Assessing Service Readiness for Quality Antenatal Care Service in Public Health Institutions of Lumbini Province, Nepal-A Study from Service Providers Perspective.

Authors

  • Rajendra Ruchal Medical Sciences, Singhania University, Rajasthan, India
  • Sumer Singh Medical Sciences, Singhania University, Rajasthan, India
  • Damaru Prasad Paneru Pokhara University, Pokhara, Nepal

DOI:

https://doi.org/10.37506/8dt0k559

Keywords:

Antenatal Care, readiness,, pregnancy,, health institution,

Abstract

Background: Health service readiness is a crucial factor in delivering high-quality antenatal care (ANC). Health facilities must be equipped with the necessary tools, medications, and adequately trained personnel to provide effective ANC services. Inadequate service readiness can lead to decreased utilization of ANC services, potentially increasing the risk of complications and maternal morbidity. Ensuring a high standard of care is essential to reducing maternal and newborn mortality and achieving the health-related targets of the Sustainable Development Goals. This study aimed to assess the service readiness for quality ANC service by public health institutions in Lumbini Province.

Materials and Methods: An institution-based cross-sectional study was conducted in 30 public health facilities in Lumbini Province, Nepal, using a 30-cluster sampling method. Face-to-face interviews with ANC service providers were carried out using a pretested structured questionnaire to assess service readiness. A validated observation checklist was used to evaluate the availability of drugs, equipment, and other essential items.

Results: Among the 30 ANC service providers surveyed, 23.3% of the surveyed providers do not supply folic acid supplements and 10% of the institutions do not provide tetanus diphtheria (TD) vaccination. 33% of the health facilities lack appropriate IEC and BCC materials and 43.3% of the providers reported that their health institutions lack Reproductive Health (RH) clinical protocols and related guidelines and 44.7% of health institutions surveyed do not have quality assurance activities.

Conclusion: This study identified several gaps in the critical aspects of service readiness in the health institutions of Lumbini province. These deficiencies directly impact the ability of healthcare providers to deliver effective, timely, and standardized care to pregnant women. Considering these findings, it is essential that health institutions in Lumbini province need to ensure the resources are consistently available, enable healthcare providers to deliver more comprehensive, standardized, and high-quality care.

Author Biographies

  • Rajendra Ruchal, Medical Sciences, Singhania University, Rajasthan, India

    Ph.D. Scholar, School of Pharmacy and Medical Sciences, Singhania University, Rajasthan, India

  • Sumer Singh, Medical Sciences, Singhania University, Rajasthan, India

    Associate Professor, School of Pharmacy and Medical Sciences, Singhania University,

    Rajasthan, India

  • Damaru Prasad Paneru, Pokhara University, Pokhara, Nepal

    Associate Professor, School of Health and Allied Sciences, Pokhara University, Pokhara, Nepal

References

Manu A, Arifeen S, Williams J, Mwasanya E, Zaka N, Plowman BA, et al. Assessment of facility readiness for implementing the WHO/UNICEF standards for improving quality of maternal and newborn care in health facilities experiences from UNICEF's implementation in three countries of South Asia and sub-Saharan Africa. BMC health services research. 2018;18(1):531.

WHO. Delivering quality health services A global imperative for universal health coverage. Book. 2018.

Fatema K, Lariscy JT. Mass media exposure and maternal healthcare utilization in South Asia. SSM - population health. 2020;11:100614.

Fetohy EM. Impact of a health education program for secondary school Saudi girls about menstruation at Riyadh city. The Journal of the Egyptian Public Health Association. 2007;82(1-2):105-26.

GoN, UNICEF. Report on Multiple Indicator Cluster Survey Final Report 2014. Kathmandu, Nepal: Central Bureau of Statistics and UNICEF Nepal.; 2015.

Shrestha JR MD, Manandhar SR, Adhikari D, Rai C, Rana H, Poudel M, Pradhan A. Maternal and Neonatal Health Knowledge, Service Quality and Utilization: Findings from a Community Based Quasi-experimental Trial in Arghakhanchi District of Nepal Journal of Nepal Health Research Council. 2015;13(29).

Gov. of Nepal M, DoHS. Annual Report. Kathmandu, Nepal; 2075/76.

Gov. of Province M. Annual Health Report. Province 5, Butwal; 2075/76.

Oyugi B, Kioko U, Kaboro SM, Okumu C, Ogola-Munene S, Kalsi S, et al. A facility-based study of women' satisfaction and perceived quality of reproductive and maternal health services in the Kenya output-based approach voucher program. BMC pregnancy and childbirth. 2018;18(1):310.

Acharya K PY. General health service readiness and its association with the facility level indicators among primary health care centers and hospitals in Nepal. Journal of Global Health Reports. 2019; 3 • e2019057.

Adhikari RP, Shrestha ML, Satinsky EN, Upadhaya N. Trends in and determinants of visiting private health facilities for maternal and child health care in Nepal: comparison of three Nepal demographic health surveys, 2006, 2011, and 2016. BMC pregnancy and childbirth. 2021;21(1):1.

Nepal A, Dangol SK, van der Kwaak A. Improving maternal health services through social accountability interventions in Nepal: an analytical review of existing literature. Public health reviews. 2020;41(1):31.

Kc A, Singh DR, Upadhyaya MK, Budhathoki SS, Gurung A, Malqvist M. Quality of Care for Maternal and Newborn Health in Health Facilities in Nepal. Maternal and child health journal. 2020;24(Suppl 1):31-8.

Belda SS, Gebremariam MB. Birth preparedness, complication readiness and other determinants of place of delivery among mothers in Goba District, Bale Zone, South East Ethiopia. BMC pregnancy and childbirth. 2016;16:73.

Lama TP MM, Katz J, Khatry SK, LeClerq SC, Mullany LC. Assessment of facility and health worker readiness to provide quality antenatal, intrapartum and postpartum care in rural Southern Nepal. BMC health services research. 2020;20(16).

Chen L, Qiong W, van Velthoven MH, Yanfeng Z, Shuyi Z, Ye L, et al. Coverage, quality of and barriers to postnatal care in rural Hebei, China: a mixed method study. BMC pregnancy and childbirth. 2014;14:31.

GoN. Nepal Health Sector Strategy (2015-2020). Kathmandu,Nepal; 2015.

Paudel YR MS, Paudel D, Dariang M, Aryal K, Poudel P, King S, Barnett S. Women’s Satisfaction of Maternity Care in Nepal and Its Correlation with Intended Future Utilization. Hindawi Publishing Corporation International Journal of Reproductive Medicine. 2015;2015.

Atkure Defar TG, Girum Taye, Tefera Tadele. Quality antenatal care services delivery at health facilities of Ethiopia, assessment ofthe structure/input of care setting. BMC Health Service Research. 2020;20(485).

Tebikew Yeneabat AH, Theodros Getachew and Angela Dawson. The efect of national antenatal care guidelines and provider training on obstetric danger sign counselling: a propensity score matching analysis of the 2014 Ethiopia service provision assessment plus survey. BMC Reproductive Health. 2022;19(1):132.

Owili P MAM, Bomar Rojas Mendez and Bradly Chen. Quality of care in six sub-Saharan Africa countries: a provider-based study on adherence to WHO’s antenatal care guideline. International Journal for Quality in Health Care. 2019;31( 1).

Resham B. KhatriID YA, Jo DurhamID,. Assessment of health system readiness for routine maternal and newborn health services in Nepal: Analysis of a nationally representative health facility survey, 2015. PLOS Global Public Health. 2022.

Downloads

Published

2025-06-07

How to Cite

Assessing Service Readiness for Quality Antenatal Care Service in Public Health Institutions of Lumbini Province, Nepal-A Study from Service Providers Perspective. (2025). Indian Journal of Public Health Research & Development, 16(3), 247-254. https://doi.org/10.37506/8dt0k559