Poor quality of antenatal care services—Is lack of competence and support the reason? An observational and interview study in rural areas of Lao PDR

Midwifery ◽  
2013 ◽  
Vol 29 (3) ◽  
pp. 195-202 ◽  
Author(s):  
Chanthanom Manithip ◽  
Kerstin Edin ◽  
Amphoy Sihavong ◽  
Rolf Wahlström ◽  
Hans Wessel
Keyword(s):  
Antenatal Care ◽  
Rural Areas ◽  
Lao Pdr ◽  
Poor Quality ◽  
Interview Study ◽  
Care Services

scholarly journals Piecing the evidences: Barriers to utilization of Antenatal Care Services by Currently Married Women in Rural Uttarakhand- A community-based study

2020 ◽  
Vol 32 (1) ◽  
pp. 114-119
Author(s):  
Ruchi Juyal ◽  
Jayanti Semwal ◽  
Sunil Dutt Kandpal ◽  
Ashok Kumar Srivastava ◽  
Deep Shikha ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Rural Areas ◽  
Economic Status ◽  
Married Women ◽  
Chi Square ◽  
Services Utilization ◽  
Care Services ◽  
Chi Square Test ◽  
Area Of Concern

Background: High maternal mortality has always been an area of concern in developing countries. Availability and availment of adequate antenatal care play a significant role in reduction of maternal deaths. Aim & Objective: To know the extent of antenatal care (ANC) services utilization by the currently married women of rural Uttarakhand during their last pregnancy, to find the barriers for utilization of ANC services and correlate the socio-demographic variables with the non-utilization of ANC services. Methods and Material: This correlational study was conducted in rural areas of 3 randomly selected districts in Uttarakhand. Multistage stratified and simple random samplings were used for area selection and PPS technique was used to recruit the participants. Overall, 637 currently married women (CMW) who delivered in last 5 years prior to survey, were interviewed by trained social workers. Chi-square test was used to ascertain association between variables and regression analysis was done to adjust for confounding associations. Results: Overall 496 (77.9%) women availed one or more ANC services during their last pregnancy, but the complete package was availed by only 210 (33%) of the CMW. Majority of the women who did not avail any ANC services were older, illiterate, labourer, spouse of labourer/ unemployed person and belonged to lower socio-economic status. Unawareness was the most commonly cited reason for not availing ANC services followed by financial issues and unfelt need. Conclusions: Women in Uttarakhand are pliant to ANC services, but there is a need to create demand for it by increasing awareness and improving the quality of ANC services.

Assessment of patient satisfaction and perception of quality of antenatal care services among pregnant women attending antenatal clinics at a secondary health care facility in Anambra State, Nigeria.

2021 ◽  
Vol 3 (1) ◽  
pp. 025-034
Author(s):  
Chigozie Joseph Ezeoke ◽  
Onyeka Chukwudalu Ekwebene ◽  
Tyotswam Simeone Yanmeer ◽  
Chioma Favour Ekwebene ◽  
Chigbo Chisom God’swill ◽  
...  
Keyword(s):  
Quality Of Service ◽  
Patient Satisfaction ◽  
Child Health ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Rural Areas ◽  
Anambra State ◽  
Care Services ◽  
And Child Health

Introduction: Prenatal care is an important component of maternal care worldwide more so in sub-Saharan Africa. Methodology: This work is a cross-sectional descriptive study carried out among 170 pregnant women attending antenatal clinic in health facilities in Ekwulobia, Anambra state. Convenience sampling technique was used in this study. The study instrument was a semi structured interviewer administered questionnaire which was developed according to the objectives of the study. In this study we evaluated patient waiting time, pregnancy outcome, quality of care, attitude of staff and facility neatness as parameters for measuring patient satisfaction, we also evaluated quality of service, attitude of staff, proximity to ANC centre, waiting time and cost as determinants of ANC use. Result: The study showed a demonstration of good knowledge of ANC and its importance in maternal and child health, 65.6% were aware of first trimester has the most appropriate time for ANC booking. A high level of satisfaction was recorded among the participants, 65.6% rated the ANC services as very good and 30.3% rated the service as good. Conclusion: Pregnant women in rural areas in eastern Nigeria receive quality and accessible antenatal care services and majority of the women are satisfied with the quality of service. Efforts to improve maternal and child health status in Eastern Nigeria is yielding fruit especially in rural areas. It is recommended that similar studies studies be conducted in other parts for the country to discover the conditions of ANC use and i effects and compare the factors that influence ANC use

Content of antenatal care and perception about services provided by primary hospitals in Nepal: a convergent mixed methods study

2021 ◽  
Vol 33 (2) ◽  
Author(s):  
Yubraj Acharya ◽  
Nigel James ◽  
Rita Thapa ◽  
Saman Naz ◽  
Rishav Shrestha ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Mixed Methods ◽  
Antenatal Care ◽  
Quality Care ◽  
National Level ◽  
Poor Quality ◽  
Public Hospitals ◽  
World Health ◽  
Outcome Variable

Abstract Background Nepal has made significant strides in maternal and neonatal mortality over the last three decades. However, poor quality of care can threaten the gains, as maternal and newborn services are particularly sensitive to quality of care. Our study aimed to understand current gaps in the process and the outcome dimensions of the quality of antenatal care (ANC), particularly at the sub-national level. We assessed these dimensions of the quality of ANC in 17 primary, public hospitals across Nepal. We also assessed the variation in the ANC process across the patients’ socio-economic gradient. Methods We used a convergent mixed methods approach, whereby we triangulated qualitative and quantitative data. In the quantitative component, we observed interactions between providers (17 hospitals from all 7 provinces) and 198 women seeking ANC and recorded the tasks the providers performed, using the Service Provision Assessments protocol available from the Demographic and Health Survey program. The main outcome variable was the number of tasks performed by the provider during an ANC consultation. The tasks ranged from identifying potential signs of danger to providing counseling. We analyzed the resulting data descriptively and assessed the relationship between the number of tasks performed and users’ characteristics. In the qualitative component, we synthesized users’ and providers’ narratives on perceptions of the overall quality of care obtained through focus group discussions and in-depth interviews. Results Out of the 59 tasks recommended by the World Health Organization, providers performed only 22 tasks (37.3%) on average. The number of tasks performed varied significantly across provinces, with users in province 3 receiving significantly higher quality care than those in other provinces. Educated women were treated better than those with no education. Users and providers agreed that the overall quality of care was inadequate, although providers mentioned that the current quality was the best they could provide given the constraints they faced. Conclusion The quality of ANC in Nepal’s primary hospitals is poor and inequitable across education and geographic gradients. While current efforts, such as the provision of 24/7 birthing centers, can mitigate gaps in service availability, additional equipment, infrastructure and human resources will be needed to improve quality. Providers also need additional training focused on treating patients from different backgrounds equally. Our study also points to the need for additional research, both to document the quality of care more objectively and to establish key determinants of quality to inform policy.

scholarly journals Quality of antenatal care services in Rwanda: assessing practices of health care providers

2018 ◽  
Vol 18 (1) ◽  
Author(s):  
Akashi Andrew Rurangirwa ◽  
Ingrid Mogren ◽  
Joseph Ntaganira ◽  
Kaymarlin Govender ◽  
Gunilla Krantz
Keyword(s):  
Health Care ◽  
Antenatal Care ◽  
Health Care Providers ◽  
Care Providers ◽  
Care Services

scholarly journals Exploring the pregnant women’s perspective of late booking of antenatal care services at Mbekweni Health Centre in Eastern Cape, South Africa

2018 ◽  
Vol 10 (1) ◽  
Author(s):  
Ramprakash Kaswa ◽  
George F.D. Rupesinghe ◽  
Benjamin Longo-Mbenza
Keyword(s):  
South Africa ◽  
Qualitative Study ◽  
Antenatal Care ◽  
Integrated Management ◽  
Health Centre ◽  
Poor Quality ◽  
Eastern Cape ◽  
Structured Interviews ◽  
Care Services ◽  
Late Booking

Background: Antenatal care (ANC) services are the gateway for integrated management of several conditions that adversely affect the mother and foetus. More stillbirths than neonatal deaths in South Africa are a reflection of poor quality ANC services. Aim: The primary aim of this study was to explore the reasons for late booking, and also to determine pregnant women’s knowledge, perceptions and attitude towards antenatal care services they receive in Mthatha area in Eastern Cape, South Africa. Setting: This was a qualitative study, conducted at Mbekweni Health Centre in the King Sabata Dalindyebo (KSD) subdistrict municipality of the Eastern Cape Province. Methods: This qualitative study consisted of selected pregnant women who presented after 19 weeks of gestation at Mbekweni Health Centre. Data were collected through two different methods, namely, semi-structured interviews and focus group discussions were used until saturation of the themes were reached. The interviews were transcribed verbatim and thematic analyses were undertaken. Results: Twenty women participated in the study. They were diverse in terms of age 18–41 years, gravidity 1–6 and time of ANC booking 20–28 weeks. The interviews identified a variety of personal, service and organisational reasons for late ANC booking. The themes identified for late ANC bookings were: health care system related issues, socio-economic factors, women’s perceptions and knowledge, and failure of family planning services. Conclusions: Women’s beliefs, knowledge and perceptions regarding antenatal services outweigh the perceived benefit of early ANC visit. The majority of women had lack of knowledge of contraception, early signs of pregnancy, purpose, timing and benefits of ANC visit.

scholarly journals Utilization of antenatal care services and its sociodemographic correlates in urban and rural areas in Delhi, India

2021 ◽  
Vol 5 (September) ◽  
pp. 1-5
Author(s):  
Ruchir Rustagi ◽  
Saurav Basu ◽  
Suneela Garg ◽  
Mongjam Singh ◽  
Y. Mala
Keyword(s):  
Antenatal Care ◽  
Rural Areas ◽  
Care Services ◽  
Sociodemographic Correlates ◽  
Urban And Rural Areas

scholarly journals The Correlation of Maternal Factors and The Quality of Antenatal Care Services With Low Birth Weight Babies In Health Facilities Level I

2018 ◽  
Vol 3 (1) ◽  
pp. 103
Author(s):  
Wira Meiriza ◽  
Aladin Aladin ◽  
Edison Edison
Keyword(s):  
Birth Weight ◽  
Maternal Health ◽  
Nutritional Status ◽  
Antenatal Care ◽  
Maternal Age ◽  
Economic Status ◽  
Maternal Factors ◽  
Care Services ◽  
Low Birth Weight Babies

Infant Mortality Rate in West Sumatra still increased from 96 cases in 2015 becomes 111 cases in 2016. One of the contributors to this was the case of Low Birth Weight Babies (LBWB), wich is birth weight < 2500 grams. Causative factors of LBWB are derived from maternal factors because it is related to fetal growth, starting from the moment of conception until the baby is born. Maternal health is very influential towards the growth and development of the fetus. In addition, Antenatal Care is also require to monitor maternal health. Antenatal service care quality can detect the occurrence of risk in pregnancy. This study aims to determine the relationship of maternal factors based on maternal age, parity, distance of pregnancy, complications of pregnancy, economic status, nutritional status, anemia status, antenatal care implementation and the quality of antenatal care services with LBWB incidence on health facilities level 1 in Padang City.This study used a comparative cross-sectional design totalling 72 respondents consisting of a group of mothers who gave birth to babies with birth weight < 2500 grams and ≥ 2500 grams using consecutive sampling technique. Then conducted interviews and observations by using questionnaires as well as data processing were carried out using SPSS. The results showed there was a correlation between pregnancy complications (p = 0.033), anemia status (p = 0.016) and the implementation of antenatal care (p = 0.000) with the incidence of LBWB, while the unrelated were maternal age (p = 0.405), parity (p = 1,000), pregnancy distance (p = 1,000), economic status (p = 0.637), nutritional status (p = 0.326), and quality of antenatal care services (p = 0.812).The conclusion of this study is that there is no correlation between the quality of antenatal care services and the incidence of LBWB, and the implementation of antenatal care is the dominant factor related with the incidence of LBWB in Padang City.

Chemotherapy at the end of life: Do we know when to stop?

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e24005-e24005
Author(s):  
Renana Barak ◽  
Einav Zagagi Yohay ◽  
Barliz Waissengrin ◽  
Ido Wolf
Keyword(s):  
End Of Life ◽  
Disease Duration ◽  
Performance Status ◽  
Poor Quality ◽  
Palliative Intent ◽  
Care Services ◽  
Palliative Care Services ◽  
Eol Care ◽  
Oncologic Treatment

e24005 Background: Aggressive end-of-life (EOL) care in cancer patients, especially the administration of chemotherapy, is considered a poor-quality measure, that may divert the treatment course from its' main palliative intent. Decisions taken at EOL are more than evidence-based and often rely on cultural and personal prospects. The universal and free Israeli health care system enables the administration of active treatment without financial or regulatory barriers, even at EOL. Two major advancements in recent years were the implementation of national at-home palliative care services and the approval of targeted and immunotherapies for advanced cancers. We hypothesized that these changes will reduce the use of chemotherapy at EOL. Methods: We sampled consecutive patients treated at a tertiary oncology center who died of advanced cancers between January 2019 to August 2020, and examined the administration of oncologic treatments near EOL. Results: A total of 294 patients were included. Their median age was 67 and 147 were men, 64% (189) of the patients received oncologic treatment during the last month before death, chemotherapy was administered in nearly two-thirds of the cases, 64% (121), followed by immunotherapy (21%, 40), targeted therapy (10%, 19) and a clinical trial (5%, 9). Neither age (P = 0.4), gender (P = 0.9), performance status (P = 0.8), disease duration (P = 0.5), and type of previous oncologic treatment (P = 0.3) were associated with aggressive EOL care. Conclusions: Our data demonstrate that in the absence of any regulatory or financial limitations, an aggressive EOL care may be administered to the majority of patients, regardless of age, performance status or disease duration. Despite increasing use of immunotherapy and targeted therapies and despite its’ toxicity profile and low beneficial effect at this stage, chemotherapy remained the most commonly used type of treatment. These data call for the implementation of educational measures and appropriate universal guidelines, aiming at improving quality of treatment at the EOL, focusing on quality of life rather than the elusive potential of extending life.

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