Abstract:

Background: ANC is to prepare women for birth and parenthood and prevent problems for pregnant women, mothers and babies through early detection, alleviation and or management of health problems that affect mothers and babies during pregnancy (1). The success of any ANC depends on its policy formulation and implementation. It also depends on functional and operational continuum of care with affordable, accessible, high quality care during and after pregnancy and childbirth (2).

The objective of this study was to assess the quality of ANC services to mothers attending ANC and RCH clinic at SDDH, and the number of visits made by mothers attending ANC as well as RCH at SDDH. Which included also assessment of the investigations, prophylactic treatment and screening services for diseases provided during pregnancy in ANC with aid of RCH card and direct questioning the mother at RCH or in postnatal ward. The study also assessed pregnancy danger signs’ knowledge among mothers attending RCH at SDDH as well as in postnatal ward in SDDH.

Methods: This was a cross sectional hospital based study, total number of 284 women attending antenatal clinic and RCH at Sengerema DDH were involved in the study. It included mothers who delivery at Sengerema DDH and attended their ANC at SDDH who are in postnatal ward following delivery irrespective of their birth outcomes, and those attending Reproductive and Child Health (RCH) who are not more than six months postpartum for quality and almost precise memory recall by the mothers, mothers attending RCH but who attended ANC at SDDH to term pregnancy irrespective of hospital of delivery.

The exclusion was to all mothers not willing to participate in the study or severely ill patients plus those who delivered at SDDH but did not attend their ANC at SDDH, because they are not the right and appropriate mothers (not the true candidates) to give the best information about ANC services at the facility.

Results: A total of 284 clients attending RCH clinic at Sengerema Designated District Hospital were participated in this study, their age varied as those below 20 years 45 (15.8%), 20 to 30 years were 119 (41.9%), 30 to 40 years were 88 (31.0%). Of all 284 (100%), 214 equivalent to 75.4% mothers made their booking in appropriate gestation (in their first trimester) during their previous pregnancy, of which 105 (37.0) booked during the first month of pregnancy (first trimester), 87 (30.6%) booked during first trimester within the second month of pregnancy, and 22 (7.7%) booked during first trimester of but within third month of pregnancy. However there was a late booking with 24.6% in which 70 mothers booked late beyond first trimester during their previous pregnancy, where by 47 (16.5%) mothers made their first visit in the second trimester within fourth to fifth month of their previous pregnancy whereas 23 (8.1%) booked at second trimester within sixth month of pregnancy.

Concerning the number of ANC visit attained by these expectant mothers, of all 284 (100%), with very varied reasons ranging from service compliance, service based recommendations to a wide spectrum of socioeconomic factors (inclusively education and income status), 54 (19.0%) of expectant mothers attained three visits, where by 151 (53.2%) attained four visits and only 79 (27.8%) made more than four visits.

Conclusion: The late and unsatisfactory number of visits to ANC with the ……..randomly selected clients in study sample signifies that the participants are representative of the general population bigger than at the facility of study. This calls for necessitated further studies in different parts in Tanzania.

To my study point of view, there is still a state of substandard ANC in rural Tanzania due human resources inadequacy, care giver commitment inadequacy, medical resources inadequacy, and motherhood knowledge inadequacy as far as ANC is of high concern. These inadequacies keep adversely affecting the quality of ANC, and so becoming suggestive to ongoing and immediate responses from policies’ makers for the health system to invest more resources to alter situation in order to enhance maternal health in this country.

Recommendation:
1. All women of child bearing ages who are expecting to conceive and have babies should be well educated on knowledge about the antenatal care utilization.
2. All expectant mothers have to be provided knowledge about pregnancy danger signs to ensure ANC utilization.
3. The Government of Tanzania should put more efforts by employing more medical personnel Psychologist, sociologist who are very well in counselling this group of people to stop substandard utilization of ANC
4. In services’ ongoing training and further research have to be implemented for further updates on ANC services.