Trends in antenatal care attendance and health facility delivery following community and health facility systems strengthening interventions in Northern Uganda
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Date
2013
Journal Title
Journal ISSN
Volume Title
Publisher
BMC Pregnancy and Childbirth
Abstract
Maternal morbidity and mortality remains high in Uganda; largely due to inadequate antenatal care
(ANC), low skilled deliveries and poor quality of other maternal health services. In order to address both the
demand and quality of ANC and skilled deliveries, we introduced community mobilization and health facility
capacity strengthening interventions.
Methods: Interventions were introduced between January 2010 and September 2011. These included: training
health workers, provision of medical supplies, community mobilization using village health teams, music dance and
drama groups and male partner access clubs. These activities were implemented at Kitgum Matidi health center III
and its catchment area. Routinely collected health facility data on selected outcomes in the year preceding the
interventions and after 21 months of implementation of the interventions was reviewed. Trend analysis was
performed using excel and statistical significance testing was performed using EPINFO StatCal option.
Results: The number of pregnant women attending the first ANC visit significantly increased from 114 to 150 in
the first and fourth quarter of 2010 (OR 1.72; 95% CI 1.39–2.12) and to 202 in the third quarter of 2011(OR 11.41;
95% CI 7.97–16.34). The number of pregnant women counselled, tested and given results for HIV during the first
ANC attendance significantly rose from 92 (80.7%) to 146 (97.3%) in the first and fourth quarter of 2010 and then to
201 (99.5%) in the third quarter of 2011. The number of male partners counseled, tested and given results together
with their wives at first ANC visit rose from 13 (16.7%) in the fourth quarter of 2009 to 130 (89%) in the fourth
quarter of 2010 and to 180 (89.6%) in the third quarter of 2011. There was a significant rise in the number of
pregnant women delivering in the health facility with provision of mama-kits (delivery kits), from 74 (55.2%) to 149
(99.3%) in the second and fourth quarter of 2010.
Conclusions: Combined community and facility systems strengthening interventions led to increased first ANC
visits by women and their partners, and health facility deliveries. Interventions aimed at increasing uptake of
maternal health services should address both the demand and availability of quality services
Description
Keywords
Trends, Antenatal care, Health facility delivery, Community Health facility, Systems strengthening
Citation
Ediau, M., Wanyenze, R. K., Machingaidze, S., Otim, G., Olwedo, A., Iriso, R., & Tumwesigye, N. M. (2013). Trends in antenatal care attendance and health facility delivery following community and health facility systems strengthening interventions in Northern Uganda. BMC pregnancy and childbirth, 13(1), 1-11.