Author:
Radovich Emma,Chaudhry Monica,Penn-Kekana Loveday,Raju K. Radha Krishnam,Mishra Aparajita,Vallabhuni Ramya,Jarhyan Prashant,Mohan Sailesh,Prabhakaran Dorairaj,Campbell Oona M. R.,Calvert Clara
Abstract
AbstractBackgroundAntenatal care coverage has dramatically increased in many low-and middle-income settings, including in the state of Telangana, India. However, there is increasing evidence of shortfalls in the quality of care women receive during their pregnancies. This study aims to examine dimensions of antenatal care quality in Telangana, India using four primary and secondary data sources.MethodsData from two secondary statewide data sources (National Family Health Survey (NFHS-5), 2019–21; Health Management Information System (HMIS), 2019–20) and two primary data sources (a facility survey in 19 primary health centres and sub-centres in selected districts of Telangana; and observations of 36 antenatal care consultations at these facilities) were descriptively analysed.ResultsNFHS-5 data showed about 73% of women in Telangana received all six assessed antenatal care components during pregnancy. HMIS data showed high coverage of antenatal care visits but differences in levels of screening, with high coverage of haemoglobin tests for anaemia but low coverage of testing for gestational diabetes and syphilis. The facility survey found missing equipment for several key antenatal care services. Antenatal care observations found blood pressure measurement and physical examinations had high coverage and were generally performed correctly. There were substantial deficiencies in symptom checking and communication between the woman and provider. Women were asked if they had any questions in 22% of consultations. Only one woman was asked about her mental health. Counselling of women on at least one of the ten items relating to birth preparedness and on at least one of six danger signs occurred in 58% and 36% of consultations, respectively.ConclusionDespite high coverage of antenatal care services and some essential maternal and foetal assessments, substantial quality gaps remained, particularly in communication between healthcare providers and pregnant women and in availability of key services. Progress towards achieving high quality in both content and experience of antenatal care requires addressing service gaps and developing better measures to capture and improve women’s experiences of care.
Funder
Medical Research Council
Department of Biotechnology, Ministry of Science and Technology, India
Publisher
Springer Science and Business Media LLC
Subject
Obstetrics and Gynecology
Reference29 articles.
1. Hodgins S, D’Agostino A. The quality–coverage gap in antenatal care: toward better measurement of effective coverage. Glob Health Sci Pract. 2014;2(2):173–81.
2. Radovich E, Benova L, Penn-Kekana L, Wong K, Campbell O. ‘Who assisted with the delivery of (NAME)?’ Issues in estimating skilled birth attendant coverage through population-based surveys and implications for improving global tracking. BMJ Glob Health. 2019;4(2):e001367.
3. Benova L, Tunçalp Ö, Moran AC, Campbell OMR. Not just a number: examining coverage and content of antenatal care in low-income and middle-income countries. BMJ Glob Health. 2018;3(2):e000779.
4. Chou VB, Walker N, Kanyangarara M. Estimating the global impact of poor quality of care on maternal and neonatal outcomes in 81 low- and middle-income countries: A modeling study. PLOS Med. 2019;16(12):e1002990.
5. WHO. Standards for improving quality of maternal and newborn care in health facilities [Internet]. Geneva: World Health Organization; 2016 [cited 2020 Mar 29]. Available from: http://www.who.int/maternal_child_adolescent/documents/improving-maternal-newborn-care-quality/en/
Cited by
2 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献