Antenatal care strengthening for improved quality of care in Jimma, Ethiopia: an effectiveness study

Research output: Contribution to journalJournal articleResearchpeer-review

Standard

Antenatal care strengthening for improved quality of care in Jimma, Ethiopia : an effectiveness study. / Villadsen, Sarah Fredsted; Negussie, Dereje; GebreMariam, Abebe; Tilahun, Abebech; Friis, Henrik; Rasch, Vibeke.

In: B M C Public Health, Vol. 15, No. 1, 360, 2015.

Research output: Contribution to journalJournal articleResearchpeer-review

Harvard

Villadsen, SF, Negussie, D, GebreMariam, A, Tilahun, A, Friis, H & Rasch, V 2015, 'Antenatal care strengthening for improved quality of care in Jimma, Ethiopia: an effectiveness study', B M C Public Health, vol. 15, no. 1, 360. https://doi.org/10.1186/s12889-015-1708-3

APA

Villadsen, S. F., Negussie, D., GebreMariam, A., Tilahun, A., Friis, H., & Rasch, V. (2015). Antenatal care strengthening for improved quality of care in Jimma, Ethiopia: an effectiveness study. B M C Public Health, 15(1), [360]. https://doi.org/10.1186/s12889-015-1708-3

Vancouver

Villadsen SF, Negussie D, GebreMariam A, Tilahun A, Friis H, Rasch V. Antenatal care strengthening for improved quality of care in Jimma, Ethiopia: an effectiveness study. B M C Public Health. 2015;15(1). 360. https://doi.org/10.1186/s12889-015-1708-3

Author

Villadsen, Sarah Fredsted ; Negussie, Dereje ; GebreMariam, Abebe ; Tilahun, Abebech ; Friis, Henrik ; Rasch, Vibeke. / Antenatal care strengthening for improved quality of care in Jimma, Ethiopia : an effectiveness study. In: B M C Public Health. 2015 ; Vol. 15, No. 1.

Bibtex

@article{52960f32769c4b9aa56ead47079548e2,
title = "Antenatal care strengthening for improved quality of care in Jimma, Ethiopia: an effectiveness study",
abstract = "BACKGROUND: Interventions for curing most diseases and save lives of pregnant and delivering women exist, yet the power of health systems to deliver them to those in most need is not sufficient. The aims of this study were to design a participatory antenatal care (ANC) strengthening intervention and assess the implementation process and effectiveness on quality of ANC in Jimma, Ethiopia.METHODS: The intervention comprised trainings, supervisions, equipment, development of health education material, and adaption of guidelines. It was implemented at public facilities and control sites were included in the evaluation. Improved content of care (physical examinations, laboratory testing, tetanus toxoid (TT)-immunization, health education, conduct of health professionals, and waiting time) were defined as proximal project outcomes and increased quality of care (better identification of health problems and increased overall user satisfaction with ANC) were distal project outcomes. The process of implementation was documented in monthly supervision reports. Household surveys, before (2008) and after (2010) intervention, were conducted amongst all women who had given birth within the previous 12 months. The effect of the intervention was assessed by comparing the change in quality of care from before to after the intervention period at intervention sites, relative to control sites, using logistic mixed effect regression.RESULTS: The continued attention to the ANC provision during implementation stimulated increased priority of ANC among health care providers. The organizational structure of the facilities and lack of continuity in care provision turned out to be a major challenge for implementation. There was a positive effect of the intervention on health education on danger signs during pregnancy (OR: 3.9, 95{\%} CI: 2.6;5.7), laboratory testing (OR for blood tests other than HIV 2.9, 95{\%} CI: 1.9;4.5), health problem identification (OR 1.8, 95{\%} CI: 1.1;3.1), and satisfaction with the service (OR: 0.4, 95{\%} CI: 0.2;0.9). There was no effect of intervention on conduct of health professionals. The effect of intervention on various outcomes was significantly modified by maternal education.CONCLUSION: The quality of care can be improved in some important aspects with limited resources. Moreover, the study provides strategic perspectives on how to facilitate improved quality of ANC.",
author = "Villadsen, {Sarah Fredsted} and Dereje Negussie and Abebe GebreMariam and Abebech Tilahun and Henrik Friis and Vibeke Rasch",
note = "CURIS 2015 NEXS 142",
year = "2015",
doi = "10.1186/s12889-015-1708-3",
language = "English",
volume = "15",
journal = "B M C Public Health",
issn = "1471-2458",
publisher = "BioMed Central Ltd.",
number = "1",

}

RIS

TY - JOUR

T1 - Antenatal care strengthening for improved quality of care in Jimma, Ethiopia

T2 - an effectiveness study

AU - Villadsen, Sarah Fredsted

AU - Negussie, Dereje

AU - GebreMariam, Abebe

AU - Tilahun, Abebech

AU - Friis, Henrik

AU - Rasch, Vibeke

N1 - CURIS 2015 NEXS 142

PY - 2015

Y1 - 2015

N2 - BACKGROUND: Interventions for curing most diseases and save lives of pregnant and delivering women exist, yet the power of health systems to deliver them to those in most need is not sufficient. The aims of this study were to design a participatory antenatal care (ANC) strengthening intervention and assess the implementation process and effectiveness on quality of ANC in Jimma, Ethiopia.METHODS: The intervention comprised trainings, supervisions, equipment, development of health education material, and adaption of guidelines. It was implemented at public facilities and control sites were included in the evaluation. Improved content of care (physical examinations, laboratory testing, tetanus toxoid (TT)-immunization, health education, conduct of health professionals, and waiting time) were defined as proximal project outcomes and increased quality of care (better identification of health problems and increased overall user satisfaction with ANC) were distal project outcomes. The process of implementation was documented in monthly supervision reports. Household surveys, before (2008) and after (2010) intervention, were conducted amongst all women who had given birth within the previous 12 months. The effect of the intervention was assessed by comparing the change in quality of care from before to after the intervention period at intervention sites, relative to control sites, using logistic mixed effect regression.RESULTS: The continued attention to the ANC provision during implementation stimulated increased priority of ANC among health care providers. The organizational structure of the facilities and lack of continuity in care provision turned out to be a major challenge for implementation. There was a positive effect of the intervention on health education on danger signs during pregnancy (OR: 3.9, 95% CI: 2.6;5.7), laboratory testing (OR for blood tests other than HIV 2.9, 95% CI: 1.9;4.5), health problem identification (OR 1.8, 95% CI: 1.1;3.1), and satisfaction with the service (OR: 0.4, 95% CI: 0.2;0.9). There was no effect of intervention on conduct of health professionals. The effect of intervention on various outcomes was significantly modified by maternal education.CONCLUSION: The quality of care can be improved in some important aspects with limited resources. Moreover, the study provides strategic perspectives on how to facilitate improved quality of ANC.

AB - BACKGROUND: Interventions for curing most diseases and save lives of pregnant and delivering women exist, yet the power of health systems to deliver them to those in most need is not sufficient. The aims of this study were to design a participatory antenatal care (ANC) strengthening intervention and assess the implementation process and effectiveness on quality of ANC in Jimma, Ethiopia.METHODS: The intervention comprised trainings, supervisions, equipment, development of health education material, and adaption of guidelines. It was implemented at public facilities and control sites were included in the evaluation. Improved content of care (physical examinations, laboratory testing, tetanus toxoid (TT)-immunization, health education, conduct of health professionals, and waiting time) were defined as proximal project outcomes and increased quality of care (better identification of health problems and increased overall user satisfaction with ANC) were distal project outcomes. The process of implementation was documented in monthly supervision reports. Household surveys, before (2008) and after (2010) intervention, were conducted amongst all women who had given birth within the previous 12 months. The effect of the intervention was assessed by comparing the change in quality of care from before to after the intervention period at intervention sites, relative to control sites, using logistic mixed effect regression.RESULTS: The continued attention to the ANC provision during implementation stimulated increased priority of ANC among health care providers. The organizational structure of the facilities and lack of continuity in care provision turned out to be a major challenge for implementation. There was a positive effect of the intervention on health education on danger signs during pregnancy (OR: 3.9, 95% CI: 2.6;5.7), laboratory testing (OR for blood tests other than HIV 2.9, 95% CI: 1.9;4.5), health problem identification (OR 1.8, 95% CI: 1.1;3.1), and satisfaction with the service (OR: 0.4, 95% CI: 0.2;0.9). There was no effect of intervention on conduct of health professionals. The effect of intervention on various outcomes was significantly modified by maternal education.CONCLUSION: The quality of care can be improved in some important aspects with limited resources. Moreover, the study provides strategic perspectives on how to facilitate improved quality of ANC.

U2 - 10.1186/s12889-015-1708-3

DO - 10.1186/s12889-015-1708-3

M3 - Journal article

VL - 15

JO - B M C Public Health

JF - B M C Public Health

SN - 1471-2458

IS - 1

M1 - 360

ER -

ID: 136844183