In Africa, the proportion Africa, such as malaria, STIs, maternal and neonatal of pregnant women who attended the recommended four tetanus, HIV, tuberculosis TB , and some nutritional or more visits increased by six percent over 10 years. If not Similarly, the proportion of women who received ANC in effectively managed, most of these conditions interact the first six months of pregnancy increased by 10 percent during pregnancy and may worsen pregnancy outcomes, over 10 years, faster than the increase of overall ANC especially HIV and malaria Section III.
Thus, coverage. Country-specific data is available on the and emergency obstetric care services. ANC offers an opportunity to develop a birth and emergency preparedness plan. WHO recommends that all pregnant women have a written plan for dealing with birth and any unexpected adverse events, such as complications or emergencies that may occur during pregnancy, childbirth, or the immediate postnatal period.
Women should discuss and review this plan with a skilled attendant at every ANC assessment and one month before the expected date of birth.
Although little evidence exists to show the direct correlation between birth preparedness and reducing morbidity or mortality for mothers and babies, small-scale studies show that there is considerable benefit to be gained from this intervention. For instance, the adoption of new practices associated with planning such as setting aside money for the birth, transport arrangements, and the use of a birth plan at family and community levels is encouraging.
In Africa, neonatal tetanus deaths have been halved during the s, partly due to increased tetanus toxoid immunisation. Seven countries in sub-Saharan African have eliminated neonatal tetanus. ANC services provide an opportunity to vaccinate pregnant women with the recommended two doses of tetanus toxoid vaccination.
Where ANC coverage is low, or misses certain populations mass immunisation of women of childbearing age is an alternative option. Prevention and case management of maternal malaria Section III chapter 8 In Africa, at least 25 million pregnancies are threatened by malaria each year, resulting in an estimated percent of maternal anaemia. In areas of high and moderate stable malaria transmission, adult women acquire immunity, and most malaria infections in pregnant women are asymptomatic.
Nevertheless, these asymptomatic infections of the placenta result in anaemia for the mother and contribute to low birthweight LBW and preterm birth, which lead to higher infant mortality and impaired development of the child. Maternal malaria infection accounts for almost 30 percent of all the causes of LBW that can be prevented during pregnancy. In most settings, coverage of intermittent preventive treatment in pregnancy for malaria IPTp at 10 percent and insecticide treated bednets ITN at percent are both significantly lower than coverage of at least one antenatal visit see profile for sub Saharan Africa.
However, women should be made aware of the danger signs of malaria, and ANC providers need the knowledge and skills to treat women with uncomplicated malaria and refer those with complicated malaria. Prevention of maternal anaemia and malnutrition Section III chapter 6 Anaemia affects nearly half of all pregnant women in the world and is a risk factor for maternal morbidity and mortality. For the mother, anaemia during pregnancy increases the risk of dying from haemorrhage, a leading cause of maternal death.
Anaemia in pregnancy is also associated with an increased risk of stillbirth, LBW, prematurity, and neonatal death. In addition to health promotion activities, the strategies for control of anaemia in pregnancy include iron and folic acid supplementation, de-worming for intestinal infestations, malaria prevention, improved obstetric care, and management of severe anaemia.
Antenatal services can integrate advice on nutrition including supplementation in settings with micronutrient deficiencies, and can encourage breastfeeding practices. Although estimates vary, at least 50 percent of women with acute syphilis suffer adverse pregnancy outcomes. The more recent the maternal infection, the more likely the infant will be affected.
Most sub-Saharan African countries have high rates of syphilis infection. WHO recommends that all pregnant women should be screened for syphilis at the first ANC visit in the first trimester and again in childbirth.
Women testing positive for syphilis should be treated and informed of the importance of being tested for HIV infection. Their partners should also be treated, and plans should be made to treat their babies after birth. Syphilis control in pregnant women through universal antenatal screening and treatment of positive cases has been established as a feasible and cost effective intervention — syphilis complications are severe, yet therapy is cheap and effective.
Nevertheless, many women attending ANC are not screened or treated for syphilis, resulting in avoidable stillbirths and neonatal deaths. Simple and effective screening tests for syphilis are now available, which can be used on site at even the lowest levels of service delivery.
Despite current low levels of coverage, strong political commitments, increased resources allocated to PMTCT, and increased focus on integrated care from the same provider all represent good opportunities for strengthening ANC, particularly birth preparedness, use of skilled attendants at birth, and information and counselling on infant feeding options.
These include calcium supplementation in settings with low calcium intake, treatment of bacteriuria, antenatal steroids for preterm labour, and antibiotics for prolonged rupture of membranes. These are becoming available in teaching hospitals and private ANC clinics. Challenges staff in the absence of incentives.
Additionally, lack of up-to-date standards and protocols, poorly defined roles To respond to the needs of pregnant women, ANC must among programmes or staff, and weak monitoring address multiple conditions directly or indirectly related systems contribute to low quality ANC. ANC should also provide required contribute to the difficulty in assessing quality of care in information and advice on pregnancy, childbirth, and the public and private ANC clinics.
Establishing and postnatal period, including newborn care. The most sustaining a functional health system that can provide effective way to do this is through integration of universal coverage of quality ANC at least four visits at programmes and availability of health care providers with the correct times during pregnancy is a challenge for a wide range of skills.
But integration is easier to say than many countries in Africa. Deployment of under funded See Section IV. Staff services along the continuum of care, ANC shares with may not have the required skills to provide all other components overarching challenges that are components of ANC or may not receive the support they influenced by supply and demand: general health system need.
ANC can be the platform to support special groups weaknesses and social, economic, and cultural barriers. LBW , and child abandonment and neglect. However, Competition for staff and money as well as poor this is difficult for a lot of already overburdened ANC communication with other programmes or components providers, who often struggle just to provide the basic malaria, HIV, emergency obstetric care can be found at health promotion messages with limited resources and different levels of the health system, particularly where heavy caseloads.
A recent study found that providing policies are ill defined. National and sub-national level focused ANC was thirty minutes more on average than health budgets may be too small and heavily dependent the current practice.
The time required for each focused on donor funding. As a relatively low-profile service, ANC visit has implications for staffing levels and ANC may not receive enough funding. Low managerial opportunity costs for both clinics and the women capacity is common at district level, and poorer districts attending.
In addition, many may simply lack knowledge the utilisation of services. Weak health referral systems to about danger signs in pregnancy and will not know how support case management of complications of pregnancy to seek care when a complication occurs during inevitably reduces the overall impact of ANC.
Finally, a lack of awareness exists about the extent and impact of traditional household and Social, economic, and cultural barriers community beliefs and customs, such as suboptimal ANC coverage is lower among women who need it the maternal nutrition and infant feeding practices. The most: those who are poor, less educated, and living in attitudes and behaviours of health care providers in ANC rural areas. An important barrier is the inability to pay for clinics compound this problem by failing to respect the ANC or the treatment prescribed in ANC, where user privacy, confidentiality, and traditional beliefs of the fees are in place and safety nets for the poor do not exist.
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Download Download PDF. Translate PDF. Antenatal care, formal education and child-bearing in collaboration with C.
BANO, N. Both formal education and antenatal care had tremendous impact on the results of childbearing. Among women in their thirties and beyond. Formal education, by changing social attitudes, holds the key to improvements in maternal and pcrinatal health.
Antenatal care is known universally to be associ- the last no more than 2 weeks before delivery. Yet existing social attitudes deliveries, and they were of three subgroups. This report initial intention of receiving any modern system strengthens the belief that under these circum- of maternity care.
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