scholarly journals A Multilevel Bayesian Markov Chain Monte Carlo Poisson Modelling of Factors Associated With Number of Components of Antenatal Care Offered Pregnant Women In Nigeria

2021 ◽  
Author(s):  
Adeniyi Francis Fagbamigbe ◽  
Omon Stellamaris Fagbamigbe ◽  
Olugbenga Sunday Olaseinde ◽  
Oluwasomidoyin O. Bello ◽  
Vincent Setlhare ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Monte Carlo ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Blood Test ◽  
Urine Test ◽  
Iron Supplement ◽  
Number Of Components ◽  
Danger Signs

Abstract Background: The most recent WHO guideline on antenatal care (ANC) utilization reaffirmed the necessary and compulsory care and services a pregnant woman should receive to maximize the importance and gains of ANC. While most studies focused on the time of initiation and number of ANC contacts, emphasis was rarely placed on the components of ANC offered women. This study assessed the number of components of ANC received by pregnant women as a proxy for the quality of ANC services offered in Nigeria. We also assessed the clustering of the components and within-country differentials and inequalities in the components of ANC received in Nigeria.Methods: We used nationally representative cross-sectional data from the 2018 Nigeria Demographic Health Survey. We analysed data of 11867 women who had at least one ANC contacts during the most recent pregnancy within five years preceding the survey. The assessed components were tetanus injection, blood pressure, urine test, blood test, iron supplement, malaria intermittent preventive treatment in pregnancy (IPTp), and told about danger signs. Others are intestinal parasite drugs (IPD)intermittent and HIV/PMTCT counsel. Descriptive statistics, bivariable and multivariable multilevel Bayesian Monte Carlo Poisson model were used. Results: In all, 94% had blood pressure measured, 91% received tetanus injection, had iron supplement-89%, blood test-87%, urine test-86%, IPTp-24%, danger signs-80%, HIV/PMTC-82% and IPD-22%. The overall prevalence of receiving all 9 components was 5% and highest in Ogun (24%) and lowest in Kebbi (0.1%). The earlier the initiation of ANC, the higher the number of contacts, and the higher the quality of ANC received. Respondents with higher education have 4% (adjusted incidence risk ratio (aIRR): 1.04, 95% credible interval (CrI): 1.01-1.09) higher risk of receiving more components of ANC relative to those with no education. The risk of receiving more ANC components were 5% (aIRRR: 1.05, 95% CI: 1.01-1.10) higher among pregnant women aged 40 to 49 years than those aged 15 to 19 years. Women who decide their healthcare utilization alone had 2% higher risk of getting more components than those whose spouses are the only decision taker of health care use. Other significant factors were household wealth status, spouse education, ethnicity, place of ANC, and skill of ANC provider. Pregnant women who had their blood pressure measured were very likely to have blood and urine tests, tetanus injection, iron supplement, and HIV talks.Conclusions: Only one in every 20 pregnant women received all the 9 ANC components with wide disparities and inequalities across the background characteristics and the States of residence in Nigeria. There is a need to ensure that all pregnant women receive adequate components. Stakeholders should increase supplies, train, and create awareness among ANC providers and pregnant women in particular.

scholarly journals Quality of antenatal care and associated factors in a rural county in Kenya: an assessment of service provision and experience dimensions

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Patience A. Afulani ◽  
Laura Buback ◽  
Francisca Essandoh ◽  
Joyceline Kinyua ◽  
Leah Kirumbi ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Antenatal Care ◽  
Service Provision ◽  
Blood Pressure Monitoring ◽  
Urine Test ◽  
Information Communication ◽  
Experience Of Care ◽  
The Individual ◽  
Recommended Services

Abstract Background This study aimed to assess the quality of antenatal care (ANC) women received in Migori county, Kenya—including both service provision and experience dimensions—and to examine factors associated with each dimension. Methods We used survey data collected in 2016 in Migori county from 1031 women aged 15–49 who attended ANC at least once in their most recent pregnancy. ANC quality service provision was measured by nine questions on receipt of recommended ANC services, and experience of care by 18 questions on information, communication, dignity, and facility environment. We summed the responses to the individual items to generate ANC service provision and experience of care scores. We used both linear and logistic regression to examine predictors. Results The average service provision score was 10.9 (SD = 2.4) out of a total of 16. Most women received some recommended services once, but not at the frequency recommended by the Kenyan Ministry of Health. About 90% had their blood pressure measured, and 78% had a urine test, but only 58 and 14% reported blood pressure monitoring and urine test, respectively, at every visit. Only 16% received an ultrasound at any time during ANC. The average experience score is 27.3 (SD = 8.2) out of a total score of 42, with key gaps demonstrated in communication. About half of women were not educated on pregnancy complications. Also, about one-third did not often understand the purposes of tests and medicines received and did not feel able to ask questions to the health care provider. In multivariate analysis, women who were literate, employed, and who received all their ANC in a health center had higher experiences scores than women who were illiterate (coefficient = 1.52, CI:0.26,2.79), unemployed (coefficient = 2.73, CI:1.46,4.00), and received some ANC from a hospital (coefficient = 1.99, CI: 0.84, 3.14) respectively. The wealthiest women had two times higher odds of receiving an ultrasound than the poorest women (OR = 2.00, CI:1.20,3.33). Conclusion Quality of ANC is suboptimal in both service provision and experience domains, with disparities by demographic and socioeconomic factors and facility type. More efforts are needed to improve quality of ANC and to eliminate the disparities.

Quantifying Pregnant Women’s Knowledge of Educational Components of Antenatal Care in Lesotho

2019 ◽  
Vol 21 (1) ◽  
Author(s):  
Tabeta Seeiso ◽  
Mamutle M. Todd-Maja
Keyword(s):  
Antenatal Care ◽  
Maternal Mortality ◽  
Pregnant Women ◽  
Rural Areas ◽  
Geographic Location ◽  
Sub Saharan Africa ◽  
World Health ◽  
Cross Sectional ◽  
Danger Signs ◽  
In Pregnancy

Antenatal care (ANC) literacy is particularly important for pregnant women who need to make appropriate decisions for care during their pregnancy and childbirth. The link between inadequate health literacy on the educational components of ANC and maternal mortality in sub-Saharan Africa (SSA) is undisputable. Yet, little is known about the ANC literacy of pregnant women in SSA, with most studies inadequately assessing the four critical components of ANC literacy recommended by the World Health Organization, namely danger signs in pregnancy; true signs of labour; nutrition; and preparedness for childbirth. Lesotho, a country with one of the highest maternal mortality rates in SSA, is also underexplored in this research area. This cross-sectional study explored the levels of ANC literacy and the associated factors in 451 purposively sampled women in two districts in Lesotho using a structured questionnaire, making recourse to statistical principles. Overall, 16.4 per cent of the participants had grossly inadequate ANC literacy, while 79.8 per cent had marginal levels of such knowledge. The geographic location and level of education were the most significant predictors of ANC literacy, with the latter variable further subjected to post hoc margins test with the Bonferroni correction. The participants had the lowest scores on knowledge of danger signs in pregnancy and true signs of labour. Adequate ANC literacy is critical to reducing maternal mortality in Lesotho. Improving access to ANC education, particularly in rural areas, is recommended. This study also provides important recommendations critical to informing the national midwifery curriculum.

EFFECTIVENESS OF USING MCH BOOKS AND MONSCA APPLICATIONS IN THE IMPLEMENTATION OF 14 T ANTENATAL SERVICE STANDARDS

2020 ◽  
Vol 12 (1) ◽  
pp. 68-73
Author(s):  
Rahmawati Rahmawati ◽  
Syarif Syafruddin ◽  
Nontji Wena
Keyword(s):  
Antenatal Care ◽  
Pregnant Women ◽  
Continuity Of Care ◽  
Control Design ◽  
Sampling Technique ◽  
Limited Time ◽  
Control Groups ◽  
Post Test ◽  
Service Standards

The component of antenatal care received by pregnant women is classified as incomplete because the implementation of standard pregnancy services is still using conventional methods. There are obstacles faced by midwives, such as the limited time in a recording, which has an impact on the declining quality of antenatal care standards. This research aims to compare the effectiveness of the use of KIA books and MONSCA applications in midwives in the application of the standard Antenatal service 14 T. This research was conducted in Puskesmas Tanete and Puskesmas Bontobangun Bulukumba District. The method used in the study is experimental quasi (pre-test post-test nonequivalent control design). Using a sample of midwives in this study, as many as 36 people were divided into two groups (18 intervention groups and 18 control groups). The sampling technique in this study used purposive sampling. Data were analyzed using the Mann-Whitney Test. The results showed that there was a difference in the effectiveness of using KIA books with MONSCA applications, MOSCA's applications were easier to use, faster, safer, and more accurate than KIA books. It can be concluded that the MONSCA application is more effective than KIA books. Key words: Effectiveness, Android-based Smart Continuity of Care application, KIA book, Antenatal service 14 T

The Effect of Counselling Intervention during Antenatal Care on the Knowledge and Attitude about Danger Signs in Pregnancy: A Cross-Sectional Study in Takalar Regency -

2020 ◽  
Vol 10 (2) ◽  
pp. 51-55
Author(s):  
Nurhikmah ◽  
Tahir Abdullah ◽  
Stang ◽  
Suriah ◽  
Andi Imam Arundhana ◽  
...  
Keyword(s):  
Health Service ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Community Health ◽  
Health Workers ◽  
Community Health Service ◽  
Cross Sectional ◽  
Danger Signs ◽  
Knowledge And Attitude ◽  
In Pregnancy

Objective: This study was to examine the effects of counselling delivered during antenatal care on the knowledge and attitudes of pregnant women about danger signs in pregnancy.Methods: This was a pre-experimental design using one group pre- and post-test only. This study was conducted in Takalar, specifically within Sanrobone Community Health Service working area. Takalar is located in South Sulawesi Province Indonesia and this area is coastal with the majority of people working as a fisherman. Participants of this study were pregnant women living in the villages which are included in the working area of Sanrobone Community Health Service.Results: The study shows that counselling improved knowledge and attitude of pregnant women about danger signs in pregnancy (p=0.011 and p=0.025, respectively). The number of pregnant women with good knowledge and positive attitude increased after the intervention (43.8% vs 93.8%, 62.5% vs 93.8%, respectively).Conclusions: In can be concluded that intervention by means of counselling can improve the knowledge and attitude of pregnant women about danger signs in pregnancy. Therefore, it is important to implement the counselling program delivered by health workers in Community Health Service in order to mitigate the risk of maternal mortality.

scholarly journals Analisis Faktor yang Berhubungan dengan Kinerja Bidan dalam Memberikan Pelayanan Antenatal Berkualitas Diwilayah Kerja Puskesmas Kota Bukittinggi Tahun 2018

2019 ◽  
Vol 19 (1) ◽  
pp. 53
Author(s):  
Khairan Nisa ◽  
Joserizal Serudji ◽  
Delmi Sulastri
Keyword(s):  
Data Analysis ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Monitoring And Evaluation ◽  
Dominant Factor ◽  
The Public ◽  
Depth Interview ◽  
Quantitative Data Analysis

Quality antenatal care has a major role in reducing maternal mortality. Every effort to improve quality must also be accompanied by efforts to pay attention to factors that contribute to improving the performance of midwives in providing services. The study used a combination of quantitative approaches in 67 midwives in the Bukittinggi and qualitatively in 15 informants, of which 9 people included in-depth interview informants to coordinator midwives, head of the Public health center and staffing and 6 FGD informants to midwives on duty at the health center.The results of quantitative data analysis, factors related to the performance of midwives are incentives, motivation and workload. Motivation is the most dominant factor related to the performance of midwives. The results of qualitative data analysis, the leadership plays an important role in increasing motivation to work midwives and optimizing the role of midwives in overcoming problems related to overlapping workloads. Midwives also need to increase their participation efforts and empower pregnant women so that programs can run well and provide positive feedback for improving the health status of pregnant women. Basically antenatal services provided by midwives are in accordance with standards, but the paradigm of antenatal care for pregnant women must shift from achieving quantity to focus on quality. To improve the performance of midwives in providing antenatal care, several efforts are needed: monitoring and evaluation of the quality of antenatal care by midwives, leadership involvement in efforts to increase midwife motivation both from supervision and reward management in non-material forms. Providing equal opportunities for midwives to improve competence through training, especially training related to quality antenatal care. In addition, the provision of infrastructure at the polindes needs attention. 

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 Do the quality of health care services provided at personal health care institutions of Kaunas city and access to it meet expectations of pregnant women

Medicina ◽  
2009 ◽  
Vol 45 (8) ◽  
pp. 652 ◽  
Author(s):  
Virginija Vanagienė ◽  
Birutė Žilaitienė ◽  
Tadas Vanagas
Keyword(s):  
Health Care ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Quality Of Health Care ◽  
Response Rate ◽  
Care Facility ◽  
Family Physicians ◽  
Personal Health ◽  
Health Care Institutions

Objectives. To evaluate if the quality of services provided by family physicians and obstetricians/gynecologists at primary personal health care institutions of Kaunas city and access to it meet the needs and expectations of pregnant women. Material and methods. Pregnant women visiting the selected health care institutions at their third trimester of pregnancy were asked to fill in the anonymous questionnaire. The study was conducted at two randomly selected maternity centers of Kaunas city and two family practices of Kaunas city where antenatal care was provided by family physicians. The questionnaires were given to 106 patients visiting family physicians (response rate was 88.7%) and to 202 patients visiting obstetricians/ gynecologists (response rate was 81.7%). Results. Health services provided by family physicians and obstetricians/gynecologists met the expectations of pregnant women in respect of providing with information and communication. The patients of obstetricians/gynecologists significantly more often stated that they were very satisfied with patient-physician communication (P<0.05), they significantly more often understood explanations given by the physician (P<0.001) and claimed having sufficient knowledge about pregnancy (P<0.05), while the patients of family physicians significantly more often asserted that the physician helped them in preparation for childbirth (P<0.05). The patients of obstetricians/gynecologists significantly more often did not face any problems with access to services as compared to the patients of family physicians (z=3.0). Most of pregnant women stated that they were satisfied or very satisfied with the quality of health care at the health care facility providing them with antenatal care irrespective of the physician’s specialty. Conclusions. The quality of antenatal health care provided by both family physicians and obstetricians/gynecologists and access to it satisfied the needs and expectations of the surveyed women. Correction of the limitations noticed, e.g., closer communication, more understandable explanations, more attention to preparation for childbirth, better work planning, could improve the quality of antenatal care provided by the family physicians.

scholarly journals Factors Related to the Quality of Antenatal Care Based on The Complete Scope of the Examination of Pregnant Women in the Health Center at Palopo City

2019 ◽  
Vol 3 (3S) ◽  
pp. 84-89
Author(s):  
Dian Furqani ◽  
Nuraerni Semagga
Keyword(s):  
Antenatal Care ◽  
Pregnant Women ◽  
Gestational Age ◽  
Statistical Significance ◽  
P Value ◽  
Service Access ◽  
Maternal Knowledge ◽  
Cross Sectional ◽  
Maternal Characteristics

This study aims to see the factors that influence the quality of Antenatal Care in the City of Palopo; the type of design used is analytical descriptive with the Cross-Sectional Study approach. Samples from this study were all pregnant women based on 1, 2 and 3th-trimester pregnancy age, and 3 who were lived at the research location as many as 154 people who conducted inspection visits from January to March 2018. The results showed that the average age of the mother was 20 years. In the research statisticallly interconnected variables are maternal knowledge showed p-value (0.000). There are several variables have statistical significance, but there are differences in the percentage between the classification of each variabels as for the quality of Antenatal care associated with parity, maternal characteristics (age, education and occupation), antenatal care in each of the 1.2 trimester, and 3. Service access and economic welfare status, where each variable has a p-value> 0.005. The study expects that a health program should not look the quantity of maternal pregnancy visits, but pay attention to the examination checks received at each gestational age. We hope to encourage mothers to be more active in paying attention to the examinations that will be accepted based on their gestational age so that good health services and of recipients of services occur.

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