Quality Assessment of Antenatal Care in Public Health Facilities of Nepal’s Hilly District: An Observational Study

TL;DR

This study in Nepal found that most pregnant women received good antenatal care, but counseling and education need improvement.

Contribution

The study provides empirical data on antenatal care quality in Nepal's hilly districts from the perspective of pregnant women.

Findings

70.69% of pregnant women reported receiving good quality antenatal care.

Only 52.46% received adequate counseling and education during antenatal visits.

Improvements in counseling and education are needed to enhance overall care quality.

Abstract

Quality of antenatal care is essential for improving maternal and newborn health and plays a vital role in reducing maternal morbidity and mortality. This study aimed to assess perceptions of pregnant women regarding the quality of antenatal care.

A facility-based descriptive study was conducted among 406 third trimester pregnant women using systematic random sampling. Semi-structured questionnaires were administered through face-to-face interviews in the Nepali language. Both low- and high-risk women who consented to participate were included. Ethical approval and informed consent were obtained. The data were analyzed using descriptive statistics.

Among the 406 pregnant women, 317 (78.07%) were between 20-35 years old, 255 (62.80%) were Brahman/Chhetri, and 380 (93.59%) followed Hinduism. About 240 (59.11%) belonged to Joint families, 369 (90.88%) were literate, 237 (58.37%) engaged in agriculture, and 181 (44.58%) were primigravida women. Overall, 287 (70.69%) reported receiving good quality antenatal care. Regarding the perception of quality care during pregnancy in different aspects, good quality care related to antenatal examination was received by 312 (76.84%), antenatal care by 339 (83.49%), 213 (52.46%) received adequate counselling and education, and 289 (71.18%) were satisfied with the service provision.

Although the majority of pregnant women received good quality care during the antenatal period, gaps remained in counselling and education. Strengthening these components is essential to improve the overall quality of antenatal care services.