Assessment of Quality of Antenatal Care Services in Primary Health Centres in Ado-Ekiti, Ekiti State
Chapter One
Objective of the study
The objectives of the study are;
- To assess the adherence of primary health centers to evidence-based practices in the provision of antenatal care services.
- To evaluate the availability and competence of trained healthcare providers in delivering comprehensive antenatal care.
- To assess the adequacy of infrastructure and availability of essential equipment and supplies in primary health centers for providing quality antenatal care.
- To examine the extent to which primary health centers prioritize client-centered care during antenatal visits.
CHAPTER TWO
REVIEWED OF RELATED LITERATURE
Focused Antenatal Care
Antenatal care refers to the regular medical and nursing care recommended for women During pregnancy; It is a type of preventive care with the goal of providing regular checkups that allow doctors or midwives to prevent, detect as well as treat Potential health problems that may arise in a pregnant woman, (WHO, 2005). Focused Antenatal Care is an individualized and quality care provided to pregnant women which emphasizes on the woman’s overall health; her preparation for childbirth and readiness for complications during her term of pregnancy (Miriam, 2014). The new 9 approach to ANC emphasizes the quality of care rather than the quantity (Global health, 2014). Antenatal care is the care a woman receives throughout her pregnancy in order to ensure that women and newborns survive pregnancy and childbirth (Ademola, Adenike, & Motunrayo,2011).
Goals of Focused ANC
The new approach to ANC emphasizes the quality of care rather than the quantity. For normal pregnancies WHO recommends only four antenatal visits. The major goal of focused antenatal care is to help women maintain normal pregnancies through: Identification of pre-existing health conditions Early detection of complications arising during the pregnancy Health promotion and disease prevention Birth preparedness and complication readiness planning (Global health,2014).
Objectives of focused antenatal care are;
(1)Maintenance of health of mother during pregnancy(2)Identification of high risk cases and appropriate management(3)Prevent development of complications(4)Decrease maternal and infant mortality and morbidity(5)Remove the stress and worries of the mother regarding the delivery process(6)Teach the mother about child care, nutrition, sanitation and hygiene(7)Advice about family planning(8)Care of under fives accompanying pregnant mothers (Johnson, 2015).
Schedule of visits during pregnancy
Focused antenatal care (FANC) became the recommended type of antenatal care following the publication of a (WHO,2014). Trial on antenatal care where it was discovered that more frequent visits (of the traditional antenatal care approach) do not necessarily improve pregnancy outcomes and advocate a minimum of 4 visits for pregnancies without complications scheduled as o First visit: within 16 weeks or when woman first thinks she is pregnant. o Second visit: At 20 – 24 weeks or at least once in second trimester. o Third visit: At 28 – 32 weeks and o Fourth visit: At 36 weeks or later. Limited resources of developing countries like Nigeria can be redirected to give better quality antenatal care services across the re- commended four visits (villar and Bergsgo, 2001).Antenatal services comprise complete health supervision of the pregnant women in order to maintain, protect and promote health and well being of the mother and the fetus (Ojo 2004). The services rendered to a pregnant woman at monthly intervals, to 28 weeks of gestation, then fortnightly until 36 weeks and finally weekly visit until the birth of the baby. Similarly, (Adesokan, 2010) describes antenatal services as the attention, education, supervision and treatment given to the pregnant women from the time conception is confirmed until the beginning of labour, in order to ensure safe pregnancy, labour and puerperium.
CHAPTER THREE
RESEARCH METHODOLOGY
INTRODUCTION
In this chapter, we described the research procedure for this study. A research methodology is a research process adopted or employed to systematically and scientifically present the results of a study to the research audience viz. a vis, the study beneficiaries.
RESEARCH DESIGN
Research designs are perceived to be an overall strategy adopted by the researcher whereby different components of the study are integrated in a logical manner to effectively address a research problem. In this study, the researcher employed the survey research design. This is due to the nature of the study whereby the opinion and views of people are sampled. According to Singleton & Straits, (2009), Survey research can use quantitative research strategies (e.g., using questionnaires with numerically rated items), qualitative research strategies (e.g., using open-ended questions), or both strategies (i.e., mixed methods). As it is often used to describe and explore human behaviour, surveys are therefore frequently used in social and psychological research.
POPULATION OF THE STUDY
According to Udoyen (2019), a study population is a group of elements or individuals as the case may be, who share similar characteristics. These similar features can include location, gender, age, sex or specific interest. The emphasis on study population is that it constitutes of individuals or elements that are homogeneous in description.
This study was carried to examine assessment of Quality of Antenatal Care Services in Primary Health Centres. Selected health centers in Ado-Ekiti, Ekiti state form the population of the study.
CHAPTER FOUR
DATA PRESENTATION AND ANALYSIS
INTRODUCTION
This chapter presents the analysis of data derived through the questionnaire and key informant interview administered on the respondents in the study area. The analysis and interpretation were derived from the findings of the study. The data analysis depicts the simple frequency and percentage of the respondents as well as interpretation of the information gathered. A total of eighty (80) questionnaires were administered to respondents of which only seventy-seven (77) were returned and validated. This was due to irregular, incomplete and inappropriate responses to some questionnaire. For this study a total of 77 was validated for the analysis.
CHAPTER FIVE
SUMMARY, CONCLUSION AND RECOMMENDATION
Introduction
It is important to ascertain that the objective of this study was to ascertain assessment of Quality of Antenatal Care Services in Primary Health Centres in Ado-Ekiti, Ekiti state. In the preceding chapter, the relevant data collected for this study were presented, critically analyzed and appropriate interpretation given. In this chapter, certain recommendations made which in the opinion of the researcher will be of benefits in addressing assessment of Quality of Antenatal Care Services in Primary Health Centres in Ado-Ekiti, Ekiti state
Summary
This study was on assessment of Quality of Antenatal Care Services in Primary Health Centres in Ado-Ekiti, Ekiti state. A study of Rivers State University. Three objectives were raised which included: To assess the adherence of primary health centers to evidence-based practices in the provision of antenatal care services, to evaluate the availability and competence of trained healthcare providers in delivering comprehensive antenatal care, to assess the adequacy of infrastructure and availability of essential equipment and supplies in primary health centers for providing quality antenatal care and to examine the extent to which primary health centers prioritize client-centered care during antenatal visits. A total of 77 responses were received and validated from the enrolled participants where all respondents were drawn from Ado-Ekiti, Ekiti state. Hypothesis was tested using Chi-Square statistical tool (SPSS).
Conclusion
In conclusion, the assessment of the quality of antenatal care services in primary health centers is crucial for improving maternal and child health outcomes. This study aimed to evaluate the current state of antenatal care services in primary health centers and identify areas for improvement. Through the examination of adherence to evidence-based practices, availability of trained healthcare providers, adequacy of infrastructure and essential supplies, client-centered care, and coordination with other maternal health services, important insights have been gained.
The findings of this study highlight several key issues that need to be addressed to enhance the quality of antenatal care services in primary health centers. These include gaps in adherence to evidence-based practices, challenges in recruiting and retaining trained healthcare providers, inadequate infrastructure and essential supplies, limited emphasis on client-centered care, and suboptimal coordination with other maternal health services.
Addressing these challenges requires a multi-faceted approach. Policy and decision-makers should prioritize the development and implementation of evidence-based guidelines and protocols for antenatal care. Efforts should be made to enhance the recruitment and training of healthcare providers, ensuring their competency in delivering comprehensive care. Investments in healthcare infrastructure, equipment, and essential supplies are crucial to ensure the availability of necessary resources. Promoting client-centered care through personalized approaches, shared decision-making, and effective communication is essential for improving the overall experience of pregnant women.
Furthermore, enhancing coordination and integration between antenatal care services and other maternal health services can contribute to a continuum of care and better health outcomes for both mothers and infants. Collaboration between primary health centers and higher-level healthcare facilities is important to ensure seamless referrals and continuity of care.
While this study provides valuable insights into the quality of antenatal care services in primary health centers, it is important to acknowledge its limitations, such as sample size, reliance on self-reported data, and contextual factors. Further research is needed to validate the findings and explore additional dimensions of quality that were not fully addressed in this study.
Overall, this study serves as a call to action for policymakers, healthcare providers, and stakeholders to invest in improving the quality of antenatal care services in primary health centers. By addressing the identified challenges and implementing the recommended strategies, it is possible to enhance the delivery of comprehensive and evidence-based antenatal care, ultimately leading to improved maternal and child health outcomes.
Recommendation
Based on the findings of the study assessing the quality of antenatal care services in primary health centers, the following recommendations are proposed to enhance the quality of care:
- Strengthen adherence to evidence-based practices: Efforts should be made to ensure that primary health centers strictly adhere to evidence-based guidelines and protocols for antenatal care. Regular training programs and supportive supervision should be provided to healthcare providers to update their knowledge and skills.
- Improve recruitment and training of healthcare providers: Measures should be taken to address the shortage of trained healthcare providers in primary health centers. Initiatives such as increasing recruitment, providing incentives for healthcare professionals to work in primary care settings, and offering continuous professional development opportunities can help enhance the competence and capacity of healthcare providers.
- Enhance healthcare infrastructure and essential supplies: Adequate investment should be made in improving healthcare infrastructure, including the provision of sufficient examination rooms, equipment, and supplies necessary for antenatal care. Regular assessments should be conducted to ensure the availability and functionality of essential resources.
- Promote client-centered care: Primary health centers should prioritize the implementation of client-centered care approaches. This can be achieved by involving pregnant women in shared decision-making, providing personalized care based on their needs and preferences, and improving communication and information sharing during antenatal visits.
- Strengthen coordination and integration of services: Primary health centers should establish effective coordination mechanisms with higher-level healthcare facilities to ensure seamless referral and continuity of care. Collaborative efforts should be made to integrate antenatal care with other maternal health services, such as skilled birth attendance and postnatal care, to provide a comprehensive continuum of care.
- Conduct regular monitoring and evaluation: Regular monitoring and evaluation of antenatal care services in primary health centers should be conducted to assess the implementation of recommended interventions and identify areas for further improvement. Quality indicators and performance metrics should be established to measure progress and guide quality improvement efforts.
- Foster community engagement and participation: Engaging the community in the planning, implementation, and evaluation of antenatal care services is crucial. Community members should be involved in decision-making processes, health education initiatives, and mobilization efforts to ensure the provision of culturally sensitive and responsive care.
- Advocate for policy changes and resource allocation: Policymakers should prioritize maternal and child health by allocating adequate resources to primary health centers. Policy changes should be advocated to support the provision of high-quality antenatal care services, including funding for infrastructure improvement, workforce development, and procurement of essential supplies.
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