Facility level factors that determine consistent delivery of essential newborn care at health centers in Ethiopia

Abstract Background: Essential newborn care (ENC) is a package of interventions which should be provided for every newborn baby regardless of body size or place of delivery immediately after birth and should be continued for at least the seven days that follows. Although a minimum package of proven interventions to reduce newborn mortality have been adopted, countries are still challenged by multiple system related problems. Methods: This study employed a retrospective cross-sectional study design and used program monitoring data collected from 425 facilities between October and December 2019. Descriptive statistics were formulated and presented in tables. Binary logistic regression was employed to assess the statistical association between the outcome variable and the independent variables. All variables with p<0.2 in the bivariate analysis were identified as candidate variables. Then, multiple logistic regression analysis was performed using candidate variables to determine statistically significant predictors of the consistent delivery of ENC by adjusting for possible confounders. Results: A total of 273, (64.2%), of facilities demonstrated consistent delivery of ENC. Five factors - availability of essential obstetrics drugs in delivery rooms, high CSC performances, availability of maternity waiting homes, consistent partograph use, and availability of women-friendly delivery services were included in the model. The strongest predictor of CD-ENC was consistent partograph use, recording an odds ratio of 2.66. Similarly, providing women-friendly services was strongly associated with increased likelihood of exhibiting CD-ENC. Furthermore, facilities with essential obstetric drugs had 1.88 times higher odds of exhibiting consistent delivery of ENC. Conclusion: Health worker commitment to provide ENC is linked to the practices and platforms created by health facility management. Health facility managers should establish a platform or mechanism to enhance providers relationship with their clients as well as comprehensive tools to remind health workers’ responsibilities with regards to ENC. In addition, the health service managers should also consider availing the required supplies and drugs closer to the service delivery rooms and tables.

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Facility level factors that determine consistent delivery of essential newborn care at health centers in Ethiopia

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-04358-4 ◽

2022 ◽

Vol 22 (1) ◽

Author(s):

Binyam Fekadu ◽

Ismael Ali ◽

Zergu Tafesse ◽

Hailemariam Segni

Keyword(s):

Logistic Regression ◽

Health Facility ◽

Health Care Providers ◽

Multiple Logistic Regression Analysis ◽

Newborn Care ◽

Outcome Variable ◽

Care Practice ◽

Care Providers ◽

Essential Newborn Care ◽

Facility Level

Abstract Background Essential newborn care (ENC) is a package of interventions which should be provided for every newborn baby regardless of body size or place of delivery immediately after birth and should be continued for at least the seven days that follows. Even though Ethiopia has endorsed the implementation of ENC, as other many counties, it has been challenged. This study was conducted to measure the level of essential newborn care practice and identify health facility level attributes for consistent delivery of ENC services by health care providers. Methods This study employed a retrospective cross-sectional study design in 425 facilities. Descriptive statistics were formulated and presented in tables. Binary logistic regression was employed to assess the statistical association between the outcome variable and the independent variables. All variables with p < 0.2 in the bivariate analysis were identified as candidate variables. Then, multiple logistic regression analysis was performed using candidate variables to determine statistically significant predictors of the consistent delivery of ENC by adjusting for possible confounders. Results A total of 273, (64.2%), of facilities demonstrated consistent delivery of ENC. Five factors—availability of essential obstetrics drugs in delivery rooms, high community score card (CSC) performances, availability of maternity waiting homes, consistent partograph use, and availability of women-friendly delivery services were included in the model. The strongest predictor of consistent delivery of essential newborn care (CD-ENC) was consistent partograph use, recording an odds ratio of 2.66 (AOR = 2.66, 95%CI: 1.71, 4.13). Similarly, providing women-friendly services was strongly associated with increased likelihood of exhibiting CD-ENC. Furthermore, facilities with essential obstetric drugs had 1.88 (AOR = 1.88, 95%CI: 1.15, 3.08) times higher odds of exhibiting consistent delivery of ENC. Conclusion The delivery of essential newborn care depends on both health provider and facility manager actions and availability of platforms to streamline relationships between the clients and health facility management.

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Health facility structure and maternal characteristics related to essential newborn care in Brazil: a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2017-021431 ◽

2018 ◽

Vol 8 (12) ◽

pp. e021431 ◽

Cited By ~ 2

Author(s):

Maria Alexsandra Silva Menezes ◽

Ricardo Gurgel ◽

Sonia Duarte Azevedo Bittencourt ◽

Vanessa Eufrazino Pacheco ◽

Rosana Cipolotti ◽

...

Keyword(s):

Health Facility ◽

Breast Feeding ◽

Perinatal Care ◽

Newborn Care ◽

Health Facilities ◽

Cross Sectional ◽

Essential Newborn Care ◽

Skin Contact ◽

Postnatal Women ◽

Skin To Skin

ObjectivesTo assess the use of the WHO’s Essential Newborn Care (ENC) programme items and to investigate how the non-use of such technologies associates with the mothers' characteristics and hospital structure.DesignA cross-sectional observational health facility assessment.SettingThis is a secondary analysis of the ‘Birth in Brazil’ study, a national population-based survey on postnatal women/newborn babies and of 266 publicly and privately funded health facilities (secondary and tertiary level of care).ParticipantsData on 23 894 postnatal women and their newborn babies were analysed.Main outcome measuresThe facility structure was assessed by evaluating the availability of medicines and equipment for perinatal care, a paediatrician on call 24/7, a neonatal intensive care unit (NICU) and kangaroo mother care. The use of each ENC item was assessed according to the health facility structure and the mothers’ sociodemographic characteristics.ResultsThe utilisation of ENC items is low in Brazil. The factors associated with failure in pregnant woman reference were: pregnant adolescents (ORadj1.17; 95% CI 1.06 to 1.29), ≤7 years of schooling (ORadj1.47; 95% CI 1.22 to 1.78), inadequate antenatal care (ORadj1.67; 95% CI 1.47 to 1.89). The non-use of corticosteroids was more frequently associated with the absence of an NICU (ORadj3.93; 95% CI 2.34 to 6,66), inadequate equipment and medicines (ORadj2.16; 95% CI 1.17 to 4.01). In caesarean deliveries, there was a less frequent use of a partograph (ORadj4,93; 95% CI 3.77 to 6.46), early skin-to-skin contact (ORadj3.07; 95% CI 3.37 to 4.90) and breast feeding in the first hour after birth (ORadj2.55; 95% CI 2.21 to 2.96).ConclusionsThe coverage of ENC technologies use is low throughout Brazil and shows regional differences. We found a positive effect of adequate structure at health facilities on antenatal corticosteroids use and on partograph use during labour. We found a negative effect of caesarean section on early skin-to-skin contact and early breast feeding.

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Evaluation of the Intermittent Preventive Therapy in Pregnancy using Sulphadoxine/ Pyrimethamine (IPTp-SP) Program in Chiredzi District, Zimbabwe, 2021

10.21203/rs.3.rs-1016538/v1 ◽

2021 ◽

Author(s):

Amanda Sarah Thakataka ◽

Joseph Mberikunashe ◽

More Mungati ◽

Tsitsi Patience Juru ◽

Addmore Chadambuka ◽

...

Keyword(s):

Pregnant Women ◽

Health Workers ◽

Intermittent Preventive Treatment ◽

Outcome Evaluation ◽

Outcome Variable ◽

Bivariate Analysis ◽

Stock Management ◽

Cross Sectional ◽

Sulphadoxine Pyrimethamine ◽

In Pregnancy

Abstract Background Intermittent Preventive Treatment in Pregnancy (IPTp) with Sulphadoxine/ Pyrimethamine (SP) is used for the prevention of malaria among pregnant women in Zimbabwe. The program is integrated into routine Antenatal care (ANC) where a minimum of three doses is recommended during each pregnancy. The third dose coverage for Chiredzi District has consistently been below the 80% target coverage. We evaluated IPTp implementation in Chiredzi to understand the reasons for underperformance. Methods An analytical cross-sectional study was conducted using a Process-Outcome evaluation with the Logical Framework Approach. We interviewed 50 women in postnatal care and determined ANC services accessed using their ANC booklets. Health workers were interviewed for knowledge of the program. Stock availability and drug delivery records were reviewed using checklists at five high-volume sites. Epi Info 7.2.4.0™ was used for data capturing and analysis. The software was used to calculate frequencies, medians, proportions, odds ratios and p-values at a 95% confidence interval. The outcome variable was receiving ≥3 doses of SP which was computed against the independent variables such as client-related characteristics to determine which factors were contributory using univariate and bivariate analysis. Results Only 12/50 (24%) women received ≥3 doses of SP during their pregnancy. Two (4%) women started their ANC visits in the first trimester. Thirty-three (66%) had missed at least one SP dose during their ANC visit because of medicine unavailability. Knowing the number of times SP is given (OR 11.9; 95% CI 2.54-55.8) and having attended at least 4 ANC visits (OR 13.6; 95% CI 1.59 -116.0) increased the likelihood of receiving adequate SP dosing. Conclusions The IPTp-SP program in Chiredzi District was underperforming, we attributed this largely to health system factors. Erratic supply and stock-outs of SP resulted in clients missing SP doses. Clients also missed SP doses because of late ANC booking and lack of knowledge on IPTp benefits. Improving stock management and raising community awareness on prevention of malaria among pregnant women was recommended.

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Community-Based Essential Newborn Care Practices and Associated Factors among Women of Enderta, Tigray, Ethiopia, 2018

International Journal of Reproductive Medicine ◽

10.1155/2020/2590705 ◽

2020 ◽

Vol 2020 ◽

pp. 1-7

Author(s):

Gebrehiwot Gebremariam Weldeargeawi ◽

Zenawi Negash ◽

Alemayehu Bayray Kahsay ◽

Yemane Gebremariam ◽

Kidanemaryam Berhe Tekola

Keyword(s):

Associated Factors ◽

Newborn Care ◽

Educational Status ◽

Outcome Variable ◽

Care Practice ◽

Community Based ◽

Cross Sectional ◽

Essential Newborn Care ◽

Newborn Care Practice ◽

Care Practices

Introduction. Neonatal mortality contributes a higher percentage of infant mortality, especially in developing countries including Ethiopia where the rate of institutional delivery is low. In Ethiopia, scientific evidences on the level of community-based essential newborn care practice were scanty and inconclusive. Objectives. The aim of the study was to assess community-based essential newborn care practices and associated factors among women who have infant<12 months. Methods. A community-based cross-sectional study was employed among 634 randomly selected women who have infant<12 months from June 23, 2017, to August 29, 2017, at Enderta district. Data was collected by a face-to-face interview through structured questionnaires, and it was coded, entered, and cleaned using EpiData version 3.1. Then, the data was exported to SPSS version 21 for analysis. Odds ratios and p value were computed to know the association between the independent variables with the dependent variable. Finally, a variable at p values of p<0.05 was considered statistically significant with the outcome variable. Result. The overall community-based essential newborn care practice was found 40.7%. Educational status (AOR=6.6, 95% CI, 2.49-11.97), previous ANC follow-up (AOR=1.7, 95% CI, 1.2-3.80), weight of the child during birth (AOR=1.3, 95% CI, 1.12-2.98), and place of delivery (AOR=2.1, 95% CI, 1.50-4.63) were found to be significantly associated with community-based essential newborn care. Even though overall newborn practice was found to be good, the cord care practices were found to be poor that indicated there is a need to rise community awareness.

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The shadow challenges to improve the state essential newborn care practices in healthcare providers: evidence from a multicentre cross-sectional study in Ethiopia

BMC Pediatrics ◽

10.1186/s12887-021-02903-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Ermias Sisay Chanie ◽

Amare Kassaw ◽

Melkamu Senbeta ◽

Fisha Alebel GebreEyesus ◽

Aragaw Tesfaw ◽

...

Keyword(s):

Logistic Regression ◽

Healthcare Providers ◽

Newborn Care ◽

Educational Status ◽

Care Practice ◽

Cross Sectional ◽

Essential Newborn Care ◽

Multivariable Logistic Regression ◽

Newborn Care Practice ◽

Care Practices

Abstract Background Neonatal mortality can be reduced by providing essential newborn care. However, it is overlooked by most healthcare providers in Ethiopia. Hence, this study aims to examine immediate essential newborn care practices and associated factors among healthcare providers in Ethiopia. Methods Institution-based cross-sectional study was conducted among 214 healthcare providers from November 11 to December 19, 2020, at a selected South Gondar health facility. Data were entered into Epi-data 4.2 and then exported to STATA14.0 for analysis. Both bivariable and multivariable logistic regression with a 95% confidence interval were computed. The variable that had a p-value less than 0.25 in bivariable logistic regression was entered into the multivariable logistic regression. In multivariable logistic regression, variables having a p-value < 0.05 were considered a statistically significant association with the poor practice of essential newborn care practice. Results The overall essential newborn care practice among healthcare providers was found to be 74.8% (95% CI: 68.4, 80.2). Diploma educational status (AOR = 7.8, 95% CI:2.80–21.9), presence of workload (AOR = 9.7, 95% CI: 2.76–23.9), unavailability of drugs and vaccines (AOR = 9.8, 95% CI: 6.95–17.7), and having no training (AOR = 3.9, 95% CI: 1.73–8.92) were found to be predictors for poor essential newborn care practices. Conclusion Essential newborn care practice among healthcare providers at South Gondar health institutions was found to be low. Being diploma educational status, presence of workload, unavailability of drugs and vaccines, and having no training were found to be independent predictors for poor practice of essential newborn care. Hence, periodic evaluation and strategies are needed for those predictor variables to address the gaps.

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Utilization of Long-lasting Insecticide Treated Net and Associated Factors Among Pregnant Women in Awabel District,North-West Ethiopia, 2017

10.21203/rs.3.rs-936592/v1 ◽

2021 ◽

Author(s):

Mengistie Kassahun Tariku

Keyword(s):

Logistic Regression ◽

Antenatal Care ◽

Pregnant Women ◽

Health Facility ◽

Associated Factors ◽

Positive Association ◽

Outcome Variable ◽

P Value ◽

Cross Sectional ◽

North West

Abstract BackgroundUtilization of long-lasting insecticide treated net (LLITN) is one of the main vector control activities. It has a killing, repellent and physical barrier effects against mosquito. Even if priority is given for pregnant women, not all nets owned by household have been utilized by pregnant women. The objective of the study was to assess utilization of Long-lasting insecticidal net and associated factors among pregnant women in malarious kebeles, Awabel woreda, North-West Ethiopia.MethodsA community-based cross-sectional study was conducted from May 1 to June 30, 2017. A systematic random sampling was used to select 422 households. Two days training was given for data collectors and supervisors. Collected data were coded and entered using epi-data version 3.1, then it was exported to Statistical Package for Social Science (SPSS) version 20. After bivariate logistic regression analysis, all variables with a p-value less than or equal to 0.25was entered into multivariable logistic regression and p value < 0.05 considered as significantly associated with the outcome variable. ResultsUtilization of LLITN was 33.6%. Factors such as attending antenatal care [adjusted odd ratio (AOR) =1.89; 95% CI; 1.04-3.44], traveling <1 hour to reach health facility AOR=4.41; 95% CI; 2.06-9.43], age ≥ 35 year [AOR= 3.67; 95% CI; 1.36-9.95], knowledge [AOR=11.68; 95% CI; 5.96-22.89] and having positive attitude [AOR=3.12; 95 CI; 1.66-5.88] were significantly associated with utilization of LLITN.ConclusionThis study showed that low utilization of LLITN. Attending antenatal care (ANC), traveling <1 hour to reach health facility, age ≥ year, knowledge and attitude had positive association with LLITN utilization. Every concerned body should focus on reducing distance barrier by giving outreach services and increasing ANC, the attitude and knowledge of pregnant women toward malaria and LLITN which might increase utilization of LLITN.

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65 Mama na Mtoto: Health Outcome Achievements Following Implementation of Comprehensive Maternal Newborn Programming in Rural Tanzania

Paediatrics & Child Health ◽

10.1093/pch/pxaa068.064 ◽

2020 ◽

Vol 25 (Supplement_2) ◽

pp. e27-e27

Author(s):

Jennifer L Brenner ◽

Dismas Matovelo ◽

Boniphace Maendaelo ◽

Wemaeli Mweteni ◽

Nalini Singhal ◽

...

Keyword(s):

Health Outcomes ◽

Health Facility ◽

Postnatal Care ◽

Health Workers ◽

Scale Up ◽

Newborn Care ◽

Health Facilities ◽

Care Seeking ◽

Essential Newborn Care ◽

Facility Readiness

Abstract Introduction/Background Preventable deaths in pregnant women and newborns remain unacceptably high in East Africa. Limited antenatal, delivery and postnatal care-seeking combined with service delivery gaps at government facilities contribute to high mortality. Between 2016-2019, partners from Tanzania, Uganda, and Canada jointly developed, implemented, and evaluated a comprehensive, district-wide maternal, newborn, and child health (MNCH) ‘package’ in Lake Zone, Tanzania. Known locally as ‘Mama na Mtoto’, the scale-up programming involved training and capacity building for district managers, health facility staff and a network of volunteer community health workers selected by their own communities. Objectives To quantitatively assess changes in MNCH health outcomes following the Mama na Mtoto intervention. Design/Methods MNCH household-level care-seeking outcomes were assessed using a pre/post coverage survey adapted from the Demographic Health Survey. Households and women (15-49 years), selected through cluster sampling (cluster unit=hamlet), were surveyed by local, trained research assistants using tablet-based surveys. MNCH service outcomes were assessed at all government health facilities using a comprehensive pre/post cross-sectional audit tool; key measures included staff, equipment, infrastructure, supplies, and medication availability. Descriptive statistics for antenatal care (ANC), health facility delivery (HFD), and postnatal care (PNC)-related indicators were analyzed pre- and post-intervention using R software. Composite health facility ‘Readiness Scores’ were calculated through tallies of relevant itemized facility-based measures for each core MNCH service area across the district. Absolute percentage differences, confidence intervals and design effect are presented where relevant. Results In total, 1,977 households, 2,438 women, and 45 health facilities were surveyed pre-intervention and 1,835 homes, 2,073 women, and 49 health facilities were surveyed post. Care-seeking indicators with statistically significant changes were ANC 4+ (+11%), ANC <12 weeks (+7%), HFD (+17%), and PNC for mothers (+9%); PNC for babies was not significant. Increases in composite MNCH Service Readiness Scores were as follows: ANC +24%, essential newborn care +42%, newborn resuscitation +37%, and labour and delivery +27%. Conclusion The comprehensive MnM package was associated with important improvements in the demand (care-seeking) and service (facility readiness) health outcomes. Attribution is complicated by an uncontrolled health system and lack of district controls; however, the extensive scope, reach, and positive changes are promising and consistent with sustained Ugandan experiences. Best practice documentation is critical to facilitate scale-up and progress acceleration of MNCH programs in Tanzanian and East African settings.

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Utilization of Long-Lasting Insecticide Treated Net and Associated Factors Among Pregnant Women in Malarious Kebeles in Awabel District, North-West Ethiopia, 2017

10.21203/rs.3.rs-26383/v1 ◽

2020 ◽

Author(s):

Mengistie Kassahun Tariku ◽

Zewdu Dagnew ◽

Sewnet Wongiel Misikir ◽

Abebe Habtamu Belete

Keyword(s):

Logistic Regression ◽

Antenatal Care ◽

Pregnant Women ◽

Health Facility ◽

Associated Factors ◽

Outcome Variable ◽

P Value ◽

Cross Sectional ◽

North West ◽

North West Ethiopia

Abstract Background: Utilization of long-lasting insecticide treated net (LLITN) is one of the main vector control activities. It has a killing, repellent and physical barrier effects against mosquito. Even if priority is given for pregnant women, not all nets owned by household have been utilized by pregnant women. The objective of the study was to assess utilization of Long-lasting insecticidal net and associated factors among pregnant women in malarious kebeles, Awabel woreda, North-West Ethiopia. Methods: A community-based cross-sectional study was conducted from May 1 to June 30, 2017. A systematic random sampling was used to select 422 households. Two days training was given for data collectors and supervisors. Collected data were coded and entered using epi-data version 3.1, then it was exported to Statistical Package for Social Science (SPSS) version 20. After bivariate logistic regression analysis, all variables with a p-value less than or equal to 0.25was entered into multivariable logistic regression and p value < 0.05 considered as significantly associated with the outcome variable. Results: Utilization of LLITN was 33.6%. Factors such as attending antenatal care [adjusted odd ratio (AOR) =1.89; 95% CI; 1.04-3.44], traveling <1 hour to reach health facility AOR=4.41; 95% CI; 2.06-9.43], age [AOR= 3.67; 95% CI; 1.36-9.95], knowledge[AOR=11.68; 95% CI; 5.96-22.89] and having positive attitude [AOR=3.12; 95 CI; 1.66-5.88] were significantly associated with utilization of LLITN. Conclusion: This study showed that low utilization of LLITN. Attending antenatal care (ANC), traveling <1 hour to reach health facility, age , knowledge and attitude had positive association with LLITN utilization. Every concerned body should focus on reducing distance barrier by giving outreach services and increasing ANC, the attitude and knowledge of pregnant women toward malaria and LLITN which increase utilization of LLITN. Key words : LLITN utilization, pregnant women, malarious kebeles, Awable, Ethiopia

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Penanganan Issu Terkait Keselamatan Pasien di Rumah Sakit

10.31219/osf.io/z4yw8 ◽

2020 ◽

Author(s):

Kristin Natal Riang Gea

Keyword(s):

Patient Safety ◽

Health Workers ◽

Sampling Technique ◽

Good Health ◽

Bivariate Analysis ◽

P Value ◽

Patient Identification ◽

Cross Sectional ◽

The Right ◽

The Relationship

AbstrakKeselamatan pasien merupakan dasar dari pelayanan kesehatan yang baik. Pengetahuan tenaga kesehatan dalam sasaran keselamatan pasien terdiri dari ketepatan identifikasi pasien, peningkatan komunikasi yang efektif, peningkatan keamanan obat yang perlu diwaspadai, kepastian tepat lokasi, prosedur, dan tepat pasien operasi, pengurangan risiko infeksi, pengurangan risiko pasien jatuh. Tujuan penelitian untuk mengetahui hubungan antara pengetahuan dengan penerapan keselamatan pasien pada petugas kesehatan di Puskesmas Kedaung Wetan Kota Tangerang. Metode Penelitian menggunakan deskriptif korelasi menggunakan pendekatan cross sectional. Populasi sebanyak 50 responden. Teknik pengambilan sampel menggunakan total sampling. Instrumen yang digunakan berupa lembar kuesioner. Teknik analisa diatas menggunakan analisa Univariat dan Bivariat. Hasil Penelitian ada Hubungan Pengetahuan dengan Penerapan Keselamatan Pasien pada Petugas Kesehatan, dengan hasil, p value sebesar 0,013 < 0,05 maka dapat disimpulkan bahwa ada Hubungan Pengetahuan dengan Penerapa Keselamatan Pasien pada Petugas Kesehatan. Kesimpulan penelitian ada Hubungan Pengetahuan dengan Penerapan Keselamatan Pasien.. AbstrackPatient safety is the basis of good health services. Knowledge of health personnel in patient safety targets consists of accurate patient identification, increased effective communication, increased safety of the drug that needs to be watched, certainty in the right location, procedure, and precise patient surgery, reduction in risk of infection, reduction in risk of falling patients. The purpose of this study was to determine the relationship between knowledge and the application of patient safety to health workers in the Kedaung Wetan Health Center, Tangerang City. The research method uses descriptive correlation using cross sectional approach. The population is 50 respondents. The sampling technique uses total sampling. The instrument used was a questionnaire sheet. The analysis technique above uses Univariate and Bivariate analysis. The results of the study there is a Relationship of Knowledge with the Implementation of Patient Safety in Health Officers, with the result, p value of 0.013 <0.05, it can be concluded that there is a Relationship between Knowledge and Patient Safety Implementation in Health Officers. The conclusion of the study is the Relationship between Knowledge and the Implementation of Patient Safety.Keywords Knowledge, Patient safety, Health workers

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ANALISIS HUBUNGAN SARANA, PENGETAHUAN, DAN SIKAP BIDAN PRAKTIK MANDIRI DENGAN KEPATUHAN MENJALANKAN STANDAR PELAYANAN ANTENATAL CARE DI KOTA PADANGSIDIMPUAN

Jurnal Penelitian Kebidanan & Kespro ◽

10.36656/jpk2r.v2i1.178 ◽

2019 ◽

Vol 2 (1) ◽

pp. 27-33

Author(s):

Megawati Sinambela ◽

Evi Erianty Hasibuan

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Antenatal Care ◽

Pregnant Women ◽

Logistic Regression Analysis ◽

Care Service ◽

Multivariate Logistic Regression Analysis ◽

Bivariate Analysis ◽

Cross Sectional ◽

The North

Antenatal care is a service provided to pregnant women to monitor, support maternal health and detect mothers whether normal or problematic pregnant women. According to the WHO, globally more than 70% of maternal deaths are caused by complications of pregnancy and childbirth such as hemorrhage, hypertension, sepsis, and abortion. Based on data obtained from the profile of the North Sumatra provincial health office in 2017, in the city of Padangsidimpuan in 2017 the coverage of ANC visits reached (76.58%) and had not reached the target in accordance with the 2017 Provincial Health Office strategy plan (95%). This type of research was an observational analytic study with a cross sectional design. The population in this study were independent practice midwives who were in the Padangsidimpuan, the sample in this study amounted to 102 respondents. The technique of collecting data used questionnaires and data analysis used univariate, bivariate and multivariate analysis with logistic regression analysis. Based on bivariate analysis showed that there was a relationship between facilities, knowledge and attitudes of independent midwives with compliance with the standards of antenatal care services with a value of p <0.05. The results of the study with multivariate logistic regression analysis showed that the factors associated with the compliance of independent midwives in carrying out antenatal care service standards were attitudes with values (p = 0.026).

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