School of Health Sciences, Walden University & Independent Researcher, Kampala, Uganda.
Core Faculty, School of Health Sciences, Health Services and DHA, Walden University, Minneapolis, MN, USA.
BMC Health Serv Res. 2023 Aug 24;23(1):906. doi: 10.1186/s12913-023-09913-7.
Evidence indicates that antenatal care (ANC) has both indirect and direct effects on maternal and perinatal morbidity and mortality reduction. In Uganda, the ANC attendance rate stands at 97.3% for one visit, but 59.9% for four or more visits. Given the imminent shift to the eight-contact ANC model in Uganda, combined with a lack of universal coverage for completion of four ANC visits, there is need for research that provides information on the factors that differentiate completers of recommended ANC attendances from non-completers. The aim of this quantitative study was to assess service- level factors affecting completion of ANC attendance defined by completion of four or more visits among women of reproductive age in Iganga district in Uganda.
Facility assessment scores on the service-level factors of interest for health facilities were obtained using a service level index tool. The relationship between the ANC completion rates of clients sampled from records at the health facilities and facility scores on service-level factors of interest were analyzed. Regression was conducted to determine the predictive relationship between ANC service availability, ANC service content, and ANC service organization, and completion of ANC attendance.
The model was statistically significant, χ2 (6) = 26.118, p ˂ 0.05, and accounted for approximately 17.3% of the variance of ANC attendance completion (R2 = .173). Completion of ANC attendance was primarily predicted by better timing of provision of ANC services, and to a lesser extent by higher levels of availability of medicines and medical supplies.
This study demonstrated that service-level factors have a predictive value for completion of ANC attendance. The findings can be used to improve availability, content, and organization of ANC services with the aim of enhancing positive experiences for clients and motivating them to complete the recommended number of ANC visits.
有证据表明，产前护理（ANC）对降低孕产妇和围产期发病率和死亡率具有间接和直接影响。在乌干达，一次产前护理就诊率达到 97.3%，但四次或更多次就诊率为 59.9%。鉴于乌干达即将转向八次接触 ANC 模式，加上四次 ANC 就诊完成率未普及，因此需要研究提供有关因素的信息，这些因素可区分完成推荐 ANC 就诊次数的人与未完成者。本定量研究旨在评估服务水平因素对生殖年龄妇女在乌干达伊甘加区完成四次或更多次 ANC 就诊的影响。
使用服务水平指数工具获取对卫生设施有兴趣的服务水平因素的设施评估分数。分析从卫生设施记录中抽取的客户的 ANC 完成率与感兴趣的服务水平因素的设施分数之间的关系。进行回归分析以确定 ANC 服务可用性、ANC 服务内容和 ANC 服务组织与 ANC 就诊完成率之间的预测关系。
模型具有统计学意义，χ2（6）= 26.118，p ˂ 0.05，可解释 ANC 就诊完成率的 17.3%左右（R2 =.173）。ANC 就诊完成主要由 ANC 服务提供时间更好预测，在较小程度上由药品和医疗用品供应水平更高预测。
本研究表明，服务水平因素对 ANC 就诊完成具有预测价值。研究结果可用于改善 ANC 服务的可用性、内容和组织，旨在增强客户的积极体验并激励他们完成推荐的 ANC 就诊次数。
