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Modelling Prenatal Care Pathways at a Central Hospital in Zimbabwe.

Rodreck David1, Ruth Evans2, Hamish Sf Fraser3

  • 1School of Information Management, Victoria University of Wellington, Wellington, New Zealand.

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Maternal care in Zimbabwe needs improvement. Many women delay prenatal visits, miss appointments, and receive inadequate care, highlighting critical gaps in service delivery.

Keywords:
Zimbabwecare pathway modellingmaternal mortalityprenatal care

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Area of Science:

  • Public Health
  • Maternal Health
  • Healthcare Management

Background:

  • Maternal mortality is a significant issue in low-income countries (LICs), with Zimbabwe experiencing a notable increase.
  • Effective prenatal care, including early and timely visits, is crucial for reducing adverse maternal outcomes.

Purpose of the Study:

  • To model and identify service and care delivery gaps within prenatal care pathways at Mpilo Central Hospital, Zimbabwe.
  • To improve prenatal care pathways for pregnant women in Bulawayo, Zimbabwe.

Main Methods:

  • A case study approach was employed at Mpilo Central Hospital's antenatal care department.
  • Prenatal care pathway guidelines were developed using literature from LICs to identify care gaps.
  • Reviewed 100 prenatal care records and interviewed 20 maternity clinicians.

Main Results:

  • Only 53% of pregnant women booked for prenatal care, with late average first visits (27.1 weeks gestation).
  • High rates of missed appointments were observed; 60% missed 3 or more of the recommended 5 visits.
  • Inadequate care was delivered during visits, lacking in obstetrics, physical examinations, and hematological tests. Poverty and high booking fees were identified as barriers.

Conclusions:

  • The current prenatal care pathway at Mpilo Central Hospital requires enhancements in referral systems, appointment adherence, and early booking.
  • Clinicians must adhere to standard clinical tests for each prenatal visit.
  • Investment in prenatal care and the adoption of e-health/mobile health technologies are recommended to improve care delivery and patient adherence.