CHAPTER ONE

INTRODUCTION

1.1 Background

Pregnancy related deaths and disease remain unacceptably high. Globally In 2015 an estimated 303,000 women died of pregnancy related causes, 2.7 million babies died during the neonatal period and 2.6 million were stillbirth. While substantial progress has been made over the past two decades, increased access to, and use of, higher quality health care during pregnancy and childbirth can prevent many of these deaths and diseases, as well as improve women and adolescent girls’ experience of pregnancy and childbirth. Globally however only 64% of women receive antenatal care four or more times throughout their pregnancy (Tadese et al., 2018). ANC is one the evidence-based interventions to decrease the probability of bad health outcomes for mothers and their newborns. The effectiveness of ANC however relies on the quality of care provided during each antenatal visit (Tadese et al., 2018).

ANC offers a great opportunity to inform, educate and sensitize pregnant women on important health issues including health promotion activities, screening and diagnosis. ANC is also a very powerful platform for communication with women, families and communities at a critical time in a woman’s life. Furthermore, ANC increases the chances of better management and outcome of the most common complications (e.g. infection, pregnancy induced hypertensive disorders and severe bleeding) associated with maternal morbidity and mortality in low income countries (Akashi et al., 2006). Proper ANC aids to identify pregnant women at risk and timely referral practices are known to reduce maternal and neonatal morbidity and mortality, this qualifies ANC as an important component of birth Preparedness and Complications Readiness (BPCR) matrix that encompasses all the skills needed to ensure the safety and wellbeing of the pregnant woman and her newborn throughout pregnancy, labor, childbirth and postpartum period

The new guidance increases the number of contacts a pregnant woman has with health providers throughout her pregnancy from four to eight. Recent evidence indicates that a higher frequency of antenatal contacts by women and adolescent girls with a health provider is associated with a reduced likelihood of stillbirths. This is because of increased opportunities to detect and manage potential complications. Since 2002 there has been a progressive increase in the use of ANC services among pregnant women in low- and middle-income countries leading to marked improvements in maternal and child health (Akashi et al., 2006). Moreover, women’s knowledge and proficiency in the area of ANC is limited in low income countries, several studies have identified factors that interfere with quality of ANC services rendered which are: level of education of care giver, area of residence, site of choice, perception of pregnant woman, number of visits, pregnancy groups (Egbe et al., 2015)

ANC coverage in Cameroon in 2007 stood at 82% with 60% of pregnant women having four or more visits (Halle et al., 2015). Studies of ANC in low income countries have focused mainly on monitoring quantifiable data such as the number of antenatal visits during ANC and its effects on pregnancy outcome. However, the perspective is changing to rather access quality because it is key component in health care provision. In Cameroon there are few reported studies on the quality of ANC services rendered; meanwhile the study of consumer perceptions in relation to behavioral outcomes has been on the rise in other countries. This study is therefore Assess the pregnant woman’s satisfaction on the quality of ANC rendered to them at the Buea Regional hospital.

1.2 Statement Problem

Lack of proper ANC has become a major health problem in the maternity and neonatal aspects of life all over the world. Studies have shown that poor comprehension of ANC has led to increase rate of morbidity and mortality in antenatal and postnatal units and one of the ways to fight against this is to improve on quality of the antenatal care given by health workers. Lack of satisfaction with the quality of ANC services rendered would negatively impact ANC coverage and consequently increase morbidity and mortality during pregnancy and child birth.

It is against this background that this study was undertaken to assess the pregnant women satisfaction on the quality of ANC services at the BRH.

aims at assessing the pregnant woman’s satisfaction on quality of ANC services rendered to them at the BRH.

1.3 Research Question

1. Are the clients aware of the package of ANC services offered at the BRH?
2. How satisfied are the pregnant women attending BRH with the quality of ANC services rendered?

• What are the factors/limiting the quality of ANC services offered at the BRH?

1.4 Research Objective

1.4.1 General Objective

To assess the pregnant women satisfaction on quality of ANC services at the BRH.

1.4.2 Specific Objectives

• To access the package of ANC services offered at the BRH
• To determine the level of satisfaction of pregnant women with ANC services offered at the BRH
• To identify the factors that limits patients from attending ANC at the BRH