THE RELATIONSHIP BETWEEN
KNOWLEDGE OF GOAL ORIENTED
ANTENATAL CARE AND ADHERENCE TO
GOAL ORIENTED VISITS BY ANTENATAL
CLIENTS
10th SOMSA CONGRESS
ST GEORGE HOTEL TSWANE
By Mrs. SOTAH MAHANYA 05 December 2012
OUTLINE
Background
 problem statement
 purpose and objectives
Methods
 sampling
 instruments
 data handling
Results
Discussion
BACKGROUND
Complications during pregnancy and child
birth are the leading causes of mortality and
morbidity among women of reproductive
age
 WHO has recommended the new goal
oriented ANC as a proven effective tool in
preventing pregnant related complications.
- Four antenatal visits providing focused
services
BACKGROUND
The old model consisted of 12-15 visits
The effectiveness of goal oriented ANC is based
on adherence to recommended visits.
 Zimbabwe is committed to fulfillment of the
MDGs 4and 5, hence has adopted this protocol.
Other countries have also adopted it e.g. sub-
Saharan countries
Problem Statement.
An increase in the number of pregnancy
related complications was noted.
 Of concern were stillbirths which had
increased by 1.85% between 2006 and
2007
Reduction of mortality rate is expected
instead of increase
- hence this has become a concern.
Problem Statement Cont.
Zimbabwe had a stillbirth rate of 17 per 1000 in
2000 and an infant mortality rate of 27 per 1000.
In 2007 the infant mortality rate increased to 60
per 1000 live births.
In 2011 the infant mortality rate of 29.5 per
1000 and stillbirth rate of 20 per 1000 live births
Southern Africa had an infant mortality rate of
23 per 1000 and still births rate of 21 per 1000
Globally 3.3 million babies are still born yearly.
Purpose
 The purpose of this study was:
- to examine the relationship between
knowledge of goal oriented antenatal care
and adherence to goal oriented visits among
antenatal clients at Morgenster Hospital.
Objectives
 To assess adherence to goal oriented
antenatal visits by antenatal clients
 To identify the level of knowledge on goal
oriented ANC among the antenatal clients
 To examine the relationship between
knowledge of goal oriented ANC and
adherence to goal oriented antenatal visits
Methods
Study Design
 A descriptive correlational design used.
Sampling procedure
 Simple random sampling of 80 para 1,
gravida 2, and para 2,gravida 3 antenatal
clients
 Inclusion criterion was 36 weeks gestation
and above.
 The antenatal register was used to establish
a sampling frame.
Research Instrument
Interview schedule comprising three sections
used
•
Section A – Demographic data questionnaire
•
Section B – Knowledge of goal oriented ANC
•
Section C – Adherence to goal oriented visits
Questionnaire pre-tested at a rural health center
using a sample of 5.
The instrument’s items were judged to have face
validity

Data Collection
Face to face interviews were conducted in
English or vernacular.
The investigator recorded the responses for
consistency.
 At least twenty minutes were spent with
each participant and private room was used.
Ethical Consideration
Permission to collect data was sought and
granted by the Zimbabwe Medical Research
Council
From hospital administration
Written informed consent was sought from
the participants prior to the interviews.
 The consent form addressed principles of
beneficence, autonomy, and justice.
Data Analysis
 Data analysis was done using the Statistical
Package for Social Science (SPSS)
 Descriptive statistics used to describe the data.
 Inferential statistics namely Pearson’s Product
Moment (r) as well as Regression analysis used
to examine the relationship between the
variables.
RESULTS
27.5% were aged 20-23 “youth” and those
aged 32-35 constituted 13.8%
82.5% were married while 17.5% were either
single, divorced or widowed
80% had attained secondary and higher
education
56.3% booked before 16 weeks
 However, only 48.8% attended ANC according to
recommended dates, i.e. 51.2% non-adherence.
RESULTS
 While 52.5% had correct information about the
recommended number of goal oriented visits.
 Knowledge on the services provided during goal
oriented visits was limited
 knowledge on signs and symptoms of pregnancy
related complications also limited
- gross swelling of the face and feet (46, 25%)
- severe pallor (36, 25%)
- upper abdominal pain (32, 5%).
DISCUSSION
 The youth are prone to complications in pregnancy
hence – adherence important.
 World health report (2005)indicates that educated
women are in better position to understand
information regarding their health.
 The 51.2% non-adherence supports the findings by
Mathole et al. (2004)
- women were not satisfied with the goal oriented
visits and preferred the old model with more visits.
DISCUSSION
Danger symptoms should be informed to the
clients from 26 weeks so that they report
early.(Majoko et al 2006)
Non-adherence could have resulted in the limited
knowledge
Relationship
The correlation coefficient (r) between knowledge
of goal oriented ANC and adherence to goal
oriented visits was -0.518.
DISCUSSION
 This relationship was significant with R2=0.269.
 This suggests that adherence to goal oriented
antenatal visits is affected by knowledge of goal
oriented ANC.
 52.5% knowledge is, however marginal considering
the participants, level of education
 This also suggests that there could be other factors
affecting adherence to goal oriented antenatal visits
- considering results from other studies that some
prefer the old protocol
RECOMMENDATIONS
 Goal oriented antenatal care protocol should be
strengthened and adherence emphasized .
 Health education to include explaining the goal
oriented ANC protocol
 Pamphlets on signs of pregnant related
complications , and signs of labor in both
vernacular and English .
 A study focusing more on barriers to adherence to
goal oriented antenatal visits.
Limitations: study carried out at 1 institution
CONLUSION
 Goal oriented antenatal care protocols if adhered to,
results in good quality ANC and reduction of
complications.
 any slight increase especially in stillbirths or maternal
mortality would cause concern.
 The findings showed that attendance of ANC according
to recommended times is affected by the knowledge
acquired from health education by midwives .
 Health education should therefore aim at ensuring that
the clients appreciate its effectiveness of goal oriented
ANC through adherence.
THANK YOU