scholarly journals Contributing barriers to loss to follow up from antenatal care services in villages around Addis Ababa: a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zergu Tafesse Tsegaye ◽  
Hailemariam Segni Abawollo ◽  
Binyam Fekadu Desta ◽  
Tsega Teferi Mamo ◽  
Atrie Fekadu Heyi ◽  
...  

Abstract Background Problems during pregnancy, childbirth and postpartum are the major contributors to maternal and perinatal morbidity and mortality. Focused antenatal care is an intervention set to provide basic services for pregnant women, to reduce morbidity and mortality related to pregnancy. In Ethiopia, there is a significant loss to follow up from antenatal care services between the first and fourth visits. The aim of this study is to explore the potential contributing barriers to loss to follow up of pregnant women from antenatal care services in villages around Addis Ababa, the capital city of the country. Methods A qualitative research method was used, where 20 in-depth interviews (zonal, woreda and health center managers, midwives and health extension workers were the participants) and three focus group discussions (mothers who were lost to follow up, mothers who completed four sessions of antenatal care visits, and community volunteers were the participants) were conducted. A qualitative data analysis software, ATLAS.ti 8, was applied. Results Inability to deliver essential antenatal care services which occurs primarily due to shortage of the required medical equipment, drugs, and other supplies is a major barrier for sustainable attendance of antenatal care services followed by poor care, respect, and receptiveness of service providers. Lack and cost of transport as well as partners’ approval and support were also claimed to be part of the major barriers. Community culture and pervious maternal experiences as well as maternal sociodemographic factors like maternal age at time of pregnancy and educational status of mothers were also reported as barriers to seeking and completion of antenatal care services. Conclusions Both demand and supply side barriers play a significant role in the loss to follow up from antenatal care services. Availing essential antenatal care services, closer to the community by improving the infrastructure, health workforce and supply chain system is recommended.

2020 ◽  
Author(s):  
Zergu Tsegaye ◽  
Hailemariam Abawollo ◽  
Binyam Desta ◽  
Tsega Mamo ◽  
Atrie Heyi ◽  
...  

Abstract Background: Problems during pregnancy, childbirth and postpartum are the major contributors to maternal and perinatal morbidity and mortality. Focused antenatal care is an intervention set to provide basic services for pregnant women, to reduce morbidity and mortality related to pregnancy. In Ethiopia, there is a significant antenatal care attendance dropout between the first and fourth visits. The aim of this study is to explore the potential contributing barriers to defaulting from antenatal care services in the country.Methods: A qualitative research method was used, where 20 in-depth interviews and three focus group discussions were conducted. A qualitative data analysis software, ATLAS.ti 8, was applied. Results: Low quality antenatal care service which occurs primarily due to shortage of the required drugs, supplies and equipment is a major barrier for sustainable attendance of antenatal care followed by poor care, respect and receptiveness of service providers. Lack and cost of transport as well as partners’ approval and support were also claimed to be part of the major barriers. Community culture and pervious maternal experiences as well as maternal sociodemographic factors like maternal age at time of pregnancy and educational status of mothers were also reported as barriers to the seeking and completion of antenatal care services. Conclusions: Both demand and supply side barriers play a significant role in the dropout of antenatal care services. Availing good quality antenatal care services, closer to the community by improving the health workforce and supply chain system is recommended.


Author(s):  
Nyasiro S Gibore ◽  
Agatha F Ngowi ◽  
Mariam J Munyogwa ◽  
Mwanaisha M Ali

Abstract Background Anemia is a major cause of morbidity and mortality of pregnant women and increases the risks of fetal and neonatal morbidity and mortality. Approximately 50% of all anemia is estimated to be caused by low dietary intake of iron, poor absorption of dietary iron, or blood loss. The objective of the present study was to determine the prevalence and assess the dietary habits associated with anemia among pregnant women receiving antenatal care in Unguja Island, Tanzania. A cross-sectional study was conducted to select 338 pregnant women at Kivunge, Mwembeladu and Mnazimmoja hospitals from March to June, 2018. Hemoglobin concentration was measured using a HemoCue photometer on capillary blood. Sociodemographic data and dietary habits were collected using a structured questionnaire. The data were analysed using the SPSS version 21.0. Multivariate logistic regression analysis was carried out to determine the predictors of anemia among pregnant women. The overall prevalence of anemia was 80.8%. Of these 68.64% had mild anemia, 11.24% had moderate anemia and 0.89% had severe anemia. Anemia was significantly associated with inadequate dietary diversity (Adjusted Odds Ratio (AOR) = 1.16, 95%CI = 0.57–2.36, p < 0.05), drinking tea or coffee with meal (AOR = 0.06, 95%CI = 0.03–0.13, p < 0.001), consuming less than three meals per day (AOR = 2.92, 95%CI = 1.60–5.84, p < 0.001), higher education level (AOR = 3.4, 95%CI = 1.6–7.2, p < 0.0001), birth interval of less than two years (AOR = 3.6, 95%CI = 1.1–11.9, p < 0.05) and multigravida (AOR = 1.2, 95% = 0.3–4.4, p < 0.0001). The prevalence of anemia in this study demonstrates a severe public health problem among pregnant women. Inadequate dietary diversity coupled with inadequate daily meal intake and consumption of tea or coffee were the dietary habits predictors of anemia among pregnant women. Other predictors of anemia were higher education level, multigravida and birth interval of less than two years. Nutrition policy interventions are needed in order to complement antenatal care services by providing important information on healthy eating habits during pregnancy.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Erkihun Tadesse Amsalu ◽  
Bereket Kefale ◽  
Amare Muche ◽  
Zinabu Fentaw ◽  
Reta Dewau ◽  
...  

AbstractIn the situation of high maternal morbidity and mortality in Sub-Saharan Africa, less than 80% of pregnant women receive antenatal care services. To date, the overall effect of antenatal care (ANC) follow up on essential newborn practice have not been estimated in East Africa. Therefore, this study aims to identify the effect of ANC follow up on essential newborn care practice in East Africa. We reported this review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). We searched articles using PubMed, Cochrane library, African journal online (AJOL), and HINARI electronic databases as well as Google/Google scholar search engines. Heterogeneity and publication bias between studies were assessed using I2 test statistics and Egger’s significance test. Forest plots were used to present the findings. In this review, 27 studies containing 34,440 study participants were included. The pooled estimate of essential newborn care practice was 38% (95% CI 30.10–45.89) in the study area. Women who had one or more antenatal care follow up were about 3.71 times more likely practiced essential newborn care compared to women who had no ANC follow up [OR 3.71, 95% CI 2.35, 5.88]. Similarly, women who had four or more ANC follow up were 2.11 times more likely practiced essential newborn care compared to women who had less than four ANC follow up (OR 2.11, 95% CI 1.33, 3.35). Our study showed that the practice of ENBC was low in East Africa. Accordingly, those women who had more antenatal follow up were more likely practiced Essential newborn care. Thus, to improve the practice of essential newborn care more emphasis should be given on increasing antenatal care follow up of pregnant women in East Africa.


2020 ◽  
Vol 13 (1) ◽  
pp. 569-575
Author(s):  
Lucia Drigo ◽  
Masane Luvhengo ◽  
Rachel T. Lebese ◽  
Lufuno Makhado

Background: Pregnant woman’s personal experience of antenatal care services can either be positive or negative; however, knowledge and experience appear to be of paramount importance in shaping their attitudes towards any healthcare-related services. This implies that women's experience of antenatal care services may affect their decision for seeking antenatal care in their present pregnancy, which can lead them to delay seeking care. Purpose: This study sought to explore the attitudes of pregnant women towards antenatal care services provided in primary health care facilities of Mbombela Municipality, Mpumalanga Province, South Africa. Methods: A qualitative exploratory descriptive study design was used for this study. Purposive sampling technique was used to sample pregnant women who fail to attend antenatal services as expected. Data were collected through face to face unstructured in-depth interview. A total of eighteen pregnant women participated in the study until data saturation. Data were analysed using Tech’s method of analysis. Results: Results revealed the following theme and sub-themes: Attitudes of pregnant women related to individual perceptions, perceived barriers to utilizing antenatal care services,’ attitudes of healthcare providers, long waiting times in healthcare facilities, lack privacy and confidentiality in healthcare facilities and attitudes of pregnant women related to attendance of antenatal services. Conclusion: Attitudes of pregnant women about antenatal care are shaped by their knowledge and previous encounters with the health care services that they had previously received. It is therefore important to provide women-friendly services. It is recommended that health education regarding the importance of antenatal care services must be given to all women daily in the waiting areas of each primary health care facilities, thus, the healthcare providers should promote the active participation of pregnant women during the health education sessions and provide opportunities to ask questions.


2020 ◽  
Vol 4 (1) ◽  

Background: Antenatal care (ANC) is an important health care service which is intended to potentially reduce maternal morbidity and mortality particularly in areas where the general health status of women is presumed poor, choice of facilities is limited and the service delivery compromised by geography (terrain, transport), socio-demographic factors, financial capability and awareness. Though improving the quality of health care is one of the targeted strategies in the Health Sector Development Program IV (HSDP IV) of Ethiopia, little is known about the quality of antenatal care service and client satisfaction at the different hospitals in Addis Ababa, the capital city of Ethiopia. Objective: To determine satisfaction of ANC services among pregnant women at the public teaching and private hospitals in Addis Ababa, Ethiopia. Methods: Health institution-based comparative cross-sectional study was conducted from February to June, 2019 in public and private hospitals, in Addis Ababa, using sample size determination for comparisons of proportion between the two populations. All participants who fulfilled the inclusion criteria were enrolled based on the flow of pregnant women to the ANC clinics at the selected hospitals. Data were entered and cleaned using EPI-info version 3.5.1 and analysis was performed by SPSS version 21. Association of independent variables with the client satisfaction was done using binary and multivariate logistic regression. Significant association of variables with outcome was determined using adjusted odds ratio (AOR) together with 95 % confidence interval. Level of significance was set at P-value of ≤ 0.05. Results: Five hundred seventy one pregnant women attending Antenatal Care at private (281) and public (290) hospitals were included with response rates of 94.1 and 91.2% for public and private hospitals, respectively. The age distribution of the participants was between 17 and 43 years with a mean age of 27.3±5.1 years. Most of the clients, 249 (88.7%) at private and 276 (95.2%) at public hospitals were between the ages of 20 and 34 years. One hundred fourteen (39.3%) of the clients at public and 113 (40.2%) at private hospitals were nulliparous. The clients overall satisfaction with antenatal care was mostly positive both at the private and public hospitals and two hundred twenty eight (81.1%) of the private and 174 (60%) of the public hospitals were satisfied with the services provided. Having ANC follow up at the private hospitals had statistically significant difference in client satisfaction compared to those in public hospitals with P value of 0.019, (AOR 2.97, 95% CI:1.19 -7.74). Clients’ satisfaction with the cleanliness of the environment was 11.1 times more likely to be satisfied with the general ANC service, P<0.05, (AOR 12.18 95% CI: 7.45-19.91). Having more than 4 ANC visits was positively associated with client overall satisfaction, P= 0.021, (AOR 2.41, 95% CI: 1.12-5.24,) while long waiting time is negatively associated with client satisfaction. Conclusions: The study showed significant difference in client satisfaction rate between the selected private and public facilities. Private facilities outperformed public facilities with regards to structural features (privacy, waiting time, space, and neatness). We recommend concerted effort to improve ANC visits and pay due attention to the privacy, waiting time, and the neatness of the facilities in public hospitals.


2020 ◽  
Author(s):  
Tsegahun Worku Brhanie ◽  
Walelgn Tefera ◽  
Mamo Dereje

Abstract Background: Adequate and healthy diet during pregnancy is essential for the health of both mother and newborn. Dietary diversity is a proxy indicator of maternal nutrient adequacy. However, little is documented on the prevalence of dietary diversity among pregnant women. This study was aimed to assess the dietary diversity practice and associated factors among pregnant women attending antenatal care in health centers of the coffee keranyo sub city, Addis Ababa, Ethiopia. Methods: Institution based cross-sectional study was conducted on 406 randomly selected pregnant women attending ANC in health centers of the coffee keranyo sub city, Addis Ababa from March 2-April 2/ 2018. Data were collected by using interviewer and 24 H dietary recall method. Data had entered and analyzed using SPSS version 21. Multiple logistic regression was run to assess factors associated with the dependent variable at P<0.05. Results: The mean Dietary Diversity Score of pregnant women was 5. 45+-1. 83. About 60.9% of pregnant women had good dietary diversity practice. Pregnant women who learned collage and above had more dietary diversity practice than the illiterate one [AOR=2.26, 95% CI: (1.066, 4.808)]. Pregnant women with monthly income more than 5,000 ETB had more dietary diversity than income less than 2,000 ETB [AOR=2.33, 95% CI: (1.234, 4.416)]. Pregnant women at second antenatal care visit had more dietary diversity than at the first visit [AOR=2.42, 95% CI: (1.183, 4.952)]. Having nutrition information during pregnancy increases 2 times better dietary diversity practice than none informed ones [AOR=2.10, 95% CI: (1.294, 3.422)].Conclusions: The mean Dietary Diversity Score of pregnant mothers was 5.45. And 60.9% of pregnant women had a good dietary diversity score, whereas 39.1 % of them had a poor diet diversity score. Mothers’ education, monthly income, second and third antenatal care visit and nutrition information had a significantly associated with pregnant mothers’ dietary diversity.


2020 ◽  
Author(s):  
Desta Samuel Umuro ◽  
Yared Lasebew Asres ◽  
Gezahegn Mamo Muluneh

Abstract Background This study aimed to assess magnitude and factors associated with anemia among pregnant women attending antenatal clinic at St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia. Methods Institution based cross sectional study design was conducted from December 1–30, 2018 on 405 pregnant women attending antenatal clinic. All pregnant women visiting the Antenatal care clinic during the study period and who fulfilled the eligibility criteria were included in the study. Secondary data was collected from clients register and personal files on hemoglobin, HIV, stool, and other variables. Descriptive statistics was used to analysis some variables by using SPSS. Logistic regression was carried out to identify factors associated with anemia in pregnancy. Adjusted odds ratio with their 95% of confidence interval and p < 0.05 are consider to have significant association. Results The magnitude of Anemia in pregnant women in this study was 19.8%, (95% CI 16.00-23.70). HIV infection (AOR = 6.12(95% CI 2.19, 17.08) parasitic infestation (AOR = 11.88 (95% CI 5.60, 25.20) and history of not taking fruit after meal during pregnancy (AOR = 3.12(95% CI 1.72, 5.67) were the major determinants of anemia. Conclusion This study showed that the magnitude of anemia among pregnant women was high especially at third trimester. Living with HIV /AIDS, parasitic infestation and no history of taking fruits after meal were the main factors.


2020 ◽  
Vol 30 (3) ◽  
Author(s):  
Berhanetsehay Teklewold ◽  
Tilahun Deresse ◽  
Goytom Kinfe ◽  
Henok Teshome

BACKGROUND: Morbidity and mortality conference has both educational and quality improvement purposes. However clear evidences for the effectiveness of the morbidity and mortality conferences in improving patient safety is lacking.METHODS: A facility based cross sectional study was conducted at St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia, to assess participants’ opinion on benefits and functioning of morbidity and mortality conferences. Univariate analysis was used to determine the influence of professional type on participants’ opinion about the morbidity and mortality conferences.RESULT: A total of 98 participants completed the survey. The majority of the participants agreed that there was a structured system of case identification (67.3%), meeting format (72.4%), the conferences were conducted every month (79.6%), it is blame free (71.4%) and system of care was focus of discussion (70%). Most (88.8%) participants agreed that the conferences were important for improvement of patient safety and quality of care, whereas 67.3% of the participants believed that there is no written term of reference and prior dissemination of agendas. Only 40% agreed that there is multidisciplinary team involvement. Fifty one percent of them disagreed that there is a follow up on the implementation of the forwarded recommendations.CONCLUSION: Even though the majority of the participants were satisfied with the mortality and morbidity conferences, most disagreed on the presence of written term of reference, earlier dissemination of agendas, multidisciplinary team involvement and follow up on the implementation of the forwarded recommendations.


Author(s):  
Otovwe Agofure ◽  
Stella Odjimogho ◽  
Oghenenioborue R. A. Okandeji-Barry ◽  
Imomotimi Glasgow

Background: Gestational diabetes mellitus is a condition in which women without previously diagnosed diabetes exhibit high blood glucose levels during pregnancy. Gestational diabetes which prevalence is on the increase in Nigeria may have negative consequences on the health of the foetus or mother. This study was designed to determine the prevalence of gestational diabetes mellitus and its complications among pregnant women attending antenatal services in Diette Koki memorial hospital Opolo Bayelsa State from 2014-2016.Methods: This was a retrospective study carried out at the Diette Koki Memorial Hospital Opolo in Bayelsa State. The study population comprised pregnant women that attended antenatal care services within the period of January 2014-December 2016. A designed proforma was used to collect the data from the hospital record department.Results: The results of the study showed that the prevalence of gestational diabetes in the year 2014 was 0.023% or 2.33 per 10,000 pregnancies while the prevalence for 2015 was 0.026% or 2.59% per 10000 pregnancies. Furthermore, other complications recorded were hypertension, pre-eclampsia and eclampsia. Similarly, there was a significant correlation between prevalence of gestational diabetes and other complications (r=0.898, p=0.022).Conclusions: In conclusion, prevalence of gestational diabetes was recorded among pregnant women of Diette Koki memorial hospital Opobo Bayelsa State. Therefore, prompt screening and preventive measures should be enforced by health care professionals to prevent maternal and foetal morbidity and mortality.


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