Pregnant women adherence level to antenatal care visit and its effect on perinatal outcome among mothers in Tigray Public Health institutions, 2017: cohort study
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Abstract
Objective
To assess pregnant women adherence level to antenatal care visit and its effect on
perinatal outcome among mothers in Tigray Public Health institutions, 2017.
Results
The overall adherence level of the women towards to antenatal care visit was 49.9%
and incidence of PPH, still birth, early neonatal death, late neonatal death and low
birth weight complication was 4.3%, 2.3%, 2.7%, 1.9% and 7.5% respectively. PPH, preterm
labor, early neonatal death and LBW complication was reduced by 81.2%, 52%, 61% and
46% respectively among women’s with complete adherence to ANC visit.
Background Ethiopia is one of the six countries which have contributed to more than 50% of all maternal deaths across the world. This country has adopted the millennium development goals (MDGs) including reducing the maternal mortality by three-quarter, and put improvement in maternal health as one of the health sector development program (HSDP) performance indicators. The purpose of this study was to review the maternal mortality ratio (MMR) in Ethiopia in the past 30 years using available literature. Methods A computer based literature search in the databases of MEDLINE, PubMed, HINARI, EBASE, MEASURE DHS, The Cochrane Library, Google Search and Google Scholar was carried out. Manual search for local articles that are not available electronically in full document were also conducted. Eighteen data sources (3 nationally representative surveys, 2 secondary data analyses, 5 small scale community based studies, and 8 hospital based studies) were included in the review. The results of this review are presented in the form of line and stock graphs. Results The national maternal mortality trend estimated by the central statistics agency of Ethiopia, The Institute for Health Metrics and Evaluation, WHO and other UN agencies showed inconsistent results. Similarly, although there were marked variations in the 95% confidence intervals among individual studies, the small scale community based and hospital based studies have shown that there has been no significant change in maternal mortality over the last three decades. A 22-year cohort analysis from Atat Hospital is the only evidence that demonstrated a very significant drop in maternal mortality among mothers who were kept in the maternity waiting area before the onset of labor. Conclusion Although the MDG and HSDP envisaged significant improvement in maternal health by this time, this review has shown that the performances are still far from the target. The multisectoral huge investment by the Ethiopian Government is a big hope to reduce the maternal mortality by three-quarters in the near future beyond 2015.
The proportion of pregnant women initiating prenatal care during first trimester pregnancy is one of the standard clinical performance measures to assess the quality of maternal health care. Aiming to assess the proportion and factors associated with late booking at antenatal care, this health-institution based cross-sectional study was conducted from April to June 2012 among 390 pregnant mothers in Gondar town. The proportion of late entry to antenatal care was 64.9% with the mean time being 4.5 ± 1.8 months of pregnancy. Multiple logistic regression analysis showed that respondents who didn't get information on correct time of booking, perceived the right time of booking beyond 12 weeks of pregnancy, were not autonomous to use antenatal care and recognized their pregnancy by missing periods were more likely to book late. Late booking was high in the study area. Empowering women and providing information, education and communication with emphasis on timely booking is important.
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