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Afrizal SH, Hidayanto AN, Handayani PW, Besral B, Martha E, Markam H, Budiharsana M, Eryando T. Evaluation of integrated antenatal care implementation in primary health care. JOURNAL OF INTEGRATED CARE 2020. [DOI: 10.1108/jica-07-2019-0031] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeThis study was aimed to evaluate the implementation of an integrated antenatal care (ANC) scheme through a retrospective document study using a checklist for measuring the adequacy of the cohort ANC register documented by midwives in an urban area and to describe the barriers for the midwives during the ANC record process.Design/methodology/approachAn exploratory descriptive study using a sequential mixed method was utilised where a quantitative method was employed by collecting secondary data of 150 entries of the cohort ANC register and followed by in-depth interviews among midwives and community health workers.FindingsThe results show that the cohort registry indicators for integrated care such as laboratory and management were poorly recorded. Several barriers were found and categorised during the implementation of the integrated ANC, namely (1) governance and strategy, (2) process of care, (3) organisation and management support.Research limitations/implicationsThe contribution of this present research is that it provides empirical data of the integrated ANC implementation in primary health care (PHC) which has the responsibility to deliver an integrated level of care for ANC using a cohort registry for pregnancy registration monitoring which facilitates the continuity and quality of care.Practical implicationsPractical implication of the finding is that functional integration such as the clinical information system to facilitate an efficient and effective approach during the implementation of integrated ANC in primary care should be considered to support the clinical, professional, organisational, system and normative integration.Originality/valueSince only limited studies have been conducted to assess the quality of the cohort ANC registry and to investigate the barriers against integrated ANC implementation in Indonesia, the research findings are valuable information for the national and local governments to improve the ANC service in Indonesia.
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Maher D, Ford N. Promoting synergies between clinical medicine and public health. Trop Med Int Health 2016; 21:938-942. [PMID: 27260369 DOI: 10.1111/tmi.12733] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Dermot Maher
- Tropical Diseases Research, World Health Organization, Geneva, Switzerland
| | - Nathan Ford
- Department of HIV and Global Hepatitis Programme, World Health Organization, Geneva, Switzerland
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Kihara AB, Harries AD, Bissell K, Kizito W, Van Den Berg R, Mueke S, Mwangi A, Sitene JC, Gathara D, Kosgei RJ, Kiarie J, Gichangi P. Antenatal care and pregnancy outcomes in a safe motherhood health voucher system in rural Kenya, 2007-2013. Public Health Action 2015; 5:23-9. [PMID: 26400598 DOI: 10.5588/pha.14.0070] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Accepted: 11/25/2014] [Indexed: 11/10/2022] Open
Abstract
SETTING A rural private health facility, Ruby Medical Centre (RMC), participating in a safe motherhood health voucher system for poor women in Kiambu County, Kenya. OBJECTIVES Between 2007 and 2013, to determine 1) the number of women who delivered at the RMC, their characteristics and pregnancy-related outcomes, and 2) the number of women who received an incomplete antenatal care (ANC) package and associated factors. DESIGN Retrospective cross-sectional study using routine programme data. RESULTS During the study period, 2635 women delivered at the RMC: 50% were aged 16-24 years, 60% transferred in from other facilities and 59% started ANC in the third trimester of pregnancy. Of the 2635 women, 1793 (68%) received an incomplete ANC package: 347 (13%) missed essential blood tests, 312 (12%) missed the tetanus toxoid immunisation and 1672 (65%) had fewer than four visits. Presenting late and starting ANC elsewhere were associated with an incomplete package. One pregnancy-related mortality occurred; the stillbirth rate was 10 per 1000 births. CONCLUSION This first assessment of the health voucher system in rural Kenya showed problems in ANC quality. Despite favourable pregnancy-related outcomes, increased efforts should be made to ensure earlier presentation of pregnant women, comprehensive ANC, and more consistent and accurate monitoring of reproductive indicators and interventions.
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Affiliation(s)
- A-B Kihara
- Department of Obstetrics and Gynaecology, University of Nairobi, Nairobi, Kenya ; Kenya Obstetrics and Gynaecology Society, Nairobi, Kenya ; Ruby Medical Centre, Kiambu West, Kenya
| | - A D Harries
- International Union Against Tuberculosis and Lung Disease, Paris, France ; London School of Hygiene & Tropical Medicine, London, UK
| | - K Bissell
- International Union Against Tuberculosis and Lung Disease, Paris, France ; School of Population Health, The University of Auckland, Auckland, New Zealand
| | - W Kizito
- Médecins Sans Frontières (MSF) Belgium, Nairobi, Kenya
| | - R Van Den Berg
- Medical Department, Brussels Operational Center, MSF-Luxembourg, Luxembourg
| | - S Mueke
- Kenya Obstetrics and Gynaecology Society, Nairobi, Kenya ; Ministry of Health, Nairobi, Kenya
| | - A Mwangi
- Moi University School of Medicine, Eldoret, Kenya
| | - J C Sitene
- Moi University School of Medicine, Eldoret, Kenya
| | - D Gathara
- Ruby Medical Centre, Kiambu West, Kenya
| | - R J Kosgei
- Department of Obstetrics and Gynaecology, University of Nairobi, Nairobi, Kenya ; Kenya Obstetrics and Gynaecology Society, Nairobi, Kenya
| | - J Kiarie
- Department of Obstetrics and Gynaecology, University of Nairobi, Nairobi, Kenya ; Kenya Obstetrics and Gynaecology Society, Nairobi, Kenya
| | - P Gichangi
- Kenya Obstetrics and Gynaecology Society, Nairobi, Kenya ; Department of Human Anatomy, University of Nairobi, Nairobi, Kenya
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