatal Care Offered at Nambale Sub County, Busia County

Abstract

Background: Focused Antenatal care (FANC) is personalized care provided to a pregnant woman which prepares her for childbirth and readiness for complications. It provides health promotion and preventive health services, including nutritional support and prevention and treatment of anemia; prevention, detection and treatment of malaria, tuberculosis and sexually transmitted infections (stis)/HIV/AIDS; and tetanus toxoid immunization. To ensure antenatal care (ANC) quality at health facilities, it is necessary that drugs and equipment are available, that health workers are available and have the necessary knowledge and skills, and that they actually provide the recommended interventions. Effectiveness of the antenatal care services provided depends on the quality of care provided during each antenatal care visit The percentage of women attending ANC at least once generally tends to be satisfactory even in low income countries but maternal and neonatal mortalities remain high. In Kenya, for example, 9 out of 10 women reported to have seen a skilled provider at least once for their most recent birth, while maternal mortality is estimated at 400 maternal deaths per 100,000 live births, and neonatal mortality at 22 neonatal deaths per 1,000 live births. Methods: The study was conducted in Nambale Sub County of Busia County in Kenya. This was a facility based cross-sectional study where 8 health facilities were surveyed for the availability of staff, infrastructure, and essential equipment and drugs necessary for the delivery of good quality antenatal care. Interactions between antenatal clients and midwives were observed, and exit interviews conducted for women. In addition, in-depth interviews with respective facility managers and one Midwife from the same facility who usually works in the ANC clinic. Findings: A total of 334 women were interviewed. Preparedness of health facilities was good in terms of infrastructure, essential equipment, and availability of essential medicines. However, Job aids and laboratory supplies were unavailable in most health facilities. Case load indicators were low. Women did not receive standard recommended care in the following areas: pelvic exams (99.4% missed opportunities); physical examination (91.9% missed opportunities); and client counseling and education (97.4% missed opportunities). Of the women interviewed, 33.7% felt that waiting time wasn't fair. Only 2.7% of the clients were accompanied by a relative (mother or mother in-law) to the clinic. Staff shortage and lack of essential drug supplies were identified by staff interviewed as key challenges. They also said that additional nurses would help improve ANC services. Discussion: Whereas health facilities in nambale sub county were adequately equipped to provide standard antenatal care in terms of infrastructure, availability of essential equipment, and medicines, they lacked job aids and did laboratory supplies. This was evident from the low number of pregnant women who had undergone the requisite tests (hemoglobin test, syphi...

Quality of Antenatal Care Service and Factors Associated with Client Satisfaction at Public Health Facilities of Bele Gasgar District

“…Pregnant women who traveled less than 60 min to reach the health facility were four times and those who traveled between 60 and 1,200 min were almost four times more likely satisfied than those who traveled more than 1,200 min. This result is similar to the study in Harar and Kenya (45,49). High probability of satisfaction with less traveling time could be related to less time consumption.…”

“…Furthermore, client satisfaction toward the given ANC service was moderately low 55% (95% CI = 50-60). This finding is consistent with the study done in Gondar, Chencha, Demba Gofa of Ethiopia, and in Kenya (17,(48)(49)(50). Lower satisfaction could be resulted from the shortage of supplies, stocking out of essential drugs, lack of ANC waiting area, absent water supply, and electricity shortage in the facilities (48,51,52).…”

“…Similarly, clients whose consultation time was less than 30 min were almost three times more likely satisfied than those whose consultation time was 30 or more minutes and this is similar with the study result in Bahir Dar, Kenya, and Kazakhstan. This might be due to the fact that pregnant women need short and easy information and want to go back home to their duties (31,49,59). On the other hand, women who were initiated to ask question on the service never were 80% and sometimes were 68% times less likely satisfied than those who were usually initiated.…”