Quality of antenatal care and associated factors among pregnant women attending government hospitals in Sidama Region, Southern Ethiopia

Abstract

Background: Good-quality antenatal care improves maternal health in the least developed countries. This study was aimed at assessing the quality of antenatal care and associated factors among pregnant women attending hospitals in the Sidama Region, Southern Ethiopia. Method: A facility-based cross-sectional study was conducted from 1 February to 30 April 2020 among 372 pregnant women. A two-stage sampling technique—the first stage, selection of health facilities; the second stage, selection of respondents—was used. Trained data collectors administered exit interviews. Data were entered into EPI Info 7 and analyzed using IBM SPSS version 25. Quality of care was assessed using a validated questionnaire containing 68 attributes of quality. Good quality of care was determined by the proportion of respondents who scored ⩾80% of 68 variables. Bivariable and multivariable logistic regressions were used in the analysis. The outputs were presented using an adjusted odds ratio with 95% confidence intervals. Results: This study revealed that 41.2% (95% confidence interval: 36.2%–46.2%) of pregnant women had received good-quality antenatal care. Increased odds of the utilization of quality antenatal care were observed among women who lived in urban areas (adjusted odds ratio = 4.32, 95% confidence interval: 2.58–7.21), attained primary education and more (adjusted odds ratio = 2.68, 95% confidence interval: 1.60–4.48), earned a monthly income >3000 Ethiopia Birr (US$93.3) (adjusted odds ratio = 3.86, 95% confidence interval: 2.28–6.51), and visited hospitals for antenatal care ⩾4 times (adjusted odds ratio = 3.68, 95% confidence interval: 2.21–6.10). Conclusions: The proportion of women who received good-quality antenatal care was low. Good quality care was associated with residence, education status, income level, and frequency of antenatal care visits. Training care providers, strengthening counseling, and promoting women’s economic empowerment to improve the utilization of quality antenatal care are recommended.

Factors associated with utilization of quality antenatal care: a secondary data analysis of Rwandan Demographic Health Survey 2020

“…Invariably, 4 or more ANC attendance is an indication of a woman’s consciousness and commitment to her wellbeing in pregnancy [ 6 , 26 ]. Additionally, frequent contact between the skilled provider and the pregnant woman helps in the development of good rapport between the two, enhances women’s familiarity with the health system, builds trust and confidence in the services received [ 47 ]. All these motivate women to freely share information with the ANC providers thereby facilitating the process of receiving more ANC components or reporting positively [ 2 , 47 , 48 ].…”

“…Additionally, frequent contact between the skilled provider and the pregnant woman helps in the development of good rapport between the two, enhances women’s familiarity with the health system, builds trust and confidence in the services received [ 47 ]. All these motivate women to freely share information with the ANC providers thereby facilitating the process of receiving more ANC components or reporting positively [ 2 , 47 , 48 ]. This demonstrates that Rwanda maternal health stakeholders need to prioritize explorative research to understand barriers of utilizing the recommended ANC contacts.…”

Multilevel analysis of quality of antenatal care and associated factors among pregnant women in Ethiopia: a community based cross-sectional study

“… 54 55 Furthermore, the frequent contact between the ANC provider and the pregnant woman also promotes a sense of trust and confidence in the services as well as enhances the familiarity of the pregnant woman with the health system. 56 This ensures that women to freely share information with skilled providers and that further ANC components can be served as a result. 53 57 …”

“…It might be that women who visit four or more ANC have a greater chance of getting extensive health education sessions, have improved rapport with ANC providers and are more likely to get and recognise quality of ANC and report it positively 54 55. Furthermore, the frequent contact between the ANC provider and the pregnant woman also promotes a sense of trust and confidence in the services as well as enhances the familiarity of the pregnant woman with the health system 56. This ensures that women to freely share information with skilled providers and that further ANC components can be served as a result 53 57…”

Variation in maternal mortality in Sidama Regional State, southern Ethiopia: A population based cross sectional household survey

“…The region has 18 hospitals (13 primary, 4 general and 1 tertiary ), 137 health centres and 553 health posts operated by the government [20]. In the region, there are also 4 hospitals (1 general and 3 primary), 21 speciality and higher clinics, 131 medium clinics and 79 primary clinics run by private owners.…”