ArticleBMC health services research2019
Detecting and managing hypertensive disorders in pregnancy: a cross-sectional analysis of the quality of antenatal care in Nigeria.
Article in BMC health services research, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 19 citations in OpenAlex.
- Knowledge and Self-Care Behaviors Regarding Hypertensive Disorders in Pregnant Women in Colombia: A Cluster Analysis.Florence Nightingale journal of nursing · 2026Article
- Article
- Outcomes of a multifaceted intervention to prevent eclampsia and eclampsia-related deaths in Nigerian referral facilities.International health · 2024Article
- Improving the readiness and clinical quality of antenatal care - findings from a quasi-experimental evaluation of a performance-based financing scheme in Burkina Faso.BMC pregnancy and childbirth · 2023Article
- A digitalized program to improve antenatal health care in a rural setting in North-Western Burundi: Early evidence-based lessons.PLOS digital health · 2023Article
- Self-monitoring of blood pressure for preeclampsia patients: Knowledge and attitudes.Curationis · 2021Article
- Neurovascular dysfunctions in hypertensive disorders of pregnancy.Metabolic brain disease · 2021Review
- Person-centered antenatal care and associated factors in Rwanda: a secondary analysis of program data.BMC pregnancy and childbirth · 2021Article
- Health facility readiness and provider knowledge as correlates of adequate diagnosis and management of pre-eclampsia in Kinshasa, Democratic Republic of Congo.BMC health services research · 2020Article
- Exploring survivor perceptions of pre-eclampsia and eclampsia in Nigeria through the health belief model.BMC pregnancy and childbirth · 2019Article
- Article
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Authors and funding
4 authors at 3 institutions in 3 countries.
Funding
Abstract
backgroundNigeria has one of the highest rates of maternal mortality in the world (576/100,000 births), with a significant proportion of death attributed to hypertensive disorders in pregnancy (HDPs). High quality antenatal care (ANC) plays a crucial role in early detection and management of HDPs. We conducted an assessment of quality of antenatal care, and its capacity to detect and manage HDPs, in two tiers of Nigerian facilities, with the aim of describing the state of service delivery and identifying the most urgent gaps.
methodsQuality of antenatal care was assessed and compared between primary healthcare centers (PHCs) (n = 56) and hospitals (secondary + tertiary facilities, n = 39) in seven states of Nigeria. A cross-sectional design captured quality of care using facility inventory checklists, semi-structured interviews with healthcare providers and clients, and observations of ANC consultations. A quality of care framework and scoring system was established based on aspects of structure, process, and outcome. Average scores were compared using independent sample t-tests and measures of effect were assessed by multivariate linear regression.
resultsAll domains of quality except provider interpersonal skills scored below 55%. The lowest overall scores were observed in provider knowledge (49.9%) and provider technical skill (47.7%). PHCs performed significantly worse than hospitals in all elements of quality except for provider interpersonal skills. Provider knowledge was significantly associated with their level of designation (i.e., obstetrician vs. other providers).
conclusionsIn order to provide high quality care, ANC in Nigeria must experience massive improvements to inventory, infrastructure and provider knowledge and training. In particular, ANC programs in PHCs must be revitalized to minimize the disparity in quality of care provided between PHCs and hospitals. The relatively low quality of care observed may be contributing to Nigeria's high rate of maternal mortality and burden of disease attributed to HDPs.
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