Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Nov 24;16(1):369.
doi: 10.1186/s12884-016-1167-6.

Provider adherence to first antenatal care guidelines and risk of pregnancy complications in public sector facilities: a Ghanaian cohort study

Mary Amoakoh-Coleman  1   2   3 , Kerstin Klipstein-Grobusch  4   5 , Irene Akua Agyepong  6   7 , Gbenga A Kayode  4 , Diederick E Grobbee  4 , Evelyn K Ansah  7
Affiliations

Provider adherence to first antenatal care guidelines and risk of pregnancy complications in public sector facilities: a Ghanaian cohort study

Mary Amoakoh-Coleman et al. BMC Pregnancy Childbirth. .

Abstract

Background: Guideline utilization aims at improvement in quality of care and better health outcomes. The objective of the current study was to determine the effect of provider complete adherence to the first antenatal care guidelines on the risk of maternal and neonatal complications in a low resource setting.

Methods: Women delivering in 11 health facilities in the Greater Accra region of Ghana were recruited into a cohort study. Their first antenatal visit records were reviewed to assess providers' adherence to the guidelines, using a thirteen-point checklist. Information on their socio-demographic characteristics and previous pregnancy history was collected. Participants were followed up for 6 weeks post-partum to complete data collection on outcomes. The incidence of maternal and neonatal complications was estimated. The effects of complete adherence on risk of maternal and neonatal complications were estimated and expressed as relative risks (RRs) with their 95% confidence intervals (CI) adjusted for a potential clustering effect of health facilities.

Results: Overall, 926 women were followed up to 6 weeks post-partum. Mean age (SD) of participants was 28.2 (5.4) years. Complete adherence to guidelines pertained to the care of 48.5% of women. Incidence of preterm deliveries, low birth weight, stillbirths and neonatal mortality were 5.3, 6.1, 0.4 and 1.4% respectively. Complete adherence to the guidelines decreased risk of any neonatal complication [0.72 (0.65-0.93); p = 0.01] and delivery complication [0.66 (0.44-0.99), p = 0.04].

Conclusion: Complete provider adherence to antenatal care guidelines at first antenatal visit influences delivery and neonatal outcomes. While there is the need to explore and understand explanatory mechanisms for these observations, programs that promote complete adherence to guidelines will improve the pregnancy outcomes.

Keywords: Adherence; Antenatal care; First antenatal visit; Maternal; Neonatal; Outcomes.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Flow diagram for participants’ in the study. A description of participants’ recruitment, follow-up and analysis in the study
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. The World Bank - IBRD-IDA. Millennium Development Goals (Goal 5). 2016. Ref Type: Online Source. Accessed 6 Nov 2016.
    1. Campbell OM, Graham WJ. Strategies for reducing maternal mortality: getting on with what works. Lancet. 2006;368:1284–1299. doi: 10.1016/S0140-6736(06)69381-1. - DOI - PubMed
    1. Ministry of Health (MoH) GoGaUNCTitRoG. Ghana MDG acceleration fremawork and country action plan, maternal health. 2011. Ref Type: Repor. Accessed 8 Nov 2011.
    1. Edmond KM, Zandoh C, Quigley MA, Amenga-Etego S, Owusu-Agyei S, Kirkwood BR. Delayed Breastfeeding Initiation Increases Risk of Neonatal Mortality. Pediatrics. 2006;117:e380–e386. doi: 10.1542/peds.2005-1496. - DOI - PubMed
    1. Biritwum RB. Promoting and Monitoring Safe Motherhood in Ghana. Ghana Med J. 2006;40:78–79. - PMC - PubMed

Publication types

MeSH terms