Effect of a new antenatal care programme on the attitudes of pregnant women and midwives towards antenatal care in Harare.

OBJECTIVE

The aim was to study the effect of a new antenatal care (ANC) programme on the attitudes of pregnant women and midwives towards antenatal care.

DESIGN

This was a controlled trial in which the attitudes of women and staff using the standard programme of ANC were compared to those using a new one. The new programme contained fewer but objective oriented visits, and was designed to improve consumer and provider satisfaction with ANC.

SETTING

Antenatal sessions at primary care clinics in Harare.

SUBJECTS

200 pregnant women and 65 midwives.

MAIN OUTCOME MEASURES

The satisfaction of pregnant women and staff with ANC, reasons for lack of satisfaction, and time spent waiting for consultations.

RESULTS

The new programme did not make any impact on the time spent by women waiting to be seen at the clinics, nor on the time made available for the consultations. There was no significant impact on the degree of satisfaction with the care among the women. In the control clinics, significantly more staff wished the women to make fewer visits, and in the study clinics, significantly more staff thought the use of appointments was appropriate. The major problem limiting access to ANC was lack of money to pay for the booking fees. Other problems mentioned by the women were ignorance regarding the best time to book, lack of privacy and insufficient staff at the clinics.

CONCLUSIONS

The solutions to some of the problems identified require infrastructural changes at policy making level, rather than changes within the antenatal care programmes.