The study was conducted to evaluate the quality of antenatal care (ANC) provided at rural health centres (RHC). Matebeleland North Province in Zimbabwe was selected as the study area. A qualitative, descriptive study was conducted with the application of the modified EPI/Cluster Sampling Method for the 30 rural health centres selected as primary sampling units. The research methodology consisted of an assessment of structure and process evaluation. Antenatal care clients attending rural health centres were interviewed, records audited and process observations undertaken of health centre staff performing antenatal duties. An inventory and use of equipment at these facilities was conducted. The study indicated that there was overall consumer satisfaction with the antenatal care services in the province. More than 65 pc of the clients indicating that they were less than 10 km from a health facility that provided antenatal care. As expected from the facility sample of women cost recovery did not feature as a barrier to assess. The professional performance by health workers at rural health centre level in the province in the provision of antenatal care was found to be unsatisfactory. Limited availability of equipment coupled with poor know-how contributed significantly to the provision of poor services. Whereas health workers were able to identify some pregnancy related risk factors, inadequate efforts were put into minimizing their contribution to the adverse outcome of pregnancy. The study proposes strategies to improve the quality of antenatal care through organisational review and implementation of relevant policies and technical procedures.
PIP: A study was undertaken to evaluate the quality of prenatal care provided at rural health centers in Zimbabwe. For the primary sampling unit of 30 health centers, a check list process evaluation was performed, 171 clients were interviewed, equipment was assessed, and records were audited. Data were analyzed with Epi-Info computer software. It was found that most of the facilities had adequate and functioning equipment, 63% of the clients had adequate access to the facilities (2 hours walk), 95% were satisfied with the quality of care they received, and the observed prenatal examinations were satisfactory. The audit of record-keeping revealed instances where risk factors were noted but no action was taken and instances where risk factors were not identified. Routine urinalysis, syphilis screening, and hemoglobin estimates were infrequently performed. Thus, several deficiencies were identified. Efforts must be made to improve the interpretation of recorded patient information, and streamlining record-keeping systems would help in this regard. The provision of supplies and equipment and its maintenance should be a priority as should the training of health workers in its use. The rural health center staff should be able to perform routine tests. The provision of efficient means of communication would strengthen the referral system as would the availability of ambulance services. Personnel should also receive on-going training in dealing with high risk pregnancies.