Client Factors Affect Provider Adherence to Clinical Guidelines during First Antenatal Care

Area of Science:

• Obstetrics and Gynecology
• Public Health
• Healthcare Quality Improvement

Background:

• The first antenatal clinic (ANC) visit is crucial for stratifying pregnant women into standard or special care groups.
• Established protocols, like the Safe Motherhood Protocol (SMP), guide optimal ANC care.
• Assessing adherence to these guidelines is vital for ensuring quality maternal healthcare.

Purpose of the Study:

• To determine provider adherence to first antenatal visit guidelines within the Safe Motherhood Protocol (SMP).
• To identify patient-specific factors influencing complete provider adherence to ANC guidelines.

Main Methods:

• A cross-sectional study involving a record review of the first ANC visit for 948 women in Ghana.
• A thirteen-point checklist was used to assess adherence to the SMP.
• Socio-demographic data and pregnancy history were collected; cluster-adjusted odds ratios were calculated.

Main Results:

• Overall, only 48.1% of women received care with complete adherence to guidelines.
• Complete adherence was higher for multiparous women (OR = 5.43).
• Adherence was lower for women with a history of previous pregnancy complications (OR = 0.50).

Conclusions:

• Provider adherence to first antenatal visit guidelines is suboptimal in Ghana's Greater Accra region.
• Parity and a history of previous pregnancy complications significantly influence adherence levels.
• Enhanced provider training and support are recommended to improve adherence and maternal care quality.