1 Gynaecology and Obstetrics, Department of Clinical Research, Det Sundhedsvidenskabelige Fakultet, SDU2 Children health, National Institute of Public Health, Det Sundhedsvidenskabelige Fakultet, SDU3 Department of International Health, Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3, 2200 Copenhagen N, Denmark.4 Department of Obstetrics and Gynaecology, College of Public Health and Medical Sciences, Jimma University, P.O. Box 378, Jimma, Ethiopia.5 Department of Population and Family Health, Jimma University, P.O. Box 378, Jimma, Ethiopia.6 JUCAN Research Collaboration, Jimma University, P.O. Box 378, Jimma, Ethiopia.7 Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Rolighedsvej 25, 1958 Frederiksberg C, Denmark.8 Children health, National Institute of Public Health, Det Sundhedsvidenskabelige Fakultet, SDU9 Gynaecology and Obstetrics, Department of Clinical Research, Det Sundhedsvidenskabelige Fakultet, SDU
a mixed-method needs assessment
Objective. We assessed how health system priorities matched user expectations and what the needs for antenatal care (ANC) strengthening were for improved maternal health in Jimma, Ethiopia. Methods. A questionnaire survey among all recent mothers in the study area was conducted to study the content of ANC and to identify the predictors of low ANC satisfaction. Further, a qualitative approach was applied to understand perceptions, practices, and policies of ANC. Results. There were no national guidelines for ANC in Ethiopia. Within the health system, the teaching of health professional students was given high priority, and that contributed to a lack of continuity and privacy. To the women, poor user-provider interaction was a serious concern hindering the trust in the health care providers. Further, the care provision was compromised by the inadequate laboratory facilities, unstructured health education, and lack of training of health professionals. Conclusions. Health system trials are needed to study the feasibility of ANC strengthening in the study area. Nationally and internationally, the leadership needs to be strengthened with supportive supervision geared towards building trust and mutual respect to protect maternal and infant health.
Journal of Environmental and Public Health, 2014, Vol 2014