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How much time do health services spend on antenatal care? Implications for the introduction of the focused antenatal care model in Tanzania
BACKGROUND: Antenatal care (ANC) is a widely used strategy to improve the health of pregnant women and to encourage skilled care during childbirth. In 2002, the Ministry of Health of the United Republic of Tanzania developed a national adaptation plan based on the new model of the World Health Organ...
Autores principales: | , , , , |
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Formato: | Texto |
Lenguaje: | English |
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BioMed Central
2006
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1557863/ https://www.ncbi.nlm.nih.gov/pubmed/16796749 http://dx.doi.org/10.1186/1471-2393-6-22 |
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author | von Both, Claudia Fleβa, Steffen Makuwani, Ahmad Mpembeni, Rose Jahn, Albrecht |
author_facet | von Both, Claudia Fleβa, Steffen Makuwani, Ahmad Mpembeni, Rose Jahn, Albrecht |
author_sort | von Both, Claudia |
collection | PubMed |
description | BACKGROUND: Antenatal care (ANC) is a widely used strategy to improve the health of pregnant women and to encourage skilled care during childbirth. In 2002, the Ministry of Health of the United Republic of Tanzania developed a national adaptation plan based on the new model of the World Health Organisation (WHO). In this study we assess the time health workers currently spent on providing ANC services and compare it to the requirements anticipated for the new ANC model in order to identify the implications of Focused ANC on health care providers' workload. METHODS: Health workers in four dispensaries in Mtwara Urban District, Southern Tanzania, were observed while providing routine ANC. The time used for the overall activity as well as for the different, specific components of 71 ANC service provisions was measured in detail; 28 of these were first visits and 43 revisits. Standard time requirements for the provision of focused ANC were assessed through simulated consultations based on the new guidelines. RESULTS: The average time health workers currently spend for providing ANC service to a first visit client was found to be 15 minutes; the provision of ANC according to the focused ANC model was assessed to be 46 minutes. For a revisiting client the difference between current practise and the anticipated standard of the new model was 27 minutes (9 vs. 36 min.). The major discrepancy between the two procedures was related to counselling. On average a first visit client was counselled for 1:30 minutes, while counselling in revisiting clients did hardly take place at all. The simulation of focused ANC revealed that proper counselling would take about 15 minutes per visit. CONCLUSION: While the introduction of focused ANC has the potential to improve the health of pregnant women and to raise the number of births attended by skilled staff in Tanzania, it may need additional investment in human resources. The generally anticipated saving effect of the new model through the reduction of routine consultations may not materialise because the number of consultations is already low in Tanzania with a median of only 4 visits per pregnancy. Special attention needs to be given to counselling attitudes and skills during the training for Focused ANC as this component is identified as the major difference between old practise and the new model. Our estimated requirement of 46 minutes per first visit consultation matches well with the WHO estimate of 40 minutes. |
format | Text |
id | pubmed-1557863 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2006 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-15578632006-09-01 How much time do health services spend on antenatal care? Implications for the introduction of the focused antenatal care model in Tanzania von Both, Claudia Fleβa, Steffen Makuwani, Ahmad Mpembeni, Rose Jahn, Albrecht BMC Pregnancy Childbirth Research Article BACKGROUND: Antenatal care (ANC) is a widely used strategy to improve the health of pregnant women and to encourage skilled care during childbirth. In 2002, the Ministry of Health of the United Republic of Tanzania developed a national adaptation plan based on the new model of the World Health Organisation (WHO). In this study we assess the time health workers currently spent on providing ANC services and compare it to the requirements anticipated for the new ANC model in order to identify the implications of Focused ANC on health care providers' workload. METHODS: Health workers in four dispensaries in Mtwara Urban District, Southern Tanzania, were observed while providing routine ANC. The time used for the overall activity as well as for the different, specific components of 71 ANC service provisions was measured in detail; 28 of these were first visits and 43 revisits. Standard time requirements for the provision of focused ANC were assessed through simulated consultations based on the new guidelines. RESULTS: The average time health workers currently spend for providing ANC service to a first visit client was found to be 15 minutes; the provision of ANC according to the focused ANC model was assessed to be 46 minutes. For a revisiting client the difference between current practise and the anticipated standard of the new model was 27 minutes (9 vs. 36 min.). The major discrepancy between the two procedures was related to counselling. On average a first visit client was counselled for 1:30 minutes, while counselling in revisiting clients did hardly take place at all. The simulation of focused ANC revealed that proper counselling would take about 15 minutes per visit. CONCLUSION: While the introduction of focused ANC has the potential to improve the health of pregnant women and to raise the number of births attended by skilled staff in Tanzania, it may need additional investment in human resources. The generally anticipated saving effect of the new model through the reduction of routine consultations may not materialise because the number of consultations is already low in Tanzania with a median of only 4 visits per pregnancy. Special attention needs to be given to counselling attitudes and skills during the training for Focused ANC as this component is identified as the major difference between old practise and the new model. Our estimated requirement of 46 minutes per first visit consultation matches well with the WHO estimate of 40 minutes. BioMed Central 2006-06-23 /pmc/articles/PMC1557863/ /pubmed/16796749 http://dx.doi.org/10.1186/1471-2393-6-22 Text en Copyright © 2006 von Both et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( (http://creativecommons.org/licenses/by/2.0) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Article von Both, Claudia Fleβa, Steffen Makuwani, Ahmad Mpembeni, Rose Jahn, Albrecht How much time do health services spend on antenatal care? Implications for the introduction of the focused antenatal care model in Tanzania |
title | How much time do health services spend on antenatal care? Implications for the introduction of the focused antenatal care model in Tanzania |
title_full | How much time do health services spend on antenatal care? Implications for the introduction of the focused antenatal care model in Tanzania |
title_fullStr | How much time do health services spend on antenatal care? Implications for the introduction of the focused antenatal care model in Tanzania |
title_full_unstemmed | How much time do health services spend on antenatal care? Implications for the introduction of the focused antenatal care model in Tanzania |
title_short | How much time do health services spend on antenatal care? Implications for the introduction of the focused antenatal care model in Tanzania |
title_sort | how much time do health services spend on antenatal care? implications for the introduction of the focused antenatal care model in tanzania |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1557863/ https://www.ncbi.nlm.nih.gov/pubmed/16796749 http://dx.doi.org/10.1186/1471-2393-6-22 |
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