Audit of antenatal services in primary healthcare centres in Jos, Nigeria

Abstract

Introduction: Maternal mortality remains a big challenge in developing countries including Nigeria where the figures are amongst the highest in the world. The Nigerian government's response in providing primary healthcare centres (PHCs) in all local government areas is commendable but access to quality antenatal care is still poor. The high proportion of maternal deaths resulting from late referrals from PHC's to the Jos University Teaching Hospital (JUTH), prompted this study to audit antenatal services in PHC's in Jos.

Methods: Six of the 12 PHC's in Jos were randomly sampled and 425 consecutive antenatal clinic attendees were recruited for the study. In each case, the client's records were scrutinized and a detailed history and physical examination was conducted. Details of personal data and of antenatal care provided were tabulated and analyzed using frequencies.

Results: The results showed that 35.5% of pregnant women receiving antenatal care at PHCs in the Jos area were clients with high-risk pregnancies. Over two-thirds of the pregnant women received antenatal care in the PHCs without blood pressure surveillance. Maternal weight was regularly checked in 78.1% (332/425) but height was not recorded in any woman. Sickling test/genotype and VDRL were not done and no client received malaria prophylaxis.

Conclusion: The study showed that the standard of antenatal care offered in PHCs in Jos fell short of the required level and represents a missed opportunity to impact on the poor maternal and perinatal health statistics in the area.

Keywords: antenatal care, standard of care, audit, Nigeria

Tropical Journal of Obstetrics and GynaecologyVol. 22(2) 2005: 147-151