Assessing quality of focused antenatal care provided to pregnant women at Bwaila Antenatal Clinic in Lilongwe District
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Date
2011-03-01
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Abstract
Although antenatal care coverage is high in Malawi (93%), worrying gaps exist in terms of its quality and ability to prevent, diagnose, or treat complications. According to Multiple-Indicator Cluster Survey (MICS, 2006), there is limited content of focused antenatal care services (FANC), indicating that pregnant women are not getting the quality care that would assist in the identification and management of complications. This contributes to the risk of maternal and neonatal mortality in Malawi which is currently 675 per 100, 000 live births and 33 per 1, 000 live births respectively (Malawi EmNOC Needs Assessment Report, 2010). The purpose of this study was to assess the quality of FANC services provided to pregnant women at Bwaila Antenatal Clinic in Lilongwe District. Specifically, the study identified the availability and functioning of the basic infrastructure and material resources necessary for offering quality FANC services. It also aimed at exploring the process of delivery of quality FANC services provided during antenatal consultation. Additionally, the study determined if provision of FANC services at Bwaila Antenatal Clinic met the required reproductive health standards as stipulated by Ministry of Health (MoH) in Malawi. A descriptive quantitative study was conducted on a convenience sample of 369 antenatal mothers. Following informed consent, these mothers were interviewed using a structured questionnaire to assess the perceived quality and content of FANC services provided during consultation. A checklist was used to assess structural quality and to determine if FANC services at Bwaila Antenatal Clinic met the required standards, as stipulated by Ministry of Health in Malawi. Descriptive statistics were computed using SPSS version 10.0. Study findings indicated proper structure for providing FANC services. Consultation rooms had basic equipment and essential drugs for providing FANC services. However there were inconsistencies in taking comprehensive history, incomplete physical examination, inadequate laboratory investigations and poor health education. There was lack of reagents for investigating Heamoglobin (Hb), and Syphylis. Only reagents for HIV test were readily available. Based on the national reproductive health standards; Bwaila Antenatal Clinic scored above standard on structural quality (87%) and below standard in performance (60%). It is recommended that community mobilization and training of health care providers be conducted in the district to promote awareness of the new approach in order to provide evidence based practice. The necessary material resources for providing FANC should be consistently supplied to provide an enabling environment for providing FANC services.