The Impact of Scientific and Technical Training on Improving Routine Collection of Antenatal Care Data for Maternal and Foetal Risk Assessment: A Case Study in the Province of South Kalimantan, Indonesia

Abstract

Objectives First, to assess the impact of scientific and technical training on midwives' abilities in collecting and recording the results of routine antenatal care examinations. Second, to explore midwives' views with regard to factors affecting their abilities to successfully complete the data documentation tasks. Methods The study was conducted in South Kalimantan, Indonesia (April 2016-October 2017). Nineteen urban and rural midwives were selected. Access to antenatal care information on 4,946 women (retrospective cohort study) and 381 women (prospective cohort study) was granted. A descriptive and exploratory design was used to describe midwives' abilities and challenges pertaining to timely collection and recording of results concerning antenatal care examinations. Results Scientific and technical training has significantly improved the average amount of recorded antenatal care data (from 17.5% to 62.1%, p-value < 0.0005). Lack of awareness, high workload, and insufficient skills and facilities are the main reasons for the database gaps. Conclusions The training has equipped midwives with scientific knowledge and technical abilities to allow routine collection of antenatal care data. Provision and adequate use of this information during different stages of pregnancy is crucial as an evidence-based guideline to assess maternal and foetal risk factors to ending preventable mortality.

The development of an alternative growth chart for estimated fetal weight in the absence of ultrasound: Application in Indonesia

“…A prospective cohort study, between June 1, 2016, and June 30, 2017, was carried out in South Kalimantan, Indonesia. The detailed procedures have been provided in previous publications [12,15]. The prospective data, both clinical and ultrasound information, were used to validate the existing ultrasonic-based and proposed clinical-based models for estimating fetal weight.…”

“…The data were obtained from one of the twenty selected primary health care centers that have access to both ultrasound measurement of fetal biometric characteristics and clinical assessment of fundal height (FH) at a given GA. All measurements (from the beginning of pregnancy to delivery) were performed by the dedicated midwife who runs the center. This midwife has had both ultrasound and scientific and technical training [12,15]. The selected midwife has experienced and been involved in both the provision and delivery of ANC services for � five years (actually 22 years).…”

“…Fetal growth charts have not been introduced in the Indonesian first level of health care systems. The growth charts are also not included in the current MCH booklet (Buku KIA) that is used to monitor individual mothers, fetuses, and newborns during ANC and postnatal care [12,15,16]. This study, therefore, set out with the aim of filling this gap, first by reviewing the existing studies on fetal growth charts, particularly for EFW.…”

“…However, in the majority of limited resource settings, the provision of ultrasound machines and skilled personnel is logistically not always available [1,29]. It has already been noted that the ultrasound method to estimate the fetal weight is not universally accessible in the current practice of ANC across Indonesian primary health care centers [12,15]. This hinders fetal weight estimation using the ultrasound prediction models that are commonly used in the existing fetal growth chart studies.…”

“…This information is used to derive the regression coefficients for adjusting the term optimal weight [27]. However, access to this information remains challenging in most developing countries, particularly in the majority of Indonesian primary health care centers, due to low quality in the routine collection of ANC data [12,15].…”