Assessment of quality of antenatal care services in public sector facilities in India
Objectives We undertook assessment of quality of antenatal care (ANC) services in public sector facilities in the Indian state of Bihar state delivered under the national ANC programme (Pradhan Mantri Surakshit Matritva Abhiyan, PMSMA).Setting Three community health centres and one subdistrict hospi...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2022-12-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/12/12/e065200.full |
| _version_ | 1827898639425470464 |
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| author | Lalit Dandona Rakhi Dandona G Anil Kumar Debarshi Bhattacharya Priya Nanda Md Akbar Moutushi Majumder |
| author_facet | Lalit Dandona Rakhi Dandona G Anil Kumar Debarshi Bhattacharya Priya Nanda Md Akbar Moutushi Majumder |
| author_sort | Lalit Dandona |
| collection | DOAJ |
| description | Objectives We undertook assessment of quality of antenatal care (ANC) services in public sector facilities in the Indian state of Bihar state delivered under the national ANC programme (Pradhan Mantri Surakshit Matritva Abhiyan, PMSMA).Setting Three community health centres and one subdistrict hospital each in two randomly selected districts of Bihar.Participants Pregnant women who sought ANC services under PMSMA irrespective of the pregnancy trimester.Primary and secondary measures Quality ANC services were considered if a woman received all of these services in that visit—weight, blood pressure and abdomen check, urine and blood sample taken, and were given iron and folic acid and calcium tablets. The process of ANC service provision was documented.Results Eight hundred and fourteen (94.5% participation) women participated. Coverage of quality ANC services was 30.4% (95% CI 27.3% to 33.7%) irrespective of pregnancy trimester, and was similar in both districts and ranged 3%–83.1% across the facilities. Quality ANC service coverage was significantly lower for women in the first trimester of pregnancy (6.8%, 95% CI 3.3% to 13.6%) as compared with those in the second (34.4%, 95% CI 29.9% to 39.1%) and third (32.9%, 95% CI 27.9% to 38.3%) trimester of pregnancy. Individually, the coverage of weight and blood pressure check-up, receipt of iron folic acid (IFA) and calcium tablets, and blood sample collection was >85%. The coverage of urine sample collection was 46.3% (95% CI 42.9% to 49.7%) and of abdomen check-up was 62% (95% CI 58.6% to 65.3%). Poor information sharing post check-up was done with the pregnant women. Varied implementation of ANC service provision was seen in the facilities as compared with the PMSMA guidelines, in particular with laboratory diagnostics and doctor consultation. Task shifting from doctors to ANMs was observed in all facilities.Conclusions Grossly inadequate quality ANC services under the PMSMA needs urgent attention to improve maternal and neonatal health outcomes. |
| first_indexed | 2024-03-12T23:06:00Z |
| format | Article |
| id | doaj.art-be11ba57a00444d09166d11c2a9fdfd2 |
| institution | Directory Open Access Journal |
| issn | 2044-6055 |
| language | English |
| last_indexed | 2024-03-12T23:06:00Z |
| publishDate | 2022-12-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj.art-be11ba57a00444d09166d11c2a9fdfd22023-07-18T22:00:07ZengBMJ Publishing GroupBMJ Open2044-60552022-12-01121210.1136/bmjopen-2022-065200Assessment of quality of antenatal care services in public sector facilities in IndiaLalit Dandona0Rakhi Dandona1G Anil Kumar2Debarshi Bhattacharya3Priya Nanda4Md Akbar5Moutushi Majumder6Public Health Foundation of India, Gurugram, Haryana, IndiaPublic Health Foundation of India, Gurugram, Haryana, IndiaPublic Health Foundation of India, Gurugram, Haryana, IndiaBill & Melinda Gates Foundation India, New Delhi, IndiaBill & Melinda Gates Foundation India, New Delhi, IndiaPublic Health Foundation of India, Gurugram, Haryana, IndiaPublic Health Foundation of India, Gurugram, Haryana, IndiaObjectives We undertook assessment of quality of antenatal care (ANC) services in public sector facilities in the Indian state of Bihar state delivered under the national ANC programme (Pradhan Mantri Surakshit Matritva Abhiyan, PMSMA).Setting Three community health centres and one subdistrict hospital each in two randomly selected districts of Bihar.Participants Pregnant women who sought ANC services under PMSMA irrespective of the pregnancy trimester.Primary and secondary measures Quality ANC services were considered if a woman received all of these services in that visit—weight, blood pressure and abdomen check, urine and blood sample taken, and were given iron and folic acid and calcium tablets. The process of ANC service provision was documented.Results Eight hundred and fourteen (94.5% participation) women participated. Coverage of quality ANC services was 30.4% (95% CI 27.3% to 33.7%) irrespective of pregnancy trimester, and was similar in both districts and ranged 3%–83.1% across the facilities. Quality ANC service coverage was significantly lower for women in the first trimester of pregnancy (6.8%, 95% CI 3.3% to 13.6%) as compared with those in the second (34.4%, 95% CI 29.9% to 39.1%) and third (32.9%, 95% CI 27.9% to 38.3%) trimester of pregnancy. Individually, the coverage of weight and blood pressure check-up, receipt of iron folic acid (IFA) and calcium tablets, and blood sample collection was >85%. The coverage of urine sample collection was 46.3% (95% CI 42.9% to 49.7%) and of abdomen check-up was 62% (95% CI 58.6% to 65.3%). Poor information sharing post check-up was done with the pregnant women. Varied implementation of ANC service provision was seen in the facilities as compared with the PMSMA guidelines, in particular with laboratory diagnostics and doctor consultation. Task shifting from doctors to ANMs was observed in all facilities.Conclusions Grossly inadequate quality ANC services under the PMSMA needs urgent attention to improve maternal and neonatal health outcomes.https://bmjopen.bmj.com/content/12/12/e065200.full |
| spellingShingle | Lalit Dandona Rakhi Dandona G Anil Kumar Debarshi Bhattacharya Priya Nanda Md Akbar Moutushi Majumder Assessment of quality of antenatal care services in public sector facilities in India BMJ Open |
| title | Assessment of quality of antenatal care services in public sector facilities in India |
| title_full | Assessment of quality of antenatal care services in public sector facilities in India |
| title_fullStr | Assessment of quality of antenatal care services in public sector facilities in India |
| title_full_unstemmed | Assessment of quality of antenatal care services in public sector facilities in India |
| title_short | Assessment of quality of antenatal care services in public sector facilities in India |
| title_sort | assessment of quality of antenatal care services in public sector facilities in india |
| url | https://bmjopen.bmj.com/content/12/12/e065200.full |
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