Evaluation of the implementation of focus antenatal care in the Ho Municipality

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2015-11-04
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Abstract
Focused Antenatal Care (FANC) has been identified as a program that is aimed at pro-moting the health and surĀ¬vival of mothers and babies. FANC expects that a woman will receive individualized care primarily from skilled provider, consistently over a minimum of four visits. It was introduced in a context where many critical assessments were not being widely offered or ignored hence resulting in high mortality rates among pregnant women. This study is conducted to assess the implementation of FANC in the Ho municipality with a focus on how care is rendered to clients by nurses. The study was a cross sectional descriptive survey. Thirty (30) nurses were interviewed using a structured questionnaire. A checklist was used to observe how clients were assessed by nurses, and also to assess the challenges faced with the practice of FANC. Data from the structured questionnaire was analyzed with SPSS version 16.0 A total of 12 facilities were visited, 30 ANC staff interviewed (16 Community Health Nurses and 14 Midwives), 96 maternal health records were reviewed. ANC staffs were observed interacting with 96 clients. The study revealed that the nurses were aware of the existence and practice of FANC. However, most of the staff have not had training in FANC, and therefore are not familiar with the details and components. The study revealed also that History taking on clients was poor, health workers are unable to take comprehensive history for early detection of diseases. Examination of ANC clients by health workers were also not optimal, procedures and findings are usually not explained to the women. Not all the procedures required to detect diseases in pregnancy were followed. This has also reflected in filling of the maternal record, where most of the records such as drug history, contraceptive history and physical history were not filled, but progress histories were filled. This is in line with examination done for client that is abdominal palpation and auscultation was done for all clients but ignoring the rest of the procedures. The respondents however, identified various challenges to the delivery of quality and appropriate FANC services. Chief amongst them were issues related to inadequate number of staffs, lack of infrastructure and appropriate equipment. The implementation of focused antenatal care did seem to increase the number of antenatal registrants and an increase in the number of deliveries with a skilled health care provider. But more needs to be done to increase the number of deliveries with skilled care provider. Generally, the practice of Focused Antenatal care is being implemented in the Ho municipality and it has improved upon the number of clients (pregnant women) that patronize the health facilities. Nonetheless, the structure at all levels in the facilities ought to be upgraded to support the total practice of FANC. There is also the need to orient the staff and the communities on Focus Antenatal Care.
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A thesis submitted to the Department of Population, Family & Reproductive Health College of Health Sciences, School of Public Health in partial fulfilment of the requirement for the degree of Master of Public Health in Population, Family & Reproductive Health,2015
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