Quality of antenatal care in selected health centers of Gurage Zone, South Nations Nationalities and People Region, Ethiopia, 2017

Abstract

Introduction: The quality of antenatal care is dependent on the compliance of guideline by the providers, frequency of ANC visits, resource needed to provide the service, content and kinds of information given to women during their ANC visits and their level of satisfaction. Plenty of evidences suggests that quality of care or lack of it must be at the center of every discussion. There is paucity of data on the quality of ANC especially in primary heath care centers in Ethiopia and nothing is known about quality of ANC in study area in particular given that there is 100% ANC coverage. Hence, assessment of antenatal care quality is prudent. Objective: The main objective of this study was to assess quality of ANC in public health centers of Gurage Zone, SNNPR, Ethiopia, 2017. Methods: A facility based cross-sectional study was conducted from March 05 to April 04, 2017. A total of 419 pregnant women were participated. To achieve the desired sample size for the study; data was collected from every woman (consecutively) till the proportional sample size allocated for each health center was reached. A pretested Semi- structured questionnaire, FANC card review, resource inventory, observation checklists and in-depth interview were used to obtain information. Logistic regression model was used to identify predictor variables for client satisfaction. Qualitative data was analyzed manually using thematic analysis method, and presented with quantitative result through triangulation by using narrative weaving approach. Result: About sixty five (64.9%) were satisfied. Gestational age of the mother at first visit [AOR= .28, 95% CI, (.15, .51)], the sex of ANC service provider [AOR =.055, 95%CI (0.018, .16)], waiting time [AOR =.56, 95% CI (.35, .89)] and consultation time [AOR=3.6, 95%CI (1.7, 7.5)] were found to be statistically significant with satisfaction. A mean waiting time of 56.78 + 22.89 (SD) minutes and 83.3 % of the client spent less than 20 minute with the service giver. Only 46.7% of the clients were told what is to be done and encouraged to ask questions. During observation 93.3% the provider didn’t wash his/her hands with soap/alcohol before & after examining the client. Conclusion and Recommendation: greater percentages of women were satisfied but lower compared to other studies. Lack of clean latrine & adequate water supply, lack of cleanliness and sanitation during the procedure, receiving incomplete information, lack of privacy, and long waiting time were some of the constraints forwarded by majority of pregnant women as a cause of dissatisfaction. Most of the minimum required resources to conduct the service were available in the health centers except iron sulfate/folic acid & there is a greatest gap in basic infrastructure. In adequate consultation time to discuss health issues with the providers and lower involvement in the decision making process concerning their care. Toilet facilities need to be upgraded, private examination room need to be sought, minimize waiting time and the facilities need to have ANC guideline & the service should be provided as per the guideline.