The quality of antenatal care in rural Tanzania: what is behind the number of visits?

BMC Pregnancy and Childbirth

Research Article

David P Urassa¹  Alise Bartsch-de Jong²  Jos van Roosmalen³  Angelo S Nyamtema⁴  Jaap P Hagen⁵ 

[1] Department of Community Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania;Department of Medical Humanities, EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands;Department of Medical Humanities, EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands;Department of Obstetrics, Leiden University Medical Centre, Leiden, The Netherlands;Department of Obstetrics and Gynecology, Saint Francis Referral Hospital, Ifakara, Tanzania;Department of Obstetrics, Leiden University Medical Centre, Leiden, The Netherlands;

关键词: Health Facility;    Antenatal Care;    Mebendazole;    Severe Maternal Morbidity;    Antenatal Care Service;   

DOI  :  10.1186/1471-2393-12-70

 received in 2012-01-08, accepted in 2012-07-23,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundAntenatal care (ANC) provides an important opportunity for pregnant women with a wide range of interventions and is considered as an important basic component of reproductive health care.MethodsIn 2008, severe maternal morbidity audit was established at Saint Francis Designated District Hospital (SFDDH), in Kilombero district in Tanzania, to ascertain substandard care and implement interventions. In addition, a cross-sectional descriptive study was carried out in 11 health facilities within the district to assess the quality of ANC and underlying factors in a broader view.ResultsOf 363 severe maternal morbidities audited, only 263 (72%) ANC cards were identified. Additionally, 121 cards (with 299 ANC visits) from 11 facilities were also reviewed. Hemoglobin and urine albumin were assessed in 22% – 37% and blood pressure in 69% - 87% of all visits. Fifty two (20%) severe maternal morbidities were attributed to substandard ANC, of these 39 had severe anemia and eclampsia combined. Substandard ANC was mainly attributed to shortage of staff, equipment and consumables. There was no significant relationship between assessment of essential parameters at first ANC visit and total number of visits made (Spearman correlation coefficient, r = 0.09; p = 0.13). Several interventions were implemented and others were proposed to those in control of the health system.ConclusionsThis article reflects a worrisome state of substandard ANC in rural Tanzania resulting from inadequate human workforce and material resources for maternal health, and its adverse impacts on maternal wellbeing. These results suggest urgent response from those in control of the health system to invest more resources to avert the situation in order to enhance maternal health in this country.

【 授权许可】

CC BY   
© Nyamtema et al.; 2012