The Role of Group Antenatal Care in Reducing Maternal Morbidity and Mortality Rate Among Pregnant Mothers Attending Primary Health Care Facilities: A Case Study of Angwan Waje PHCC in Keffi LGA of Nasarawa State, Nigeria
Abstract:
The increasing rates of maternal morbidity
and mortality has reached an alarming situation despite numerous antenatal care
attendances by the pregnant mothers before the end of their pregnancy period. This
tragedy posed questions on the authenticity and quality of ante-natal care services
provided to pregnant mothers at the various primary health care facilities in the
LGA. Earlier, Ante Natal Care services flow declined due to poor access, attitude
of services providers and traditional belief. The main objective of this study is
to examine the role played by the group antenatal care services in participatory
learning session that led to the reduction in maternal morbidity and mortality rates.
The study was conducted on 450 pregnant mothers attending primary health care facility
Angwan Waje with catchment area population of 50, 180 people that rally round 7
settlements with annual target population of 2,158 as pregnant mothers. The method
used during the study was cross sectional study design with mixed of both qualitative
and quantitative data collection methods using simple random sampling on pre - tested questionnaire.
Information generated from the data collection were analyzed using Statistical Package
for the Social Sciences (SPSS) 20.0 software to ascertain results for better interpretation
and presentation. Additionally, a focused group discussions and key informant interviews
were held with the health care providers including the ante-natal care focal person
and community representatives on their experiences and insight in Group ante natal
care services.
Keywords: Group Ante natal Care, Primary Health Care Facility,
Health Care Providers.
References:
[1] National Primary Healthcare
Development Agency (2017), Integrated Training Manual for PHC Workers in Nigeria.
Participant’s Manual. Pg 306-314.
[2] Soubeiga D, Gauvin L, Hatem MA, Johri M. Birth preparedness
and complication readiness (BPCR) interventions to reduce maternal and neonatal
mortality in developing countries: systematic review and meta-analysis. BMC Pregnancy
and Childbirth. 2014; 14:129 10.1186/1471-2393-14-129 [PMC free article] [PubMed]
[CrossRef] [Google Scholar].
[3] Federal Government of
Nigeria,NPHDA (2012), National Guideline for development of primary health care
system in Nigeria. Fourth revised edition. Printed by Damnori Nigeria limited. Tel:
08034251810, 08023639404. Pg 164-186.
[4] Federal Ministry of Health,
FMOH (2017), Antenatal Care: An Orientation package for Health care providers in
Nigeria. A review of ANC model in Nigeria. Pg 1-18.
[5] Peter O. (2012), Primary
Health Care for Sustainable development. Ozege publications 14 Gaborone Street,
Wuse zone 2 Abuja- Nigeria.
[6] UNICEF. Delivery care. 2018. https://data.unicef.org/topic/maternal-health/delivery-care/
(accessed March 7, 2019). [Google Scholar].
[7] World Health
Organization, WHO (2002), Department of Reproductive Health and Research. WHO antenatal
care randomized trial:manual for the
implementation of the new model. Geneva: [Google Scholar].
[8] World Health
Organization (2016), WHO recommendations on antenatal
care for a positive pregnancy experience Geneva: World Health Organization, 2016. [google scholar].
[9] World Health Organization (2003): Antenatal Care in Developing Countries: Promises,
Achievements and Missed Opportunities. Geneva: [Google Scholar].
[10] World Health Organization WHO (2015), WHO Global
Strategy on People-Centred and Integrated Health Services. Geneva: http://apps.who.int/iris/bitstream/10665/155002/1/WHO_HIS_SDS_2015.6_eng.pdf?ua=1&ua=1
Accessed June 7, 2017. [Google Scholar].
[11] McNellan, C.R., Dansereau, E., Wallace, M.C.G. et
al. (2019), Antenatal care to increase participation in the continuum of maternal
and child healthcare: an analysis of the poorest regions of four Meso American countries.
BMC Pregnancy Childbirth 19, 66 (2019). https://doi.org/10.1186/s12884-019-2207-9.
[12] Lindsay Grenier, Lauren
Arrinton and Stephanie Shuwatsky (2021), Better together: Group ANC eight visit
model. Meeting guide. Published by Jhpiego Brown’s Wharf 1615 Thames Street, Baltimore,
Maryland 21231-3492 USA.
[13] Grenier L, Walker D, Lori JR, Klimas C. (2017),
Transformative ANC service delivery: lessons from the Global Group Antenatal Care
Collaborative [Presentation]. International Confederation of Midwives 31st Triennial
Congress Toronto. Jun 18–22, 2017.
[14] Patil CL, Abrams ET, Klima C, Kaponda CP, Leshabari
SC, Vonderheid SC, et al. CenterPregnancy-Africa: a pilot of group anatenatal care
to address millennium development goals. Midwifery. 2013; 29:1190–8. 10.1016/j.midw.2013.05.008
[PMC free article] [PubMed] [CrossRef] [Google Scholar].
[15] Eluwa GI, Adebajo SB, Torpey K, Shittu O, Abdu-Aguye
S, Pearlman D, et al. The effects of centering pregnancy on maternal and fetal outcomes
in northern Nigeria; a prospective cohort analysis. BMC Pregnancy Childbirth. 2018;
18: 158 10.1186/s12884-018-1805-2 [PMC free article] [PubMed] [CrossRef] [Google
Scholar].
[16] Sarah de
M, Maurice B, Ozge T, Juan PPR, Theresa L, Olufemi, TO and Metin G. (2-17), Integrated
Person-Centered Health Care for All Women During Pregnancy: Implementing World Health
Organization Recommendations on Antenatal Care for a Positive Pregnancy Experience.
Glob Health Sci Pract. 2017 Jun 27; 5(2): 197–201.
Published online 2017 Jun 27. doi: 10.9745/GHSP-D-17-00141 [PMC free article] [PubMed] [CrossRef] [Google Scholar].
[17] Ministry of Public Health and Sanitation and Ministry
of Medical Services (Kenya). National Guidelines for Quality Obstetrics and Perinatal
Care. Nairobi: Ministry of Health, 2011. [Google Scholar].
[18] Ministry of Health (Kenya). Facilitator’s Guide:
Providing Focused Antenatal Care. Nairobi: Ministry of Health, 2014. [Google Scholar].
[19] Manant A, Dodgson JE. (2011) Centering Pregnancy:
an integrative literature review. J Midwifery Women Health. 56:94–102. 10.1111/j.1542-2011.2010.00021.x
[PubMed] [CrossRef] [Google Scholar].
[20] Doku DT, Neupane S. Survival analysis of the association
between antenatal care attendance and neonatal mortality in 57 low-and middle-income
countries. International Journal of Epidemiology. 2017; 46: 1668–1677. 10.1093/ije/dyx125
[PMC free article] [PubMed] [CrossRef] [Google Scholar].
[21] Sharma J, O'Connor M, Rima Jolivet R. Group antenatal
care models in low- and middle-income countries: a systematic evidence synthesis.
Reprod Health. 2018; 15:38 10.1186/s12978-018-0476-9 [PMC free article] [PubMed]
[CrossRef] [Google Scholar].
[22] Catling CJ, Medley N, Foureur M, ryan C, Leap N,
Teate A, et al. Group versus conventional antenatal care for women (Review). Cochrane
Database Syst Rev. 2015; 2:CD007622. [PMC free article] [PubMed] [Google Scholar].
[23] Lori JR, Ofosu-Darkwah H, Boyd CJ, Banerjee T, Adanu
RMK. Improving health literacy through
group antenatal care: a prospective cohort study. BMC Pregnancy Childbirth. 2017;
17:228 10.1186/s12884-017-1414-5 [PMC free article] [PubMed] [CrossRef] [Google
Scholar].
[24] Lori JR, Munro ML, Chuey MR. Use of a facilitated
discussion model for antenatal care to improve communication. Int J Nurs Stud. 2016;
54:84–94. 10.1016/j.ijnurstu.2015.03.018 [PMC free article] [PubMed] [CrossRef]
[Google Scholar].
[25] Kabue MM, Grenier L, Suhowatsky S, Oyetunji J, Ugwa
E, Onguti B, et al. Group versus individual antenatal and first year postpartum
care: Study protocol for a multi-country cluster randomized controlled trial in
Kenya and Nigeria. Gates Open Res. 2018; 2:56 10.12688/gatesopenres.12867.1 [PMC
free article] [PubMed] [CrossRef] [Google Scholar].