Provider-perceived benefits and constraints of complete adherence to antenatal care guideline among public health facilities, Ethiopia: A qualitative study

• Published in: PloS one Vol. 16; no. 8; p. e0255297
• Main Authors: Seyoum, Tewodros, Alemayehu, Mekuriaw, Christensson, Kyllike, Lindgren, Helena
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 09-08-2021; Public Library of Science (PLoS)
• Subjects: Adult; Attitude of Health Personnel; Biology and Life Sciences; Clinical medicine; Content analysis; Continuing education; Engineering and Technology; Ethiopia; Evaluation; Female; Guideline Adherence; Health care; Health care facilities; Health care policy; Health facilities; Health Facilities - standards; Health Knowledge, Attitudes, Practice; Health Personnel - psychology; Humans; Low income groups; Male; Maternal & child health; Maternal health services; Maternal mortality; Medicin och hälsovetenskap; Medicine and Health Sciences; Midwifery; Obstetrics; Patient compliance; People and Places; Practice guidelines (Medicine); Pregnancy; Prenatal care; Prenatal Care - standards; Public health; Public health administration; Qualitative Research; Software; Supervision; Supply chains; Training; Ethiopia; Sweden
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0255297

In Ethiopia, health care providers' level of adherence to the national Antenatal Care (ANC) guideline is relatively low. The reasons why they do not follow the guidelines are not well known. Therefore, this study aimed to explore the provider-perceived benefits and constraints associated with using the guideline for ANC in public health facilities in Gondar town.
A qualitative study was conducted using a semi-structured interview guide. The interview was conducted among a purposive sample of nine health care providers working in four public health facilities in Gondar town. After the interviews were transcribed and coded, a content analysis was done using Atlas ti version 7.5 software packages.
Decreasing provider's workload and maximizing performance, improving safe motherhood, and improving the process of service delivery were reported as the perceived benefits of following ANC guideline. Organizational problems, care providers' existing knowledge, attitude, and skills and availability of training and mentorship were the three main identified groups of factors that hinder complete providers' adherence to ANC guideline.
Although providers acknowledged the benefits of following ANC guideline, the guideline is not fully implemented. Refresher training should be given at the start of the updated eight-contact ANC guideline and continuing education and supervision throughout the implementation process. Health care providers call for profound and urgent revisions of the supply chain system for supplies and equipment.