Outcome of multifaceted interventions for improving the quality of antenatal care in Nigerian referral hospitals
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RESEARCH
Open Access
Outcome of multifaceted interventions for improving the quality of antenatal care in Nigerian referral hospitals Friday Ebhodaghe Okonofua1,2,3*, Lorretta Favour Chizomam Ntoimo1,4, Bola Ekezue5, Victor Ohenhen6, Kingsley Agholor7, Mohammed Gana8, Brian Igboin1, Chioma Ekwo1, Wilson Imongan1, Hadiza Galadanci9 and Rosemary Ogu10
Abstract Background: The study was designed as quasi-experimental research to investigate the effectiveness of multifaceted interventions for improving the quality of antenatal care in referral hospitals in Nigeria. Two referral hospitals (the Central Hospital in Benin City, South-South Nigeria, and the General Hospital in Minna) served as intervention sites, while two hospitals in comparable locations, (the Central Hospital Warri and the Suleja Hospital Abuja) were the control hospitals. Methods: Intervention activities consisted of the introduction of a strategic plan with the shared vision of reducing maternal mortality by 50% in 1 year in the hospitals; staff training and re-training; the establishment of an automated appointment system; composite health education involving couples and providers; advocacy with policymakers; and the implementation of maternal death reviews and surveillance. These activities were implemented in the intervention hospitals over 21 months (October 2017 to June 2019). Exit interviews of pregnant women at intervention and control sites by trained interviewers were used to assess the quality of antenatal care after their visit, A total of 777 women were interviewed (427 in the intervention sites and 350 in the control sites). Data were analyzed with univariate and multivariate Poisson and logistic regression to determine the extent to which health providers in the clinics completed the 18 signal functions identified in the WHO assessment tool. Results: The regression analyses showed the interventions were effective in improving six quality indicators (QIs) for counseling and information sharing. The difference between intervention and control sites on these QIs was significant at < 0.05. On the contrary, the interventions were less effective for maternal and fetal measurements; and disease testing and management QIs. (Continued on next page)
* Correspondence: [email protected] 1 Women’s Health and Action Research Centre (WHARC), Benin City, Nigeria 2 Centre of Excellence in Reproductive Health Innovation, University of Benin, Benin City, Nigeria Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a
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