Client Factors Affect Provider Adherence to Clinical Guidelines during First Antenatal Care
Identifieur interne : 000221 ( Main/Exploration ); précédent : 000220; suivant : 000222Client Factors Affect Provider Adherence to Clinical Guidelines during First Antenatal Care
Auteurs : Mary Amoakoh-Coleman [Pays-Bas, Ghana] ; Irene Akua Agyepong [Ghana] ; Nicolaas P. A. Zuithoff [Pays-Bas] ; Gbenga A. Kayode [Pays-Bas] ; Diederick E. Grobbee [Pays-Bas] ; Kerstin Klipstein-Grobusch [Pays-Bas, Afrique du Sud] ; Evelyn K. Ansah [Ghana]Source :
- PLoS ONE [ 1932-6203 ] ; 2016.
Abstract
The first antenatal clinic (ANC) visit helps to distinguish pregnant women who require standard care, from those with specific problems and so require special attention. There are protocols to guide care providers to provide optimal care to women during ANC. Our objectives were to determine the level of provider adherence to first antenatal visit guidelines in the Safe Motherhood Protocol (SMP), and assess patient factors that determine complete provider adherence.
This cross-sectional study is part of a cohort study that recruited women who delivered in eleven health facilities and who had utilized antenatal care services during their pregnancy in the Greater Accra region of Ghana. A record review of the first antenatal visit of participants was carried out to assess the level of adherence to the SMP, using a thirteen-point checklist. Information on their socio-demographic characteristics and previous pregnancy history was collected using a questionnaire. Percentages of adherence levels and baseline characteristics were estimated and cluster-adjusted odds ratios (OR) calculated to identify determinants.
A total of 948 women who had delivered in eleven public facilities were recruited with a mean age (SD) of 28.2 (5.4) years. Overall, complete adherence to guidelines pertained to only 48.1% of pregnant women. Providers were significantly more likely to completely adhere to guidelines when caring for multiparous women [OR = 5.43 (1.69–17.44),
Complete provider adherence to first antenatal visit guidelines is low across different facility types in the Greater Accra region of Ghana and is determined by parity and history of previous pregnancy complication. Providers should be trained and supported to adhere to the guidelines during provision of care to all pregnant women.
Url:
DOI: 10.1371/journal.pone.0157542
PubMed: 27322643
PubMed Central: 4913935
Affiliations:
- Afrique du Sud, Ghana, Pays-Bas
- Gauteng, Région du Grand Accra
- Accra, Johannesbourg, Legon (Ghana)
- Université du Ghana, Université du Witwatersrand
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Kayode</name><affiliation wicri:level="1"><nlm:aff id="aff001"><addr-line>Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, The Netherlands</addr-line></nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht</wicri:regionArea><wicri:noRegion>University Medical Centre Utrecht</wicri:noRegion></affiliation></author><author><name sortKey="Grobbee, Diederick E" sort="Grobbee, Diederick E" uniqKey="Grobbee D" first="Diederick E" last="Grobbee">Diederick E. Grobbee</name><affiliation wicri:level="1"><nlm:aff id="aff001"><addr-line>Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, The Netherlands</addr-line></nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht</wicri:regionArea><wicri:noRegion>University Medical Centre Utrecht</wicri:noRegion></affiliation></author><author><name sortKey="Klipstein Grobusch, Kerstin" sort="Klipstein Grobusch, Kerstin" uniqKey="Klipstein Grobusch K" first="Kerstin" last="Klipstein-Grobusch">Kerstin Klipstein-Grobusch</name><affiliation wicri:level="1"><nlm:aff id="aff001"><addr-line>Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, The Netherlands</addr-line></nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht</wicri:regionArea><wicri:noRegion>University Medical Centre Utrecht</wicri:noRegion></affiliation><affiliation wicri:level="4"><nlm:aff id="aff003"><addr-line>Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa</addr-line></nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg</wicri:regionArea><orgName type="university">Université du Witwatersrand</orgName><placeName><settlement type="city">Johannesbourg</settlement><region type="region" nuts="2">Gauteng</region></placeName></affiliation></author><author><name sortKey="Ansah, Evelyn K" sort="Ansah, Evelyn K" uniqKey="Ansah E" first="Evelyn K" last="Ansah">Evelyn K. Ansah</name><affiliation wicri:level="3"><nlm:aff id="aff004"><addr-line>Research and Development Division, Ghana Health Service, Accra, Ghana</addr-line></nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Research and Development Division, Ghana Health Service, Accra</wicri:regionArea><placeName><settlement type="city">Accra</settlement><region nuts="2">Région du Grand Accra</region></placeName></affiliation></author></analytic><series><title level="j">PLoS ONE</title><idno type="eISSN">1932-6203</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="sec001"><title>Background</title><p>The first antenatal clinic (ANC) visit helps to distinguish pregnant women who require standard care, from those with specific problems and so require special attention. There are protocols to guide care providers to provide optimal care to women during ANC. Our objectives were to determine the level of provider adherence to first antenatal visit guidelines in the Safe Motherhood Protocol (SMP), and assess patient factors that determine complete provider adherence.</p></sec><sec id="sec002"><title>Methods</title><p>This cross-sectional study is part of a cohort study that recruited women who delivered in eleven health facilities and who had utilized antenatal care services during their pregnancy in the Greater Accra region of Ghana. A record review of the first antenatal visit of participants was carried out to assess the level of adherence to the SMP, using a thirteen-point checklist. Information on their socio-demographic characteristics and previous pregnancy history was collected using a questionnaire. Percentages of adherence levels and baseline characteristics were estimated and cluster-adjusted odds ratios (OR) calculated to identify determinants.</p></sec><sec id="sec003"><title>Results</title><p>A total of 948 women who had delivered in eleven public facilities were recruited with a mean age (SD) of 28.2 (5.4) years. Overall, complete adherence to guidelines pertained to only 48.1% of pregnant women. Providers were significantly more likely to completely adhere to guidelines when caring for multiparous women [OR = 5.43 (1.69–17.44), <italic>p<0</italic>.<italic>01</italic>] but less likely to do so when attending to women with history of previous pregnancy complications [OR = 0.50 (0.33–0.75), <italic>p<0</italic>.<italic>01</italic>].</p></sec><sec id="sec004"><title>Conclusion</title><p>Complete provider adherence to first antenatal visit guidelines is low across different facility types in the Greater Accra region of Ghana and is determined by parity and history of previous pregnancy complication. Providers should be trained and supported to adhere to the guidelines during provision of care to all pregnant women.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Cabana, Md" uniqKey="Cabana M">MD Cabana</name></author><author><name sortKey="Rand, Cs" uniqKey="Rand C">CS Rand</name></author><author><name sortKey="Powe, Nr" uniqKey="Powe N">NR Powe</name></author><author><name sortKey="Wu, Aw" uniqKey="Wu A">AW Wu</name></author><author><name sortKey="Wilson, Mh" uniqKey="Wilson M">MH Wilson</name></author><author><name sortKey="Abboud, Pa" uniqKey="Abboud P">PA Abboud</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Cruz Correa, M" uniqKey="Cruz Correa M">M Cruz-Correa</name></author><author><name sortKey="Gross, Cp" uniqKey="Gross C">CP Gross</name></author><author><name sortKey="Canto, Mi" uniqKey="Canto M">MI Canto</name></author><author><name sortKey="Cabana, M" uniqKey="Cabana M">M 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Cloutier</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Peters, P" uniqKey="Peters P">P Peters</name></author><author><name sortKey="Thigpen, M" uniqKey="Thigpen M">M Thigpen</name></author><author><name sortKey="Parise, M" uniqKey="Parise M">M Parise</name></author><author><name sortKey="Newman, R" uniqKey="Newman R">R Newman</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Burua, A" uniqKey="Burua A">A Burua</name></author><author><name sortKey="Nuwaha, F" uniqKey="Nuwaha F">F Nuwaha</name></author><author><name sortKey="Waiswa, P" uniqKey="Waiswa P">P Waiswa</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Villar, J" uniqKey="Villar J">J Villar</name></author><author><name sortKey="Bergsjo, P" uniqKey="Bergsjo P">P Bergsjo</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Babinszki, A" uniqKey="Babinszki A">A Babinszki</name></author><author><name sortKey="Kerenyi, T" uniqKey="Kerenyi T">T Kerenyi</name></author><author><name sortKey="Torok, O" uniqKey="Torok O">O Torok</name></author><author><name sortKey="Grazi, V" uniqKey="Grazi V">V Grazi</name></author><author><name sortKey="Lapinski, Rh" uniqKey="Lapinski R">RH Lapinski</name></author><author><name sortKey="Berkowitz, Rl" uniqKey="Berkowitz R">RL Berkowitz</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Bai, J" uniqKey="Bai J">J Bai</name></author><author><name sortKey="Wong, Fws" uniqKey="Wong F">FWS Wong</name></author><author><name sortKey="Bauman, A" uniqKey="Bauman A">A Bauman</name></author><author><name sortKey="Mohsin, M" uniqKey="Mohsin M">M Mohsin</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Afrique du Sud</li><li>Ghana</li><li>Pays-Bas</li></country><region><li>Gauteng</li><li>Région du Grand Accra</li></region><settlement><li>Accra</li><li>Johannesbourg</li><li>Legon (Ghana)</li></settlement><orgName><li>Université du Ghana</li><li>Université du Witwatersrand</li></orgName></list><tree><country name="Pays-Bas"><noRegion><name sortKey="Amoakoh Coleman, Mary" sort="Amoakoh Coleman, Mary" uniqKey="Amoakoh Coleman M" first="Mary" last="Amoakoh-Coleman">Mary Amoakoh-Coleman</name></noRegion><name sortKey="Grobbee, Diederick E" sort="Grobbee, Diederick E" uniqKey="Grobbee D" first="Diederick E" last="Grobbee">Diederick E. Grobbee</name><name sortKey="Kayode, Gbenga A" sort="Kayode, Gbenga A" uniqKey="Kayode G" first="Gbenga A" last="Kayode">Gbenga A. Kayode</name><name sortKey="Klipstein Grobusch, Kerstin" sort="Klipstein Grobusch, Kerstin" uniqKey="Klipstein Grobusch K" first="Kerstin" last="Klipstein-Grobusch">Kerstin Klipstein-Grobusch</name><name sortKey="Zuithoff, Nicolaas P A" sort="Zuithoff, Nicolaas P A" uniqKey="Zuithoff N" first="Nicolaas P. A." last="Zuithoff">Nicolaas P. A. Zuithoff</name></country><country name="Ghana"><region name="Région du Grand Accra"><name sortKey="Amoakoh Coleman, Mary" sort="Amoakoh Coleman, Mary" uniqKey="Amoakoh Coleman M" first="Mary" last="Amoakoh-Coleman">Mary Amoakoh-Coleman</name></region><name sortKey="Agyepong, Irene Akua" sort="Agyepong, Irene Akua" uniqKey="Agyepong I" first="Irene Akua" last="Agyepong">Irene Akua Agyepong</name><name sortKey="Ansah, Evelyn K" sort="Ansah, Evelyn K" uniqKey="Ansah E" first="Evelyn K" last="Ansah">Evelyn K. Ansah</name></country><country name="Afrique du Sud"><region name="Gauteng"><name sortKey="Klipstein Grobusch, Kerstin" sort="Klipstein Grobusch, Kerstin" uniqKey="Klipstein Grobusch K" first="Kerstin" last="Klipstein-Grobusch">Kerstin Klipstein-Grobusch</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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