ASSESSMENT OF THE QUALITY OF ANTENATAL CARE IN MANAGING ANAEMIA BASED ON GUIDELINES IN ASHAIMAN MUNICIPAL AND NINGO PRAMPRAM IN GREATER ACCRA

ABSTRACT

Background: The development of maternal health services does not warrant their use by women. Nor do the use of maternal health services warrant ideal results for women. A unique element of health care components which is spotlight to explain why women do either not access facilities at all or access the facilities late and experience an average unfavourable results, in spite of timely presentation, concerns the intangible notion of care.

Quality of care based on the definition of Institute of Medicine (IOM) is the degree to which health services for people and populations are enhanced by the probability of desired health results and are coherent with present professional understanding. The six dimensions of the quality of care with regards to the World Health Organization (WHO) are effectiveness, accessibility, equity, acceptability/patient-centeredness, safety, efficiency

Anaemia during a pregnancy is viewed as a crucial conundrum of preventive health worldwide. Records from WHO estimates that more than half of the world's pregnant women have a haemoglobin grade classified as anaemia (that is a haemoglobin level below 11.0g/dl)Iron deficiency may result in manifold adverse results for both mother and infant, including an increased risk of hemorrhage, sepsis, maternal mortality, perinatal mortality, and low birth weight.

The WHO recommends 120mg/day of iron (Fe) and 400Ug/day of folic acid (FA) for 3 months for the therapeutic treatment of anaemia in pregnancy (WHO, 2017).

General objective: To assess the quality of antenatal care with respect to anaemia management in pregnancy

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Method: A mixed method of cross-sectional quantitative study design and an in-depth qualitative study design was used. Ashaiman Municipal and Ningo Prampram District are two of 26 districts in Greater Accra of Ghana.

Lot Quality Assurance Sampling (LQAS) technique was used in the study. The study covered 27% of ANC facilities in Ashaiman municipal and 38% of ANC health facilities in Ningo Prampram district. This was done to fulfill the LQAS by including a health facility in each sub-district as a supervisory area.

Results: 9 health facilities had at least a midwife, laboratory technician and auxiliary health staff at their facilities and 4 facilities had only a midwife and auxiliary staff.

Only 1 health facility had anaemia treatment framework at their maternity unit and none of the health facilities had anaemia treatment protocols at their ANC units.

The study also found out that only 3 health facilities out of the 13 provided anaemia clinics to address anaemia in pregnancy and only 6 health facilities initiated treatment for anaemic pregnant women. However, none of the health facilities provided the 3 months WHO recommended therapeutic treatment for the anaemic women at their health facilities.

Conclusion: Correction supplementation of iron deficiency anaemia as noted by the WHO is a primary focus of health care facilities. However, despite the high prevalence of anaemia in Ghana and its well documented effects, particularly on females and children, the quality of care in managing anaemia in pregnancy was poor in this study. There were lack of essential structural measures such as framework for anaemia management, anaemia treatment protocol, and referral register for management of anaemia. This structural measures are required to ensure better health service delivery process and outcome. As a result the process and outcome measures for managing anaemia in pregnancy was also poorly rated.

Key Words: Quality of care, Anaemia, Treatment guidelines for anaemia, Antenatal care and Anaemia in pregnancy.