scholarly journals Healthcare workers’ and pregnant women’s perceptions of digital tools to improve antenatal care

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
S van Pelt ◽  
K Massar ◽  
L van der Eem ◽  
M van der Pijl ◽  
L Shields-Zeeman ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Healthcare Workers ◽  
Digital Health ◽  
Quality Of Healthcare ◽  
Care Services ◽  
Rural Tanzania ◽  
Women’S Perceptions

Abstract Background To reduce maternal mortality in rural Tanzania, the need to improve antenatal care remains an urgent priority. Digital health tools are seen as a promising instrument to increase the quality of healthcare in developing countries, but it remains unclear to what extent they are perceived as beneficial during the antenatal care visit. Therefore, the aim of this research was to identify factors that could improve the quality of antenatal care in rural Tanzania, and whether digital health tools would change healthcare workers' and pregnant women's perceptions of quality of care. Methods Semi-structured in-depth interviews were conducted with sixteen healthcare workers and nineteen pregnant women, recruited from various health facilities in Magu District, Tanzania. Results Both healthcare workers and pregnant women possess a positive attitude towards antenatal care and acknowledge its importance. However, they also expressed a need for (structural) improvements in antenatal care services, particularly increased availability of diagnostic tests, and increased performance and motivation of healthcare workers. In addition, healthcare workers indicated a need for more training and better supervision. While both groups expected quality of care to increase should a digital health tool be implemented, they placed more focus on investing in health infrastructure, like the availability of medication and other materials, than investments in digital health. Conclusions Infrastructural improvements, including better communication between healthcare workers and pregnant women, as well as training opportunities and supportive leadership, are necessary before a digital health tool can be expected to increase the quality of antenatal care. Key messages Both healthcare workers and pregnant women acknowledged the need for higher quality antenatal care. Both groups suggested a number of infrastructural improvements, among which the use of a digital health tool.

scholarly journals Beyond coverage: a qualitative study exploring the perceived impact of Gabon’s health insurance plan on access to and quality of prenatal care

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
N’doh Ashken Sanogo ◽  
Arone Wondwossen Fantaye ◽  
Sanni Yaya
Keyword(s):  
Quality Of Care ◽  
Health Insurance ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Health Professionals ◽  
Supply Side ◽  
Demand Side ◽  
Structured Interviews ◽  
Compulsory Health Insurance

Abstract Background Access to affordable and adequate healthcare in a health system determines the universal health coverage achievement for all residents in a country. Achieving access to healthcare requires the availability of a financing system that ensures access to and provision of adequate care, regardless of the ability to pay. In sub-Saharan Africa, accessibility, use and coverage of prenatal visits are very low and poor, which reduces the quality of care. This paper explored the impact of a social health insurance scheme on the quality of antenatal care in Gabon. Methods This qualitative study involved the analysis of data collected from semi-structured interviews and non-participant observations to assess the quality of antenatal care. The study elicited perceptions on the demand side (pregnant women) and the supply side (health professionals) in health facilities. Fifteen semi-structured interviews were conducted with pregnant women (aged between 15 and 49) and 5 with health professionals, who each had a seniority of at least 10 years, at different levels of care. Nine non-participant observations were also conducted. Coded transcripts were reviewed and analyzed using the Canadian Institute for Public Administration of Citizen-Centered Services model as an analytical guide. Results On the demand side, women were generally satisfied with the prenatal services they receive in health facilities. However, complaints were made about the rudeness of some nurses, the high price of the delivery kit (50,000 XAF), and the fact that some essential medicines for maternity are not covered. On the supply side, participants agreed that compulsory health insurance is important in providing antenatal care access to those who need it the most. However, some problems remain. The participants outlined some logistical problems and a lack of medical equipment, including the stock of drugs, disinfectants, and the absence of clean water. Conclusion Understanding the perceptions of pregnant women and health professionals regarding the quality of antenatal care can help to inform refinements to methods through which the services can be better provided. In addition, the study findings are vital to increasing the use of care, as well as combating high maternal mortality rates. Compulsory health insurance has improved the accessibility and utilization of healthcare services and has contributed to improved quality of care.

scholarly journals Including the Excluded in Antenatal Care: A Systematic Review of Concerns for D/deaf Pregnant Women

2021 ◽  
Vol 11 (5) ◽  
pp. 67
Author(s):  
Olufemi Timothy Adigun ◽  
Olugbenga Akinrinoye ◽  
Helen Ngozichukwuka Obilor
Keyword(s):  
Systematic Review ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Healthcare Workers ◽  
The Body ◽  
Bibliographic Databases ◽  
Care Services ◽  
Depth Analysis ◽  
Comprehensive Search ◽  
Antenatal Clinics

This paper presents global evidence derived from a systematic review of the literature on the issues of D/deaf pregnant women and antenatal care. A comprehensive search through four bibliographic databases identified a dataset of 10,375 academic papers, from which six papers met the inclusion criteria for in-depth analysis related to D/deaf pregnant women’s use of antenatal care/clinics. Findings from the analysis revealed four major concerns for D/deaf pregnant women who attended antenatal clinics for care. These concerns were communication difficulties, satisfaction with antenatal care services, attendance at antenatal clinics, and associated health outcomes. Based on the identified issues and concerns, it is recommended that pre- and in-service healthcare workers should be trained on how to communicate through sign language with their D/deaf patients. In addition, there is a need to rapidly expand the body of knowledge on the issues concerning antenatal care for D/deaf pregnant women vis-à-vis their relationship with healthcare workers in antenatal facilities.

scholarly journals Quality of antenatal care services at subcentres: an infrastructure, process and outcome evaluation in a district in Tamil Nadu

2017 ◽  
Vol 4 (11) ◽  
pp. 4071 ◽  
Author(s):  
Sugunadevi G.
Keyword(s):  
Quality Of Care ◽  
Reproductive Health ◽  
Antenatal Care ◽  
Tamil Nadu ◽  
Care Delivery ◽  
Simple Random Sampling ◽  
Outcome Evaluation ◽  
Care Services ◽  
Health Care Delivery Systems

Background: Quality of care is a priority concern all over the world and all the countries are trying to improve the effectiveness and efficiency of their health care delivery systems. Recognizing the potential to improve the reproductive health status in developing countries, quality of care in reproductive health field has been the priority area of research by WHO.Methods: This study assesses the quality of antenatal care services delivered at subcentre level by comparing with the recommended Structural attributes, Process attributes and Initial outcome attributes. By simple random sampling, ten subcentres under three Block Primary Health Centres in Coimbatore district were included in the study.Results: On observing the quality of client-provider interaction, most of the women were treated with dignity (98.5%), but there were deficiencies in examination for pallor (19.2%), pedal edema (18.5%) and pulse (10.6%) which is very critical for good antenatal care. The exit interview revealed that most clients (98.6%) were satisfied with the antenatal care.Conclusions: The findings of this quality assessment study provide information about training needs for improving the quality of service and serves as a baseline data on status before implementing NRHM. 

scholarly journals The Development of an Electronic Clinical Decision and Support System to Improve the Quality of Antenatal Care in Rural Tanzania: Lessons Learned Using Intervention Mapping

2021 ◽  
Vol 9 ◽  
Author(s):  
Sandra van Pelt ◽  
Karlijn Massar ◽  
Laura Shields-Zeeman ◽  
John B. F. de Wit ◽  
Lisette van der Eem ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Support System ◽  
Healthcare Workers ◽  
Digital Health ◽  
Intervention Mapping ◽  
Clinical Decision ◽  
Lessons Learned ◽  
Maternal Deaths ◽  
Nurse Assistant

It is widely recognised that high quality antenatal care is a key element in maternal healthcare. Tanzania has a very high maternal mortality ratio of 524 maternal deaths per 100,000 live births. Most maternal deaths are due to preventable causes that can be detected during pregnancy, and antenatal care therefore plays an important role in reducing maternal morbidity and mortality. Unfortunately, quality of antenatal care in Tanzania is low: Research has shown that healthcare workers show poor adherence to antenatal care guidelines, and the majority of pregnant women miss essential services. Digital health tools might improve the performance of healthcare workers and contribute to improving the quality of antenatal care. To this end, an electronic clinical decision and support system (the Nurse Assistant App) was developed and implemented in Tanzania in 2016 to provide digital assistance during antenatal care consultations to healthcare workers. The current study systematically evaluated the development and implementation process of the Nurse Assistant App in Magu District, Tanzania, with the aim of informing future programme planners about relevant steps in the development of a digital health intervention. Desk research was combined with semi-structured interviews to appraise the development process of the digital health tool. We employed the criteria stipulated by Godin et al., which are based on the six steps of Intervention Mapping [IM; Bartholomew Eldredge et al.]. Findings indicated that five of the six steps of IM were completed during the development and implementation of the Nurse Assistant App. Tasks related to community engagement, adjustment to local context, implementation in the practical context in collaboration with local partners, and rigorous evaluation were accomplished. However, tasks related to identifying theory-based behaviour change methods were not accomplished. Based on the lessons learned during the process of developing and implementing the Nurse Assistant App, we conclude that programme developers are recommended to (1) engage the community and listen to their insights, (2), focus on clear programme goals and the desired change, (3), consult or involve a behaviour change specialist, and (4), anticipate potential problems in unexpected circumstances.

scholarly journals “The nurse assistant app” to improve healthcare worker performance during antenatal care in Tanzania

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
S van Pelt ◽  
K Massar ◽  
L van der Eem ◽  
L Shields-Zeeman ◽  
J B F de Wit ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Healthcare Workers ◽  
Digital Health ◽  
Intervention Mapping ◽  
Sub Saharan Africa ◽  
Systematic Evaluation ◽  
Future Research ◽  
Change Models ◽  
Nurse Assistant

Abstract Background The Nurse Assistant App (NAA) was developed to improve the quality of antenatal care in Magu District Tanzania by providing digital assistance to healthcare workers. The NAA guides healthcare workers step by step through all necessary antenatal care interventions and provides tailored advice and suggestions for follow-up actions. We used the Intervention Mapping framework to retrospectively evaluate the development of the NAA. Methods Desk research into the content, evidence base, and development of the NAA was performed combined with semi-structured interviews with two initial developers to fill in a planning tool consisting of 40 criteria for systematic evaluation of the data. Results Findings showed that the NAA was developed based on existing literature on antenatal care guidelines as well as the knowledge and experience of a broad variety of stakeholders and that five of the six steps of Intervention Mapping were performed. However, the development of the NAA lacked a theoretical foundation on behaviour change models. Future research will focus on the experiences of healthcare workers providing antenatal care using the NAA. Conclusions The NAA was developed in collaboration with relevant stakeholders and took practical matters as well as evidence from existing literature into account. However, we recommend that the responsibility and ownership of the NAA should be shared with the local government to increase the potential and sustainability of the NAA. Key messages The NAA was developed to improve the quality of antenatal care in rural Tanzania targeting healthcare workers. The current evaluation informs future digital health tool developers in sub-Saharan Africa about elements to take into account during the development phase such as systematic mapping of the process.

scholarly journals HUBUNGAN ANTARA KUALITAS BIDAN DALAM PELAYANAN ANTENATAL CARE TERHADAP PERSEPSI IBU HAMIL

2020 ◽  
Vol 10 (1) ◽  
pp. 36-40
Author(s):  
Citra Hadi Kurniati
Keyword(s):  
Antenatal Care ◽  
Pregnant Women ◽  
P Value ◽  
Chi Square ◽  
Cross Sectional ◽  
Care Services ◽  
Chi Square Test ◽  
Parametric Statistics ◽  
Sectional Analysis

Midwives play an important role in the process of health care, especially antenatal care services (ANC). The quality of midwife services determines the success of the service process. The perception of pregnant women when they come for a pregnancy is related to their availability to return to Antenatal Care examination. This study aims to determine the quality of midwives in ANC services on the perception of pregnant women. This type of research uses observational analytic research, where researchers are directed to explain a situation or situation. The time approach used is cross sectional. Analysis was conducted to test the quality of midwives in providing ANC services to the perception of pregnant women. Analysis of the data in research with ordinal and scale variables is non-parametric statistics. Hypothesis testing using the Chi Square Test. The results showed that there was no relationship between the quality of midwives on perceptions of pregnant women with a p value of valeu> 0.05 with an X × count of 0.325. The conclusion of this study is that there is no relationship between the quality of midwives in providing ANC services to the perception of pregnant women

scholarly journals Challenges to delivering quality care in a prevention of mother-to-child transmission of HIV programme in Soweto, South Africa

2013 ◽  
Vol 14 (2) ◽  
pp. 64-69 ◽  
Author(s):  
Coceka Nandipha Mnyani ◽  
James McIntyre
Keyword(s):  
South Africa ◽  
Quality Of Care ◽  
Pregnant Women ◽  
Support Group ◽  
Healthcare Workers ◽  
Antenatal Visit ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Mother To Child

Objectives: There has been little focus on quality of care provided in prevention of mother-to-child transmission of HIV (PMTCT) services in South Africa. We assessed quality of care in PMTCT services in Soweto, South Africa, focusing on knowledge and experiences of healthcare workers and HIV-infected pregnant women accessing the services. Methods: A cross-sectional survey was conducted between November and December 2009. A total of 201 HIV-infected pregnant women and 80 healthcare workers, from 10 antenatal clinics, were interviewed using standardised questionnaires. Results: The median gestational age at first antenatal visit was 20 weeks and 32 weeks at the time of the interview. The majority of the women, 71.5%, discovered that they were HIV-infected in the index pregnancy, and 87.9% disclosed their HIV status. Overall, 97.5% received counselling and 33.5% were members of a support group. Knowledge of antenatal and intrapartum PMTCT interventions was correct in 62.7% and 43.3% of the women, respectively. Support group membership and current use of antiretroviral prophylaxis did not impact on the quality of knowledge. Of the healthcare workers, 43.8% were professional nurses and 37.5% were lay counsellors. The majority, 80.0%, felt satisfied with their knowledge of PMTCT guidelines and 96.3% felt competent in managing HIV-infected pregnant women. Yet, there were important deficiencies in knowledge of the guidelines. Conclusion: In our study, knowledge of PMTCT interventions was low in both clients and healthcare workers. These findings point to a need to improve quality of care in PMTCT services, especially with increasingly complex PMTCT interventions recommended by international policies.

scholarly journals “If you don’t have enough equipment, you’re not going to provide quality services”: Healthcare workers’ perceptions on improving the quality of antenatal care in rural Tanzania

2020 ◽  
Vol 13 ◽  
pp. 100232
Author(s):  
Sandra van Pelt ◽  
Karlijn Massar ◽  
Lisette van der Eem ◽  
Laura Shields-Zeeman ◽  
John B.F. de Wit ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Healthcare Workers ◽  
Rural Tanzania

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

2011 ◽  
Vol 11 (1) ◽  
Author(s):  
Moke Magoma ◽  
Jennifer Requejo ◽  
Mario Merialdi ◽  
Oona MR Campbell ◽  
Simon Cousens ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Antenatal Care ◽  
Rural Tanzania

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

2021 ◽  
Vol 9 ◽  
pp. 205031212110580
Author(s):  
Assefa Philipos Kare ◽  
Amelo Bolka Gujo ◽  
Nigussie Yohanes Yote
Keyword(s):  
Quality Of Care ◽  
Confidence Interval ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Odds Ratio ◽  
Associated Factors ◽  
Adjusted Odds Ratio ◽  
Southern Ethiopia ◽  
Selection Of

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.

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