How much time is available for antenatal care consultations? Assessment of the quality of care in rural Tanzania

Magoma, Moke; Requejo, Jennifer; Merialdi, Mario; Campbell, Oona M. R.; Cousens, Simon; Filippi, Véronique

doi:10.1186/1471-2393-11-64

Cited by 46 publications

(49 citation statements)

References 12 publications

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“…The average consultation time in this study was 15 minutes but majorities, 185 (69.8%), of clients received consultation from provider in less than 15minutes. This is somewhat better than the finding of a study done in Gambia where only 2.5% clients said that they spent 10 or more minutes of consultation with their care providers [12] but lesser than the mean total duration for initial ANC consultations of 40.1 minutes (range 33 -47) a study done in Tanzania [11].…”

Section: Discussioncontrasting

confidence: 66%

Evaluation of the Quality of Antenatal Care (ANC) Service at Higher 2 Health Center in Jimma, South West Ethiopia

Abate¹,

Salgedo²,

Bayou³

2015

OALib

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Background: Antenatal care is the care that women receive during pregnancy to ensure a healthy outcome for women and newborns. In spite of its clear importance, such services continued to be important determinants of maternal mortality and morbidity throughout the world. Methods: A case study was conducted in Higher 2 Town Health Center, using client exit interviews of 265 clients who came to the health institution. In addition, 10 observations of client-provider interactions, document reviews of 246 clients' documents selected by systematic random sampling technique, and 5 in-depth interviews of the focal persons were conducted. Quantitative data were analyzed using SPSS for windows (SPSS 16.0). Qualitative data were categorized into major thematic areas and presented as narratives in triangulation with the quantitative results. In each evaluation dimension, indicators were used to judge the quality of antenatal care services. Results: Most of the minimum required basic resources recommended by World Health Organization were available in the study site. But there were incomplete sets of laboratory reagents and shortage of some drugs. Comprehensive history was recorded for 93.4% of clients. Only 34.3% of clients received prescriptions for iron supplementation. Majority (94.6%) of the clients were satisfied with the accommodations of antenatal care service. The compliance of the health care providers towards routine laboratory investigations ranged from 25.4% to 50.1%. Conclusions: The overall quality of the service was judged as fair (69.5%). Majority of the clients were satisfied with accommodation of ANC services. However, the availability of laboratory reagents and drugs remained to be challenges. Providers' compliance towards standard basic investigations was also far below World Health Organization recommendations and judged as critical. Thus it is recommended that responsible bodies should strive to improve provision of supplies and compliance of the care providers to step-up the quality of care at president capacity level.

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Section: Discussioncontrasting

confidence: 66%

Evaluation of the Quality of Antenatal Care (ANC) Service at Higher 2 Health Center in Jimma, South West Ethiopia

Abate¹,

Salgedo²,

Bayou³

2015

OALib

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“…Moreover, only 14% of the women surveyed in a previous cross-sectional survey conducted in Western Kenya reportedly attended a health talk at the ANC clinic and the health topics covered during ANC visits were noted to be limited in scope [14]. Similarly, in rural Tanzania, delivery of health information, including nutrition counselling, at the ANC clinics was noted to be among the least likely components of ANC to be effectively implemented [29]. These data indicate persistent gaps in effective counselling, specifically in nutrition topics, provided through ANC clinics.…”

Section: Discussionmentioning

confidence: 99%

Health and nutrition knowledge, attitudes and practices of pregnant women attending and not-attending ANC clinics in Western Kenya: a cross-sectional analysis

Perumal

Cole

Ouédraogo

et al. 2013

BMC Pregnancy Childbirth

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BackgroundAntenatal care (ANC) is a key strategy to decreasing maternal mortality in low-resource settings. ANC clinics provide resources to improve nutrition and health knowledge and promote preventive health practices. We sought to compare the knowledge, attitude and practices (KAP) among women seeking and not-seeking ANC in rural Kenya.MethodsData from a community-based cross-sectional survey conducted in Western Province, Kenya were used. Nutrition knowledge (NKS), health knowledge (HKS), attitude score (AS), and dietary diversity score (DDS) were constructed indices. χ2 test and Student’s t-test were used to compare proportions and means, respectively, to assess the difference in KAP among pregnant women attending and not-attending ANC clinics. Multiple regression analyses were used to assess the impact of the number of ANC visits (none, <4, ≥4) on knowledge and practice scores, adjusting for maternal socio-demographic confounders, such as age, gestational age, education level and household wealth index.ResultsAmong the 979 pregnant women in the survey, 59% had attended ANC clinics while 39% had not. The mean (±SD) NKS was 4.6 (1.9) out of 11, HKS was 6.2 (1.7) out of 12, DDS was 4.9 (1.4) out of 12, and AS was 7.4 (2.2) out of 10. Nutrition knowledge, attitudes, and DDS were not significantly different between ANC clinic attending and non-attending women. Among women who attended ANC clinics, 82.6% received malaria and/or antihelmintic treatment, compared to 29.6% of ANC clinic non-attendees. Higher number of ANC clinic visits and higher maternal education level were significantly positively associated with maternal health knowledge.ConclusionsSubstantial opportunities exist for antenatal KAP improvement among women in Western Kenya, some of which could occur with greater ANC attendance. Further research is needed to understand multi-level factors that may affect maternal knowledge and practices.

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“…Studies from Malawi, Tanzania, Uganda and Zimbabwe document the urgent need to improve the quality of ANC (Conrad et al, 2012; Lungu et al, 2011; Magoma et al, 2011; Magoma et al, 2010; Sarker et al, 2010; von Both et al, 2006). Midwives spend a third of the time needed to properly conduct a FANC visit and often omit basic components of care (von Both et al 2006; Mathole et al 2004).…”

Section: Introductionmentioning

confidence: 99%

CenteringPregnancy-Africa: A pilot of group antenatal care to address Millennium Development Goals

Patil

Abrams

Klima³

et al. 2013

Midwifery

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Background Severe health worker shortages and resource limitations negatively affect quality of antenatal care (ANC) throughout sub-Saharan Africa. Group ANC, specifically CenteringPregnancy (CP), may offer an innovative approach to enable midwives to offer higher quality ANC. Objective Our overarching goal was to prepare to conduct a clinical trial of CenteringPregnancy – Africa (CP-Africa) in Malawi and Tanzania. In Phase 1, our goal was to determine the acceptability of CP as model for ANC in both countries. In Phase 2, our objective was to develop CP-Africa session content consistent with the Essential Elements of CP model and with national standards in both Malawi and Tanzania. In Phase 3, our objective was to pilot CP-Africa in Malawi to determine whether sessions could be conducted with fidelity to the Centering process. Setting Phase 1 and 2 took place in Malawi and Tanzania. Phase 3, the piloting of two sessions of CP-Africa, occurred at two sites in Malawi: a district hospital and a small clinic. Design We used an Action Research approach to promote partnerships among university researchers, the Centering Healthcare Institute, healthcare administrators, health professionals and women attending ANC to develop CP-Africa session content and pilot this model of group ANC. Participants For Phases 1 and 2, members of the Ministries of Health, health professionals and pregnant women in Malawi and Tanzania were introduced to and interviewed about CP. In Phase 2, we finalized CP-Africa content and trained thirteen health professionals in the Centering Healthcare model. In Phase 3, we conducted a small pilot with 24 pregnant women (12 at each site). Measurements and Findings Participants enthusiastically embraced CP-Africa as an acceptable model of ANC healthcare delivery. The CP-Africa content met both CP and national standards. The pilot established that the CP model could be implemented with process fidelity to the 13 Essential Elements. Several implementation challenges and strategies to address these challenges were identified. Key Conclusions Preliminary data suggest that CP-Africa is feasible in resource-constrained, low-literacy, high-HIV settings in sub-Saharan Africa. By improving the quality of ANC delivery, midwives have an opportunity to make a contribution towards Millennium Development Goals (MDG) targeting improvements in child, maternal and HIV-related health outcomes (MDGs 4, 5 and 6). A clinical trial is needed to establish efficacy. Implications for Practice CP-Africa also has the potential to reduce job-related stress and enhance job satisfaction for midwives in low income countries. If CP can be transferred with fidelity to process in sub-Saharan Africa and retain similar results to those reported in clinical trials, it has the potential to benefit pregnant women and their infants and could make a positive contribution to MGDs 4, 5 and .6.

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How much time is available for antenatal care consultations? Assessment of the quality of care in rural Tanzania

Cited by 46 publications

References 12 publications

Evaluation of the Quality of Antenatal Care (ANC) Service at Higher 2 Health Center in Jimma, South West Ethiopia

Evaluation of the Quality of Antenatal Care (ANC) Service at Higher 2 Health Center in Jimma, South West Ethiopia

Health and nutrition knowledge, attitudes and practices of pregnant women attending and not-attending ANC clinics in Western Kenya: a cross-sectional analysis

CenteringPregnancy-Africa: A pilot of group antenatal care to address Millennium Development Goals

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