Tetui Moses, Ekirapa Elizabeth Kiracho, Bua John, Mutebi Aloysius, Tweheyo Raymond, Waiswa Peter
Department of Health Policy, Planning and Management, Makerere University School of Public Health, P.O.Box 7072, Kampala, Uganda.
Pan Afr Med J. 2012;13:27. Epub 2012 Oct 9.
More efforts need to be directed to improving the quality of maternal health in developing countries if we are to keep on track with meeting the fifth millennium development goal. The World Health Organization says developing countries account for over 90% of maternal deaths of which three fifths occur in Sub-Saharan African countries like Uganda. Abortion, obstetric complications such as hemorrhage, dystocia, eclampsia, and sepsis are major causes of maternal deaths here. Good quality Antenatal Care (ANC) provides opportunity to detect and respond to risky maternal conditions. This study assessed quality of ANC services in eastern Uganda with a goal of benchmarking implications for interventions.
Data was collected from 15 health facilities in Eastern Uganda to establish capacity of delivering ANC services. Observation checklists were used to assess structural components and completeness of the ANC consultation process among 291 women attending it. Lastly, structured exit-interviews were conducted to assess satisfaction of patients. Data analysis was done in STATA Version 10.
There was an overall staffing gap of over 40%, while infection control facilities, drugs and supplies were inadequate. However, there was good existence of physical infrastructure and diagnostic equipment for ANC services. It was observed that counseling for risk factors and birth preparedness was poorly done; in addition essential tests were not done for the majority of clients.
To improve the quality of ANC, interventions need to improve staffing, infection control facilities and drug-supplies. In addition to better counseling for risk factor-recognition and birth preparedness.
如果我们要继续朝着实现第五个千年发展目标迈进，就需要加大力度提高发展中国家的孕产妇健康质量。世界卫生组织表示，发展中国家占孕产妇死亡总数的90%以上，其中五分之三发生在乌干达等撒哈拉以南非洲国家。堕胎、出血、难产、子痫和败血症等产科并发症是这些国家孕产妇死亡的主要原因。高质量的产前保健（ANC）为发现和应对孕产妇风险状况提供了机会。本研究评估了乌干达东部的产前保健服务质量，目的是为干预措施设定基准。
从乌干达东部的15个医疗机构收集数据，以确定提供产前保健服务的能力。使用观察清单评估291名接受产前保健咨询的妇女的结构组成部分和咨询过程的完整性。最后，进行结构化的出院访谈以评估患者的满意度。数据分析使用STATA 10版本完成。
总体人员配备缺口超过40%，而感染控制设施、药品和用品不足。然而，存在良好的产前保健服务的物理基础设施和诊断设备。据观察，对风险因素和分娩准备的咨询做得很差；此外，大多数客户没有进行必要的检查。
为了提高产前保健的质量，干预措施需要改善人员配备、感染控制设施和药品供应。此外，还需要更好地就风险因素识别和分娩准备进行咨询。
