Quality of antenatal care services at subcentres: an infrastructure, process and outcome evaluation in a district in Tamil Nadu

Abstract

Background: Quality of care is a priority concern all over the world and all the countries are trying to improve the effectiveness and efficiency of their health care delivery systems. Recognizing the potential to improve the reproductive health status in developing countries, quality of care in reproductive health field has been the priority area of research by WHO.Methods: This study assesses the quality of antenatal care services delivered at subcentre level by comparing with the recommended Structural attributes, Process attributes and Initial outcome attributes. By simple random sampling, ten subcentres under three Block Primary Health Centres in Coimbatore district were included in the study.Results: On observing the quality of client-provider interaction, most of the women were treated with dignity (98.5%), but there were deficiencies in examination for pallor (19.2%), pedal edema (18.5%) and pulse (10.6%) which is very critical for good antenatal care. The exit interview revealed that most clients (98.6%) were satisfied with the antenatal care.Conclusions: The findings of this quality assessment study provide information about training needs for improving the quality of service and serves as a baseline data on status before implementing NRHM.