Department of Obstetrics and Gynecology, Saint Francis Referral Hospital, Ifakara, Tanzania.
BMC Pregnancy Childbirth. 2012 Jul 23;12:70. doi: 10.1186/1471-2393-12-70.
Antenatal care (ANC) provides an important opportunity for pregnant women with a wide range of interventions and is considered as an important basic component of reproductive health care.
In 2008, severe maternal morbidity audit was established at Saint Francis Designated District Hospital (SFDDH), in Kilombero district in Tanzania, to ascertain substandard care and implement interventions. In addition, a cross-sectional descriptive study was carried out in 11 health facilities within the district to assess the quality of ANC and underlying factors in a broader view.
Of 363 severe maternal morbidities audited, only 263 (72%) ANC cards were identified. Additionally, 121 cards (with 299 ANC visits) from 11 facilities were also reviewed. Hemoglobin and urine albumin were assessed in 22% - 37% and blood pressure in 69% - 87% of all visits. Fifty two (20%) severe maternal morbidities were attributed to substandard ANC, of these 39 had severe anemia and eclampsia combined. Substandard ANC was mainly attributed to shortage of staff, equipment and consumables. There was no significant relationship between assessment of essential parameters at first ANC visit and total number of visits made (Spearman correlation coefficient, r = 0.09; p = 0.13). Several interventions were implemented and others were proposed to those in control of the health system.
This article reflects a worrisome state of substandard ANC in rural Tanzania resulting from inadequate human workforce and material resources for maternal health, and its adverse impacts on maternal wellbeing. These results suggest urgent response from those in control of the health system to invest more resources to avert the situation in order to enhance maternal health in this country.
产前护理（ANC）为孕妇提供了广泛的干预机会，被认为是生殖保健的重要基本组成部分。
2008 年，在坦桑尼亚基洛姆贝罗区的圣弗朗西斯指定区域医院（SFDDH）建立了严重孕产妇发病率审计，以确定不达标护理并实施干预措施。此外，在该地区的 11 个卫生机构中进行了横断面描述性研究，以更全面地评估 ANC 的质量和潜在因素。
在审核的 363 例严重孕产妇发病率中，仅确定了 263 例（72%）的 ANC 卡。此外，还对来自 11 个机构的 121 张卡片（共 299 次 ANC 就诊）进行了审查。所有就诊中，血红蛋白和尿白蛋白的评估率为 22%-37%，血压的评估率为 69%-87%。52 例（20%）严重孕产妇发病率归因于 ANC 不达标，其中 39 例为严重贫血和子痫合并症。ANC 不达标主要归因于人员、设备和耗材短缺。首次 ANC 就诊时基本参数的评估与就诊总数之间没有显著关系（Spearman 相关系数，r = 0.09；p = 0.13）。已向卫生系统控制者实施了一些干预措施，并提出了其他措施。
本文反映了坦桑尼亚农村地区 ANC 不达标的令人担忧的状况，这是由于孕产妇保健人力和物质资源不足，以及对产妇健康的不利影响造成的。这些结果表明，卫生系统控制者应紧急做出回应，投入更多资源来避免这种情况，以改善该国的孕产妇健康。
