Title : Factors Influencing the Quality of Antenatal Care at Governmental Clinics in Gaza Strip
Antenatal care (ANC) for pregnant women is an important strategy to reduce maternal and infant morbidity and mortality. This study was conducted to assess the level of quality antenatal care provided at governmental primary health care centers in the Gaza Strip from women and health care provider's perspectives. Observational analytical cross-sectional study using mixed methods was carried out with both quantitative and qualitative methods to identify factors that may influence the quality of care in primary health care clinics. The six main governmental primary health care clinics were included in the study (Jabalia, Sorni, Al Remal, Rafah, Dair Al Balah, Khanyounis, and Rafah clinics) Quantitative data were collected using interviewing questionnaires .Women less than one month after delivery attending ANC participated in the study and have been randomly selected(267)to fill a questionnaire with a response rate 98.9% .Health care providers questionnaire was filled with all ANC providers(34) in the governmental primary health care. The qualitative data were collected through in- depth interviews with the providers. The study results show that women have a good utilization for the services in that the majority of them (94%) initiate the ANC services before 12 weeks of gestation, and visit the clinics according to the national guidelines. About 92.1% are satisfied about the service provided. However, there is a room for further improvement in the items related to waiting time and dealing women with more respect. The study revealed that health care providers still face challenges that may affect the provision of care. These challenges were related to limited incentives to staff, heavy workload, no feedback of patients after referral of obstetric complications, limited space for privacy, small ANC waiting area, and shortages of essential ANC supplies and others. Further improvements are needed in order to tackle these barriers, and thus making the provision of ANC services of more quality and equity.