Evaluation of Mali's Focused Antenatal Care Program Identifies Strategies for Improving Quality of Care
June 19, 2007
Pregnant mothers wait their turn for antenatal care at the Community Health Center Diangounte Camara
Abt Associates, under direction of the U.S. Agency for International Development (USAID), has identified five primary strategies to improve the Republic of Mali's Focused Antenatal Care Program (ANC). Because Mali has one of the highest rates of maternal mortality in West Africa, the Government of Mali adopted the ANC program to address the needs of pregnant women and their families.
The ANC Program emphasizes quality of care with the primary goals of detection of health conditions and complications, disease prevention, and birth preparedness. In Mali, malaria prevention is key to a healthy pregnancy, so Focused ANC includes intermittent preventative treatment (IPT) of malaria.
Eight regional ANC Programs were evaluated in order to identify strategies needed to improve upon the existing program for national implementation. Evaluation tools were created to evaluate the quality of care provided by health workers who had been trained in focused antenatal care, a questionnaire was developed to evaluate the health workers' knowledge, and a data collection process was created to collect quantitative data on antenatal care visits and IPT.
The results of the evaluation visits, along with an analysis of the gaps found in the implementation of focused antenatal care, were presented in a final workshop. The analysis found that while IPT has been introduced during antenatal consultations, various problems in the delivery of IPT persist. As a result of this analysis, the curriculum was revised and future interventions were planned at a regional level to improve the implementation of focused antenatal care in community health centers.
Five primary strategies were retained on the national level to improve upon the existing focused antenatal care program:
Supervision — Because the ANC program promotes behavioral change, supervision is necessary. A second round of supervision visits was planned and executed.
Refresher Trainings — An orientation will be held for national trainers with the newly revised curriculum to prepare them to facilitate refresher trainings at the regional level.
Infection Prevention Training — Due to the gap in infection prevention practices, training programs for infection prevention will be held.
HIV Training — The focused antenatal care program will include curriculum on the prevention of mother to child transmission of HIV, as the two tasks are interrelated.
Recognition — A district will be chosen as a champion and celebrated for the quality of their work in antenatal care.
These five strategies offer the Government of Mali a clear course to succeed in the implementation of focused antenatal care to decrease maternal morbidity and mortality
