The quality of antenatal care in the Sunyani Municipality

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Quality antenatal care is critical to improve a range of health outcomes for women and children. In recognition of this, the World Summit for Children in 1990 adopted antenatal care as a specific goal, namely “Access by all pregnant women to prenatal care, trained attendants during childbirth and referral facilities for high-risk pregnancies and obstetric emergencies”. Similar claims have been voiced in other major international conferences, including the International Conference on Population and Development in 1994, the Fourth World Conference on Women in 1995, their five-year follow-up evaluations of progress, and the United Nations General Assembly Special Session on Children in 2002. (United Nations, 2002) The main objective of the project is to assess the quality of antenatal care in Sunyani Municipality, and make recommendations to improve the quality of care. A descriptive cross sectional study was carried out in three Private and four Public health (including one specialist) facilities in six sub-municipalities within the Sunyani Municipality. A total of 250 antenatal clients who were receiving normal ANC services in the selected facilities were randomly selected for the study. It was realized that most clients could access a health facility within an hour. Age, education, marital status, residence and money were not barriers to women going for Antenatal care. The study also revealed that other factors like interpersonal relationship between provider and client, availability of amenities and technical competence were important to the client. Staff attitude was poor, waiting time was long and most clients were not satisfied with the care. Some facilities had more staff than the standard recommended by GHS. Amenities of the facilities needed improvement, as well as the technical competence of the staff. A small number of the respondents were teenagers. Emergency transport system was not adequate in the Municipality. It was therefore recommended that Health planners and managers in the municipality should: Set up systems for emergency transport during referral of complications, Strengthen the CHIPS system and upgrade local health facilities to provide additional services such as antenatal and obstetric first aid, Organize teenage clinic for teenage pregnant women and promote the National Insurance Scheme for affordable services. They should also improve staff attitude by continuous staff education impressing on commitment to work, need for empathy and understanding the needs of the clients, Improve waiting time by enforcing the gatekeeper system such that Regional Hospital only sees referred and emergency cases. Encourage the practice of focus antenatal care. Use health information to improve quality of antenatal care Inform, educate, and mobilize the community regarding danger signs and work with communities to improve access to antenatal care. Improve infrastructure and institute maintenance culture, increasing the staff numbers in facilities other than the Regional Hospital and Organize regular in-service training to improve staff skills.
A thesis submitted to the Board of Postgraduate Studies Kwame Nkrumah University of Science and Technology, Kumasi in partial fulfillment of the requirements for the award of Mph/Msc Degree in Population and Reproductive Health, 2005