Antenatal care services and associated factors in a conflict affected district

Abstract

A cross-sectional descriptive study was conducted among pregna1 mothers who had completed 36 weeks of gestation. Data were collected using an interviewer administered questionnaire from mothers who were either admitted for delivery of attended a referral clinic at the General Hospital Vavuniya and the District Hospitall Cheddikulam. The I sample included 392 consecutive pregnant mothers. The majority of the respondents were Sri Lankan Tamils by ethnicity (82.4 percent), and Hindus by religion (71.2 percent). More than half of the respondents (58.4 percent) reported that their family was affected directly by the conflict. The results revealed that: 68.4 percent of mothers were registered by PHM for ANC; I 31.4 percent were registered by PHM before 12 weeks of gestation; 38.5 percent were;~, PHM; 37.8 percent had booking clinic visit before 12 weeks of gestation; 90 percent had made at least four antenatal clinic visits. Average antenatal clinic visits to specialist antenatal clinics (5.34, 95 percent CI: 5.03-5.65) was significantly higher than that of field c1inic (2.97,95 percent CI: 2.69-3.25). On average a pregnant mother was seen by a PHM at home 1.47 times (95 percent C I: 1.25-1.70) during the pregnancy. Almost all mothers had seen a specialist in Obstetrics (97.9 percent ) at least once during their antenatal period. Approximately 52 percent of mothers had complications in the past or present pregnancy. Proportion of antenatal registration was significantly lower in mothers in urban areas and affected by conflict than others. There was a statistically significant difference in rate of mothers visited at home by PHM between MOH areas, with Vavuniya south reporting the highest rate (69.2 percent ) and Cheddikulam reporting the lowest (14.7 percent ). There was no statistically significant difference in frequency of ANC clinic visits between mothers wit different selected socio-demographic characteristics.