Suboptimal Antenatal Care in Resource – limited Settings and Quality Improvement Strategies as Perceived by midwives in Awka – South LGA in Anambra State Nigeria.

Abstract

Identifying the opportunities for quality improvement is essential to maximize the impact of midwife – led antenatal care. The aim of this study was to determine suboptimal antenatal care and the quality improvement strategies as perceived by midwives in resource – limited settings in Awka – south Local Government Area (LGA), Anambra state, Nigeria. The objectives of the study were to; determine areas of suboptimal antenatal care in resource – limited settings, in Awka –south LGA, Anambra state, Nigeria, and the areas of quality improvement as perceived by midwives. The design for the study was cross – sectional research. It was a facility study which constituted 31Primary Health Centres, 1 Secondary Health Facility, 1 Tertiary Health Facility, plus 112 midwives and 165 pregnant women. Multistage sampling technique was used for the study. Two (2) Questionnaires and one (1) Checklist were adopted for data collection in the study. Data generated from the study were analyzed using descriptive and inferential statistics. The hypotheses were tested at significant level of 0.05. The result indicated resource adequacy in the secondary and tertiary health facilities (100% and 63.1% respectively) and inadequacy in primary health facilities (38.7%). Across all the health facility levels, 75% of service delivery practices among midwives during antenatal care of pregnant women were rated as poor while 25% were categorized as good. Secondary health facility lacked presence of midwives officially on call at all times. The quality of antenatal care provided by midwives had significant association with ANC Screening training update, p – value 0.02. Antenatal care provided by midwives in resource – limited settings did not significantly differ from areas of sub –optimal antenatal care, overall p – value 0.40. Antenatal care provided by midwives had no significant association with the perceived quality improvement strategies, over all p – value 0.42. Conclusively, the study revealed a substantial disparity in resource availability across facility levels. Recommendations included that Primary health facilities need to be adequately equipped and there should be regular supervision of midwives’ practices by quality improvement team in order to identify areas of deficiencies to be properly addressed.

Keywords:

Perceived, Suboptimal Antenatal care, quality improvement strategies, Resource – Limited Settings, Midwives, Awka – South, LGA

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