Quality of Antenatal Care and Outcome of Pregnancy in a Semi-Urban Area in Fako Division, Cameroon: A Cross-Sectional Study

Crossmark: check for updates

Authors

  • Gregory E. Halle-Ekane Department of Surgery and Obstetrics-Gynecology, Faculty of Health Sciences, University of Buea, P.O Box 12, Buea, Cameroon
  • Cyril Mela Fotabong Department of Obstetrics and Gynecology, Buea Regional Hospital, P.O Box 32, Buea, Cameroon
  • Phillip Nana Njotang Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon
  • Julius Atashili Department of Public Health and Hygiene, Faculty of Health Sciences, University of Buea, P.O Box 12, Buea, Cameroon
  • Ndemazie Nkafu Bechem Department of Obstetrics and Gynecology, Limbe Regional Hospital, Limbe, Cameroon
  • Dickson S. Nsagha Department of Public Health and Hygiene, Faculty of Health Sciences, University of Buea, P.O Box 12, Buea, Cameroon
  • Thomas Egbe Obinchemt Department of Surgery and Obstetrics-Gynecology, Faculty of Health Sciences, University of Buea, P.O Box 12, Buea, Cameroon

DOI:

https://doi.org/10.17140/WHOJ-1-105

Keywords:

ANC; Quality; Adverse pregnancy outcomes; Cameroon

Abstract

Introduction: The outcome of pregnancy depends, to a large extent, on the availability and effectiveness of antenatal care. Unskilled care before, during and after child birth, late start and
inconsistent attendance of Antenatal care (ANC), and poor ANC package are seen frequently.
However, the extent to which these practices affect pregnancy outcome are not known in Fako
Division, South West Region, Cameroon.
Objective: The objective of this study was to determine the relationship between the outcome
of pregnancy and the quality of ANC in the aforementioned setting.
Patients and Methods: This was a hospital based cross-sectional study that involved 300 immediate post-partum women in three hospitals in Fako Division, Cameroon. Data was collected
using a structured questionnaire in a two-step manner; face-to-face interview, and from women’s case notes during ANC and their delivery records. Data was analyzed using Epi Info™
version 7.1.4.0 (CDC, Atlanta, USA, 2015) statistical software.
Results: Mean gestational age at start of ANC was 19.2 weeks (SD 4.2 years), 99% of participants attended at least one ANC consultation, 15.5% started ANC early; 58% attended ≥4
ANC visits. Six-seven percent of them received adequate care. There was a strong negative
correlation between gestational age at start of ANC and overall adequate care (p-value 0.001).
Inadequate care, being a teenager, and single were associated with adverse pregnancy outcomes. Inadequate care was also associated with pre-term birth, post-term birth, labour induction, dystocia, labour augmentation, stillbirth, low APGAR score, and low birth weight. (All
p-values <0.05).
Conclusion: Adverse pregnancy outcomes in this region were associated with poor quality
ANC. Sensitization of women on the benefit of quality ANC, better health care services with
well-trained health care personnel, and research to find out a more precise diagnosis of causes
of adverse foeto-maternal outcomes will lead to reduced fetal and maternal morbidity and mortality.

References

Lincetto O, Mothebesoane-anoh S, Gomez P, Munjanja S. An-tenatal Care. Int J Sci Technol Res. 2013; 2: 51-62.

WHO, UNICEF, UNIFPA, The World Bank, The United Na-tions Population Division. Trends in Mternal Mortality: 1990- 2013. Estimates by WHO, UNICEF, UNIFPA, The World Bank and the United Nations population Division. Available at: http:// apps.who.int/iris/bitstream/10665/112682/2/9789241507226_ eng.pdf 2014; Accessed 2015.

World Health Organization. Provision of effective antenatal care. Available at: http://www.who.int/reproductivehealth/publi-cations/maternal_perinatal_health/effective_antenatal_care.pdf 2006; Accessed 2015.

WHO. Consultation on improving measurement of the qual-ity of maternal, newborn and child care in health facilities. Available at: http://www.who.int/iris/bitstream/10665/128206/ 1/9789241507417_eng.pdf 2013; Accessed 2015.

Countdown to 2015, Health Metrics Network (HMN), United Nations Children’s Fund (UNICEF), World Health Organization (WHO). Monitoring maternal, newborn and child health: under-standing key progress indicators. 2011: 1-44. Available at: http:// www.who.int/healthmetrics/news/monitoring_maternal_new-born_child_health.pdf 2011; Accessed 2015.

National Statistics Institute (INS) and ICF. Demographic and health survey multiple indicator of Cameroon in 2011. Calver-ton, Maryland, USA: International; 2011.

Alibekova R, Huang J, Chen Y. Adequate prenatal care re-duces the risk of adverse pregnancy outcomes in women with history of infertility: a nationwide population-based study. PLoS One. 2013; 8: 1-8. doi: 10.1371/journal.pone.0084237

Abou-Zahr C, Tessa W. Ante-natal care in developing coun-tries: promises, achievements and missed opportunities: an anal-ysis of trends, levels and differentials, s, 1990-2001. World Heal Organ. 2003: 1-32.

Adekanle DA, Isawumi AI. Late antenatal care booking and its predictors among pregnant women in South Western Nigeria. Online Journal of Health and Allied Sciences. 2008; 7(1): 1-6.

Joshi C, Torvaldsen S, Hodgson R, Hayen A. Factors as-sociated with the use and quality of antenatal care in Nepal: a population-based study using the demographic and health survey data. BMC Pregnancy Childbirth. 2014; 14: 1-11. doi: 10.1186/1471-2393-14-94

Ashraf-ganjoei T, Mirzaei F, Anari-dokht F. Relationship be-tween prenatal care and the outcome of pregnancy in low-risk pregnancies. Open J Obstet Gynecol. 2011; 1: 109-112. doi: 10.4236/ojog.2011.13019

Kinzie B, Gomez P. Basic maternal and newborn care sec-tion two: antenatal care authors. In: Chase R, ed. Maternal & Neonatal Health. 2002.

Tayebi T, Zahrani ST, Mohammadpour R. Relationship be-tween adequacy of prenatal care utilization index and pregnancy outcomes. Iran J Nurs Midwifery Res. 2013; 18: 360-366.

Tesfay K, Gebrehiwot H, Bruh G, Fantahun A. Health promotion practice and its associated factors among pregnant mothers attending ANC services in public health institution of Mekelle City, Tigray Ethiopia. 2015; 4: 18-25. doi: 10.11648/j. sjcm.20150401.14

WHO, UN, UNICEF. Fulfilling the Health Agenda for Women and Children 2012: 2. Available at: http://www.count-down2015mnch.org/documents/2014Report/Countdown_ to_2015-Fulfilling%2520the%2520H

Hawkes SJ, Gomez GB, Broutet N. Early antenatal care: does it make a difference to outcomes of pregnancy associat-ed with syphilis? a systematic review and meta-analysis. PLoS One. 2013; 8: 2. doi: 10.1371/journal.pone.0056713

Ahmed M, Elimam G, Rmrb D, Rmbs D, Mohamed EY. Quality of antenatal care provided for pregnant women in Rib-at University Hospital, Khartoum. Sudanesse J Public Health. 2011; 6: 2.

Mosha TCE, Philemon N. Factors influencing pregnancy outcomes in morogoro municipality, Tanzania. Tanzan J Health Res. 2010; 12: 249-260.

Belayneh T, Adefris M, Andargie G. Improves timely book-ing: cross-sectional study at University of Gondar Hospital, Northwest Ethiopia. J Pregnancy. 2014; 7.

Zegeye AM, Bitew BD, Koye DN. Prevalence and deter-minants of early antenatal care visit among pregnant women attending antenatal care in Debre Berhan Health Institutions, Central Ethiopia. African J Reprod Care December. 2013; 17: 130-136.

Halle-ekane GE, Obinchemti TE, Nzang JN, et al.Assessment of the content and utilization of antenatal care services in a rural community in cameroon: a cross-sectional study. Open J Obstet Gynecol. 2014; 4: 846-856. doi: 10.4236/ojog.2014.414119

Eng J. Radiology sample size estimation: how many indi-viduals should be studied? 2003: 309-313.

Heaman MI, Sword WA, Akhtar-danesh N, et al. Quality of prenatal care questionnaire : instrument development and test-ing. BMC Pregnancy Childbirth. 2014; 14: 1-16.

Christina BL. Barriers to utilization of focused antenatal care among pregnant women in NTCHISI district in Malawi Mas-ter’s Thesis University of Tampere Tampere School of Health Sciences (Public Health). Available at: https://tampub.uta.fi/bit-stream/handle/10024/84640/gradu06772.pdf?sequence=1 2013; Accessed June 19th, 2014.

Hollowell J, Oakley l, Kurinczuk J, Brocklehurst P, Gray R. The effectiveness of antenatal careprograms to reduce infant mortality and preterm birth in socially disadvantaged and vul-nerable women in high-income countries: a systematic review. BMC Pregnancy and Childbirth. 2011, 11:13. doi: 10.1186/1471- 2393-11-13

Ajayi IO, Osakinle DC, Osakinle EO. Quality assessment of the practice of focused antenatal care (FANC) in rural and urban primary health centres in Ekiti State. Open J Obstet Gynecol. 2013; 2013: 319-326. Available at: http://www.scirp.org/journal/ ojog/

Ziyo FY, Matly FA, Mehemd GM, Dofany EM. Relation be-tween prenatal care and pregnancy outcome at Benghazi. Sudan J Public Health. 2009; 4: 403-411.

Banda I, Michelo C, Hazemba A. Factors associated with late antenatal care attendance in selected rural and urban com-munities of the copperbelt province of Zambia. Medical Journal of Zambia. 2012; 39: 29-36.

Lamina MA. GA at first booking visit in Sagum, Nigeria. Niger J Clin Pract. 2004; 7: 1-3.

Vogel JP, Habib NA, Souza JP, et al. Antenatal care packages with reduced visits and perinatal mortality: a secondary analysis of the WHO Antenatal Care Trial. Reprod Health. 2013; 10: 19. doi: 10.1186/1742-4755-10-19

Quick JD, Greenlick MR, Roghmann KJ. Prenatal care and pregnancy outcome in an HMO and general population: a multi-variate cohort analysis. 1981; 71: 4.

Kumar A, Singh T, Basu S, Pandey S, Bhargava V. Outcome of teenage pregnancy. Indian J Pediatr. 2007; 74: 927-931.

Sulaiman S, Bch MB, Mmed O, et al. Obstetric and perinatal outcome in teenage pregnancies. S Afr J OG. 2013; 19: 77-80. doi: 10.7196/SAJOG.679

Morrison J, Najman JM, W GM, Keeping JD. Socio-Eco-nomic status and pregnancy outcome: an australian study. Br J Obstet Gynaecol. 1989; 96: 298-307.

Hayford SR, Guzzo KB, Hayford SR, Guzzo KB. Age, re-lationship status, and the planning status of births. Demogr Res. 2010; 23: 365-398. doi: 10.4054/DemRes.2010.23.13

Abimbola A. Socio-cultural factors affecting pregnancy out-come among Ogu speaking people in Badagary Area of Lagos State, Nigeria. Int J Humanit Soc Sci. 2012; 2: 133-144.

Andreucci CB, Cecatti JG, Macchetti CE, Sousa MH. SIS-PRENATAL as a tool for evaluating quality of prenatal Care. Rev Saude Publica. 2011; 45: 854-864. doi: 10.1590/S0034- 89102011005000064

Regina C, Wany M, Strufaldi L, Carvalho LR De, Puccini RF. Adequacy of antenatal care and its relationship with low birth weight in Botucatu, São Paulo, Brazil: a case-control study. 2014: 1-12. doi: 10.1186/1471-2393-14-255

Downloads

Published

2015-09-15

How to Cite

Gregory E. Halle-Ekane, Cyril Mela Fotabong, Phillip Nana Njotang, Julius Atashili, Ndemazie Nkafu Bechem, Dickson S. Nsagha, & Thomas Egbe Obinchemt. (2015). Quality of Antenatal Care and Outcome of Pregnancy in a Semi-Urban Area in Fako Division, Cameroon: A Cross-Sectional Study. Women’s Health, 31–39. https://doi.org/10.17140/WHOJ-1-105

Issue

Section

Articles