Development of antenatal care services in primary care units in Muangloei district, Loei Province.

Abstract

This action research aimed to study and develop quality antenatal care in Muangloei district, Loei Province.  The participants were the officer responsible for the antenatal clinic, head of primary care unit, head of the major hospital, pregnant women in the district.  Tools used include the development of antenatal care.  Use the concept of management to achieve the achievement of the participatory process and continuous quality improvement in 2016 – 2018. The process are 1) Situational analysis 2) Development of antenatal care system 3) Evaluation.

The results are as follows. Situational Analysis, the problems are 1) Continuity Management 2) Service and Pregnant Risk Screening System 3) Information System 4) Academic Support System 5) Drug Supply Support System 6) Transfer System 7) Human Resources. Then the development is based on these issues. Development process 1) Executives and staff support the staff to evaluate themselves according to the antenatal clinic standard 2) Transfer policy and analysis of common problems 3) Develop guidelines for primary antenatal care systems according to the problems 4) Practice follow the guidelines 5) Evaluate the evaluation results in October 2018, found that pregnant women receive care quality (target ≥60) 67.49, 50.60 and 71.86 percent.  Pregnant women with pale condition (target ≤ 20 percent) 15.41 percent 20.21, 16.54 Pregnant women receive iodized / iron supplementation (100 percent target) 67.31, 71.86 and 81.25 percent. Low birth weight rate (threshold <7 percent) 9.26, 7.10 and 6.74 percent. Perinatal mortality rate (criteria <9: 1,000 births Living) 5.36, 5.58, 3.40 respectively. With teamwork, network, reduce congestion, proportion of service recipients, Loei Hospital, Ministry of Public Health, fiscal year 2016-2561 45.29: 54.81, 40.60: 59.40 and 35.13: 64.87 respectively and have adequate drug and medical support system. There is continuity in the service system from the hospital to the primary unit.

Conclusions from the development of the antenatal service system to operate according to standards personnel development potential and tool support develop a forward consultation system resulting in an appropriate service system. And can be used as a guideline for further development of antenatal care systems in Loei province.