The quality of antenatal care in rural Tanzania: what is behind the number of visits?

Nyamtema, Angelo; Jong, Alise Bartsch-de; Urassa, David P.; Hagen, Jaap P; Roosmalen, Jos van

doi:10.1186/1471-2393-12-70

Cited by 71 publications

(97 citation statements)

References 14 publications

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“…This study showed that 87.5% of respondents where not told about danger signs during pregnancy such as vaginal bleeding and 88% were not asked if she had headache. This is consistent with a study conducted in Tanzania in which in Fifty-two (20%) severe maternal morbidities were attributed to substandard ANC [12] 42% clients were not informed of any pregnancy danger signs. In this study permission was not taken before general and abdominal examination was done in 35% and 12% respectively.…”

Section: Discussionsupporting

confidence: 79%

Assessment of the Quality of Antenatal Care Rendered at a Northern Nigeria Primary Health Care Center, Zaria, Nigeria

Madugu

Abdul

Sabitu

et al. 2017

International Journal of Medical and Health Sciences Research

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Article HistoryBackground: Primary health care facilities are the closest to the community and are easily accessible to pregnant women and their children. Ensuring quality Antenatal care by skilled attendants at this level is pre-requisite to reducing pregnancy complications and over all maternal mortality Objective: This study was aimed at assessing the adequacy of antenatal care rendered at this level of care. Methods: A cross sectional study was conducted at Babban-dodo primary health center, Zaria. An exit Questionnaires was administered to 400 pregnant women. Information on their demographic status and information about the Antenatal care just received was obtained focusing standard protocol for antenatal care. Result: showed that the women were not rendered all the full component of ANC. History of feeling unwell was not asked in 88%, examination including blood pressure check was done in only 37%, Obstetrics examination was done in more 80% of the women however symphsio-fundal height was not measured with tape. The women were sent to do most of the routine investigations, as they pay for these investigations and the revenue collected is used to partially run the hospital. There was only one nurse midwife at the center; community health workers were the sole providers and no medical doctor visit the hospital. Ninety six percent of the respondents were satisfied with the services while 3.6% were dissatisfied. Conclusion: There is total disregard for standard of care for antenatal services expected at this level. There is the need for re-assessment of all primary health care centers that are the first point of contact with our pregnant women, if reducing maternal mortality rate is great concern to all of us. Contribution/ Originality:This study further demonstrated that the quality of antenatal care in primary care facilities in Nigeria particularly in the Northern part of the country is poor and indirectly explains why maternal mortality and morbidity is very high.

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Section: Discussionsupporting

confidence: 79%

Assessment of the Quality of Antenatal Care Rendered at a Northern Nigeria Primary Health Care Center, Zaria, Nigeria

Madugu

Abdul

Sabitu

et al. 2017

International Journal of Medical and Health Sciences Research

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“…Despite this change, as described in this study and in other African countries, women receive suboptimal services [25–27]. This is of concern because it deprives women from receiving interventions that can improve their health, increase their awareness of potential complications and birth preparedness, and screen for conditions that could affect the newborn [6, 28].…”

Section: Discussionmentioning

confidence: 92%

The quality of free antenatal and delivery services in Northern Sierra Leone

Koroma

Kamara

Bangura

et al. 2017

Health Res Policy Sys

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BackgroundThe number of maternal deaths in sub-Saharan Africa continues to be overwhelmingly high. In West Africa, Sierra Leone leads the list, with the highest maternal mortality ratio. In 2010, financial barriers were removed as an incentive for more women to use available antenatal, delivery and postnatal services. Few published studies have examined the quality of free antenatal services and access to emergency obstetric care in Sierra Leone.MethodsA cross-sectional survey was conducted in 2014 in all 97 peripheral health facilities and three hospitals in Bombali District, Northern Region. One hundred antenatal care providers were interviewed, 276 observations were made and 486 pregnant women were interviewed. We assessed the adequacy of antenatal and delivery services provided using national standards. The distance was calculated between each facility providing delivery services and the nearest comprehensive emergency obstetric care (CEOC) facility, and the proportion of facilities in a chiefdom within 15 km of each CEOC facility was also calculated. A thematic map was developed to show inequities.ResultsThe quality of services was poor. Based on national standards, only 27% of women were examined, 2% were screened on their first antenatal visit and 47% received interventions as recommended. Although 94% of facilities provided delivery services, a minority had delivery rooms (40%), delivery kits (42%) or portable water (46%). Skilled attendants supervised 35% of deliveries, and in only 35% of these were processes adequately documented. None of the five basic emergency obstetric care facilities were fully compliant with national standards, and the central and northernmost parts of the district had the least access to comprehensive emergency obstetric care.ConclusionThe health sector needs to monitor the quality of antenatal interventions in addition to measuring coverage. The quality of delivery services is compromised by poor infrastructure, inadequate skilled staff, stock-outs of consumables, non-functional basic emergency obstetric care facilities, and geographic inequities in access to CEOC facilities. These findings suggest that the health sector needs to urgently investigate continuing inequities adversely influencing the uptake of these services, and explore more sustainable funding mechanisms. Without this, the country is unlikely to achieve its goal of reducing maternal deaths.

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“…To achieve maximum ANC services and practices among pregnancy women with high and low risk, there is a need to integrate public and private sector concerning ANC services planned and conducted in order to improve their maternal health and eventually improve the health status of newborn child. Empowered of women toward the primary level of education should be focused in order to have good maternal health outcome [36][37][38][39][40][41][42][43][44][45][46][47][48].…”

Section: Discussionmentioning

confidence: 99%

Reported Knowledge, Attitude and Practice of Antenatal Care Services among Women in Dodoma Municipal, Tanzania

Lilungulu¹,

Matovelo²,

Gesase³

2016

JPNC

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The quality of antenatal care in rural Tanzania: what is behind the number of visits?

Cited by 71 publications

References 14 publications

Assessment of the Quality of Antenatal Care Rendered at a Northern Nigeria Primary Health Care Center, Zaria, Nigeria

Assessment of the Quality of Antenatal Care Rendered at a Northern Nigeria Primary Health Care Center, Zaria, Nigeria

The quality of free antenatal and delivery services in Northern Sierra Leone

Reported Knowledge, Attitude and Practice of Antenatal Care Services among Women in Dodoma Municipal, Tanzania

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