| dc.description.abstract | The burden of maternal and child mortality and morbidity has remained high globally with
pronounced effects in Sub Saharan Africa. Despite improvements in global ANC first visits to
about 86% only half of these receive adequate antenatal care. In particular, antenatal
laboratory screening tests uptake has been low in many developing countries yet results or
absence of results from such tests can determine the quality of antenatal care given to
pregnant women. Global and national guidelines recommend that all women attending
antenatal care get laboratory screening tests for HIV, Hemoglobin level (Hb), Syphilis, Blood
Grouping/ABO and Rhesus grouping and Urine tests. Study objectives included: establishing
socio demographic, client and health facility factors that influenced utilization of antenatal
laboratory test and establishing the proportion of women that received antenatal screening
tests at health facilities in Kamuli district.
Methods:
The study was a mixed methods descriptive cross-sectional, using both qualitative and
quantitative methods of data collection with concurrent triangulation. Predetermined survey
questionnaires for pregnant women, and maternity staff were administered. In-depth
interviews were conducted with laboratory staff and health facility/maternity in charges, with
focus group discussions and observation checklists as other forms of data collection.
Pearson’s Chi Square and Ordinal logistic regression were used for bivariate and multivariate
analyses respectively.
Results:
Study findings show that only 14.1% of women received adequate laboratory tests, 38.5% and
47.4% received inadequate and moderate laboratory tests respectively. Individually, 40.9%,
34.2%, 21.1%, 91.1% and 24.1% received a syphilis test, Urine test, Blood grouping, HIV and
Hb measurement respectively. Women that attended ANC1 and ANC2 were 60% less likely
to receive adequate testing (OR: 0.391 CI: 0.206-0.741) and (OR: 0.386 CI: 0.201-0.740)
respectively in comparison to those making 4 or more visits. Women attending at Public
facilities were slightly more likely to receive high levels of tests utilization by a factor 1.037,
C1:0.593-1.815 compared to those attending at PNFPs. It was also however found that
majority 59.6% of those that received adequate testing were at PNFP facilities. Employment
status, attendance to ANC talks and the person a woman stayed with were also other factors
that affected laboratory tests utilization. The unavailability of test kits and reagents, frequent
stock outs, cost of tests and lack of test requests were identified as main barriers to testing.
Conclusion:
Antenatal test uptake was significantly low especially for Hb measurement and ABO. There is
need for timely supply of all test kits in the recommended quantities, with minimal bias
towards particular tests. Robust supervision measures should be taken to ensure that tests
supplied are administered for the intended purposes, in addition to allocating health workers
basing on outputs rather than level of healthcare. | en_US |
