Department of Gynecology and Obstetrics, Emory University, Atlanta, GA, USA.
Division of Global HIV/AIDS and Tuberculosis, U.S. Centers for Disease Control and Prevention, Pretoria, South Africa.
Int J Gynaecol Obstet. 2020 Dec;151(3):431-437. doi: 10.1002/ijgo.13349. Epub 2020 Sep 19.
To determine quality of antenatal care (ANC). Most literature focuses on ANC attendance and services. Less is known about quality of care (QoC).
Data were analyzed from the 2016 Kigoma Reproductive Health Survey, a population-based survey of reproductive-aged women. Women with singleton term live births were included and principal component analysis (PCA) was used to create an ANC quality index using linear combinations of weights of the first principal component. Nineteen variables were selected for the index. The index was then used to assign a QoC score for each woman and linear regression used to identify factors associated with receiving higher QoC.
A total of 3178 women received some ANC. Variables that explained the most variance in the QoC index included: gave urine (0.35); gave blood (0.34); and blood pressure measured (0.30). In multivariable linear regression, factors associated with higher QoC included: ANC at a hospital (versus dispensary); older age; higher level of education; working outside the home; higher socioeconomic status; and having lower parity.
Using PCA methods, several basic components of ANC including maternal physical assessment were identified as important indicators of quality. This approach provides an affordable and effective means of evaluating ANC programs.
确定产前保健（ANC）的质量。大多数文献都集中在 ANC 的参与和服务上。关于护理质量（QoC）的了解较少。
对 2016 年基戈马生殖健康调查的数据进行了分析，这是一项针对育龄妇女的基于人群的调查。纳入单胎足月活产的妇女，并使用主成分分析（PCA），通过第一主成分的权重线性组合，创建 ANC 质量指数。选择了 19 个变量用于该指数。然后，该指数用于为每位妇女分配 QoC 评分，并使用线性回归确定与获得更高 QoC 相关的因素。
共有 3178 名妇女接受了一些 ANC。解释 QoC 指数中最大差异的变量包括：尿液检查（0.35）；血液检查（0.34）；血压测量（0.30）。在多变量线性回归中，与更高 QoC 相关的因素包括：在医院（而非诊所）进行 ANC；年龄较大；更高的教育水平；外出工作；更高的社会经济地位；以及较低的生育次数。
使用 PCA 方法，确定了包括产妇身体评估在内的 ANC 的几个基本组成部分，这些都是质量的重要指标。这种方法提供了一种经济实惠且有效的 ANC 项目评估方法。
