Assessment of quality of antenatal care services in Nigeria: evidence from a population-based survey
Assessment of quality of antenatal care services in Nigeria: evidence from a population-based survey
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DOI：
10.1186/s12978-015-0081-0
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发表时间：
2015-09-18
影响因子：
3.4
通讯作者：
Idemudia, Erhabor Sunday
中科院分区：
文献类型：
--
作者：
Fagbamigbe, Adeniyi Francis;Idemudia, Erhabor Sunday
背景资料：新推出的“重点产前护理”的目标不仅是实现最少4次就诊，而且是及时开始就诊，以及在就诊期间提供的服务的质量和相关性。因此，这项研究的目的是评估ANC服务的质量在尼日利亚。方法：我们使用的13410名受访者谁声称已经使用ANC设施至少有一次在五年内提供的信息2013年尼日利亚人口和家庭调查（NDHS）。评估ANC的10个组成部分，包括提供HIV检测、破伤风类毒素注射、接受铁补充、间歇性预防性治疗（IPT）、肠道预防性药物（IPD）、ANC的及时入组和访视次数。所有十个组件的接收均被归类为ANC服务的理想（良好）质量，而十个组件中的八个关键组件的接收则被认为是最低可接受质量。结果：在尼日利亚，测量血压和接受铁补充是最常见的ANC组成部分，各占91.0%，而IPD和IPT分别仅占20.7%和37.6%。不到三分之二的人接受了关于防止母婴传播的教育，而41.7%的人接受了艾滋病毒检测并取得了结果。只有4.6%（95%CI：4.2-5.1）的妇女接受了良好质量的ANC，而近1.0%的妇女没有接受任何成分。约11.3%（95%CI：10.6- 11.9%）的与会者具有最低可接受的ANC质量。在早期开始ANC、至少有4次ANC就诊、由熟练卫生工作者护理、去过政府和私人医院和诊所的用户中，接受优质ANC服务的比例较高。更高的几率获得良好的ANC质量被发现谁住在城市地区的用户之间，具有较高的教育程度，属于家庭在上财富五分之一，并出席了熟练的ANC provider.Conclusions：理想的和最低可接受的ANC服务质量的水平是穷人在尼日利亚，从而危及努力实现千年发展目标。尼日利亚的国家和州政府以及其他利益攸关方需要加强承诺，以确保用户接受产前护理的主要组成部分。
Background: The aim of the newly introduced "focused Antenatal Care (ANC)" is not only to achieve a minimum number of 4 visits, but also the timeliness of the commencement of the visits as well as the quality and relevance of services offered during the visits. This study is therefore designed to assess the quality of ANC services in Nigeria.Methods: We used information supplied by the 13410 respondents who claimed to have used the ANC facilities at least once within five year preceding the 2013 Nigeria Demographic and Household Survey (NDHS). Ten components of ANC including: offer of HIV test, Tetanus Toxoid injection, receiving iron supplementation, intermittent preventive treatment (IPT), intestinal preventive drug (IPD), timely ANC enrollment and number of visits were assessed. Receipts of all the ten components were classified as desirable (good) quality of ANC services while receipt of eight critical components among the ten were assumed to be the minimum acceptable quality. Data was weighted and analyzed using descriptive statistics and logistic regression models at 5 % significance level.Results: Measurement of blood pressure and receiving iron supplementation were the most commonly offered ANC component in Nigeria with 91.0 % each while IPD and IPT were given to only 20.7 % and 37.6 % respectively. Less than two thirds were taught on PMTCT while 41.7 % had HIV test and obtained results. Only 4.6 % (95 % CI: 4.2-5.1) of women received good quality of ANC while nearly 1.0 % did not receive any of the components. About 11.3 % (95 % CI: 10.6-11.9 %) of the attendees had minimum acceptable quality of ANC. Receipt of good quality ANC services was higher among users who initiated ANC early, had at least 4 ANC visits, attended to by skilled health workers, attended government and private hospitals and clinics. Higher odds of receiving good quality of ANC were found among users who lives in urban areas, having higher educational attainment, belonging to households in upper wealth quintiles and attended to by skilled ANC provider.Conclusions: The levels of desirable and minimum acceptable quality of ANC services were poor in Nigeria thereby jeopardizing efforts to achieve the MDGs. There is need for intensified commitment by national and state governments in Nigeria as well as other stakeholders to ensure that main components of ANC are received by the users.