International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Vol. 8, Issue 1, pp: (21-29), Month: April 2020 - September 2020, Available at: www.researchpublish.com
Assessment of Focused Antenatal Care Compliance Predictors in Kisumu East District Hospital, Kenya 1
Anne Ayieko Ibworo, 1Vincent Ibworo 1
Great lakes University of Kisumu
Abstract: Focused Antenatal care was introduced following failure of the Standard ANC model, to limit the number of visits to the clinic, restrict tests, clinical procedures and actions to those which would improve the outcome of both the mother and the newborn. FANC is intended to prevent or identify and treat conditions that may threaten the health of the newborn and/or the mother, and help a woman to approach pregnancy and birth as a positive experience, and to a large extent it helps to provide a good start for the newborn child. This study assessed the predictors of compliance of FANC among pregnant women at Kisumu East District Hospital. Data was collected from 258 women of reproductive age group through cross-sectional study, and one-stage exit interviews from the Antenatal clinic (ANC) and post natal ward. 74.1% of women reported satisfaction with history taking and clinical examination. On the other hand, history taking and obstetric examination were only carried out in 75.3% and 93.5% respectively at the first visit but the rates were lower with consecutive visits. Significant predictors of FANC compliance that were found to have a p-value < 0.05 were: residence (p-value= 0.001, OR=1.1, CI=.5-2.36), maternal education (OR= 3.6, CI=1.7-7.7), Household financial status (OR= 5.2, CI= 2.8-9.6), woman’s source of income (OR=4.1, CI=.7-3.3) and awareness of FANC (OR=1.9, CI=1.1-3.5). This study showed that the compliance to FANC service was very low despite the presence of skilled and friendly service providers in the facilities. Factors associated with poor compliance included limited knowledge and poor attitude among participants and KEDH staff. Based on this study, it is recommended that stakeholders improve awareness of the new FANC model, improve counseling/ health education and upgrade antenatal clinic infrastructure as well as supplies at KEDH. It is also recommended for further research to elucidate the implications of poor compliance. Keywords: Significant predictors, Focused Antenatal Care, compliance, World Health Organisation, enabling Factors.
I. INTRODUCTION Lack of quality services, lack of essential supplies and trained personnel, lack of access to quality care, lack of facilities for emergency transport, poor infrastructure and lack of or poor referral services, are all crucial steps on the road towards mortality. Questionable quality of health care in the United States has been associated with lack of compliance by patients (Ronan, 2006) that is, most segments of population receive sub-standard health care. This is repeated in most part of the world due to poor socio-economic class. For example, in a study conducted in Ethiopia, where low utilization of professional ANC (27%) was mainly attributed to HCWs attitude based on the clients place of residence and level of education. According to a study conducted in South Africa to determine utilization of ANC services among primigravidas, indicated that poor utilization was due to poor service provision. In this study, service provision was described in terms of communication with HCWs and health service provision. Others included marital status and religion. In Uganda, components of FANC were better offered in private hospital clinics than in public clinics in quality of care thus increasing compliance of 4+ ANC, leading to an increase in hospital deliveries (Tann et al, 2007). In Rarieda (Nyanza), 18% of pregnant women were reported not to have visited the nearest ANC clinics and instead visited distant facilities due to better-perceived care (78%), or lower cost (13%). Seven percent (7%) of women visited more than one ANC, because of a temporary move or because services were thought to be better in the second ANC ( Eijk et al, 2006).
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