Factors associated with quality antenatal care services in Lusaka

Abstract

The quality of antenatal care (ANC) that pregnant women receive in Zambia continues to be poor despite several interventions. Research has shown that only 29% of women in Zambia receive high quality antenatal care. The quality of ANC a woman receives during pregnancy is crucial to both the child and the mother’s life. It has been established that providing high quality ANC can save lives and has a positive impact on postnatal health care services. However, the quality of ANC in Zambia requires attention as maternal and neonatal mortality rates are still unacceptably high with Lusaka district not being left out of the bottleneck. Using a cross sectional study design, the main aim of this study was to determine factors associated with high quality antenatal care among pregnant women in Lusaka. The study population comprised of all pregnant women aged 15-49 years attending ANC either in the first, second or third trimester. A multi-stage sampling technique was used to select the 380 study participants. The study estimated the proportion of women who received high quality ANC during their last antenatal visit. The research further used a backward elimination method by removing all variables with the least significant global p-values. This process was repeated until the model only had variables with a p-value of < 0.05. Data analysis of this study was done in STATA 13.1. It was established that only 47.1% of pregnant women received high quality ANC while 52.9% received low quality. Six key ANC interventions were considered, urine (36.7%) and blood (46.8%) testing were the least received basic components of ANC. After adjusting for the effect of other factors, women with secondary education had higher odds of receiving high quality ANC than women with primary level of education (OR = 1.93; 95% CI: 1.17 to 3.15). Women who received ANC services from midwives and nurses were less likely to receive high quality ANC compared to those who received ANC from a doctor (OR = 0.18; 95% CI: 0.05 to 0.59) and (OR = 0.13; 95% CI: 0.04 to 0.41) respectively. Generally, the quality of antenatal care received by pregnant women in Lusaka is unacceptable. It is therefore imperative that in the short run, continued effort to improve the delivery of basic services such as blood and urine testing is required and consequently in the long run, there is need to improve the quality of health care services provided by medical personnel at all levels.