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Antenatal care services in rural Uganda: Missed opportunities for good-quality care

机译：乌干达农村地区的产前护理服务：错过优质护理的机会

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Experience from countries that have achieved low maternal mortality suggests that access to good-quality maternity services is critical to improve maternal health. In this article we appraise the quality of antenatal care (ANC) services in a rural district of Uganda. We used a mixed methods approach, relying on a combination of semistructured interviews with both clients and providers, structured observations of provider-patient interactions, and infrastructure assessment of selected health facilities. We found several bottlenecks in health service delivery, including ineffective organization of educational sessions; selective omission of certain services; lack of explanation of important clinical and laboratory procedures; failure to link the performed procedures with preventive information; and occasional lack of respect for clients. The policy implications of these findings are discussed in relation to the need to (a) ensure an adequate supply of medical equipment and drugs, (b) enhance health workers' compliance with ANC guidelines, and (c) combine medical procedures with educational messages.
机译：孕产妇死亡率低的国家的经验表明，获得优质孕产服务对于改善孕产妇健康至关重要。在本文中，我们评估了乌干达农村地区的产前护理（ANC）服务质量。我们使用了一种混合方法方法，依赖于对客户和提供者的半结构化访谈，对提供者与患者互动的结构化观察以及对选定医疗机构的基础设施评估的结合。我们发现卫生服务提供中存在几个瓶颈，包括教育会议组织不力;有选择地省略某些服务;对重要的临床和实验室程序缺乏解释;无法将执行的程序与预防信息联系起来;偶尔不尊重客户。讨论了这些发现的政策含义，涉及以下方面的需求：（a）确保医疗设备和药品的充足供应;（b）加强卫生工作者对ANC指南的遵守;（c）将医疗程序与教育信息相结合。

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