Antenatal coverage and quality in secondary-care hospitals of Punjab province, Pakistan
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Manawan Hospital, Indus Hospital and Health Network, Wagha, Pakistan
Publication date: 2023-04-27
Popul. Med. 2023;5(Supplement):A1019
Background: Antenatal care (ANC) can avoid the majority of adverse maternal and perinatal outcomes in LMICs. A closer examination reveals that only one in every two women in Punjab has the required number of ANC 4+ visits. This study was conducted to assess the coverage and quality of ANC at secondary care hospitals in Punjab. Methods: In this retrospective descriptive study, the data provided through the Annual Report on DHIS 2021 and the Electronic Medical Record (EMR) available at TMH were analyzed. The quality of antenatal care was assessed against the criteria of the essential package described in the Punjab Ministry of Healths Minimum Standards of Service Delivery. Results: The monthly average ANC-1 visits per THQ were 420 and 905 at TMH. TMH recorded 114,467 follow-up visits with an average of 3.5 visits per parturient and a referral rate of 10.46%. The dropout rate at THQ Hospitals was 33.52%, while 16.41% at TMH. Normal vaginal delivery and caesarean section rate were 83% and 17% at THQ hospital whereas 49.76% and 50.23% were for TMH respectively. The EMR gives evidence on history taking, questions about stillbirths, assisted deliveries, abortions, headaches/blurred vision, swelling, and fever. Highlights include, baby movement feeling (96%) Findings of the breast examination (83), measurement of blood pressure (100%), counselling on breastfeeding and Tetanus Toxoid vaccination (78%) and prescriptions for anti-malarial, iron, and folic acid (100%). Conclusions: The advantages of TMH over THQ hospitals include accessibility, adherence to policies and the EMR, front desk services, the availability of skilled staff, diagnostics, medication, patient education, counselling, and safety. It is proposed that data on ANC follow-up, the average number of ANC visits per parturient, the dropout rate, and referral from health facilities be included in the DHIS report to improve the study of ANC coverage and quality.  
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