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| Predicate | Object |
|---|---|
| rdf:type | |
| lifeskim:mentions | |
| pubmed:dateCreated |
1999-1-20
|
| pubmed:abstractText |
In the preparation of a randomised controlled trial to evaluate a new programme of antenatal care (ANC) in different parts of the world, we conducted a baseline survey of the ANC procedures in all 53 clinics participating in the trial. There were two components of this survey: (1) description of clinic characteristics and services offered: the staff of each clinic was interviewed and direct observation was made by field supervisors, and (2) the actual use of services by pregnant women attending these clinics: we reviewed a random sample of 2913 clinical histories. The clinical units surveyed were offering most of the activities, screening, laboratory tests and interventions recommended as effective according to the Cochrane Pregnancy and Childbirth Database (PCD), although some of these were not available in some sites. On the other hand, some tests and interventions that are considered not effective according to these criteria are reportedly offered. There was a difference across sites in the availability and offer to low-risk women of vaginal examination, evaluation of pelvic size, dental examination, external version for breech presentation and formal risk score classification, and a notable difference in the type of principal provider of ANC. There was a large variation in the actual use of screening and laboratory tests and interventions that should be offered to all women according to Cochrane PCD criteria: some of these are simply not available in a site; others are available, but only a fraction of women attending the clinics are receiving them. The participating sites all purport to follow the traditional 'Western' schedule for ANC, but in three sites we found that a high percentage of women initiate their ANC after the first trimester, and therefore do not have either the recommended minimum number of visits during pregnancy or the minimum first trimester evaluation. It is concluded that the variability and heterogeneity of ANC services provided in the four study sites are disturbing to the profession and cast doubts on the rationale of routine ANC.
|
| pubmed:keyword |
http://linkedlifedata.com/resource/pubmed/keyword/ARGENTINA,
http://linkedlifedata.com/resource/pubmed/keyword/Americas,
http://linkedlifedata.com/resource/pubmed/keyword/Arab Countries,
http://linkedlifedata.com/resource/pubmed/keyword/Asia,
http://linkedlifedata.com/resource/pubmed/keyword/Baseline Surveys,
http://linkedlifedata.com/resource/pubmed/keyword/CUBA,
http://linkedlifedata.com/resource/pubmed/keyword/Caribbean,
http://linkedlifedata.com/resource/pubmed/keyword/Clinical Research,
http://linkedlifedata.com/resource/pubmed/keyword/Clinical Trials,
http://linkedlifedata.com/resource/pubmed/keyword/Delivery Of Health Care,
http://linkedlifedata.com/resource/pubmed/keyword/Demographic Factors,
http://linkedlifedata.com/resource/pubmed/keyword/Developing Countries,
http://linkedlifedata.com/resource/pubmed/keyword/Health,
http://linkedlifedata.com/resource/pubmed/keyword/Health Facilities,
http://linkedlifedata.com/resource/pubmed/keyword/Health Services,
http://linkedlifedata.com/resource/pubmed/keyword/INTERNATIONAL AGENCIES,
http://linkedlifedata.com/resource/pubmed/keyword/Latin America,
http://linkedlifedata.com/resource/pubmed/keyword/Maternal Health Services,
http://linkedlifedata.com/resource/pubmed/keyword/Maternal-child Health Services,
http://linkedlifedata.com/resource/pubmed/keyword/North America,
http://linkedlifedata.com/resource/pubmed/keyword/Organizations,
http://linkedlifedata.com/resource/pubmed/keyword/PRENATAL CARE,
http://linkedlifedata.com/resource/pubmed/keyword/Population,
http://linkedlifedata.com/resource/pubmed/keyword/Population Characteristics,
http://linkedlifedata.com/resource/pubmed/keyword/Pregnant Women,
http://linkedlifedata.com/resource/pubmed/keyword/Primary Health Care,
http://linkedlifedata.com/resource/pubmed/keyword/Research Methodology,
http://linkedlifedata.com/resource/pubmed/keyword/Sampling Studies,
http://linkedlifedata.com/resource/pubmed/keyword/Saudi Arabia,
http://linkedlifedata.com/resource/pubmed/keyword/South America,
http://linkedlifedata.com/resource/pubmed/keyword/Southeastern Asia,
http://linkedlifedata.com/resource/pubmed/keyword/Studies,
http://linkedlifedata.com/resource/pubmed/keyword/Summary Report,
http://linkedlifedata.com/resource/pubmed/keyword/Surveys,
http://linkedlifedata.com/resource/pubmed/keyword/THAILAND,
http://linkedlifedata.com/resource/pubmed/keyword/Un,
http://linkedlifedata.com/resource/pubmed/keyword/Western Asia,
http://linkedlifedata.com/resource/pubmed/keyword/Who
|
| pubmed:language |
eng
|
| pubmed:journal | |
| pubmed:citationSubset |
IM
|
| pubmed:status |
MEDLINE
|
| pubmed:month |
Oct
|
| pubmed:issn |
0269-5022
|
| pubmed:author | |
| pubmed:issnType |
Print
|
| pubmed:volume |
12 Suppl 2
|
| pubmed:owner |
NLM
|
| pubmed:authorsComplete |
Y
|
| pubmed:pagination |
116-41
|
| pubmed:dateRevised |
2007-11-15
|
| pubmed:otherAbstract |
PIP: This paper reports the results of an antenatal care (ANC) baseline survey in four study sites in different parts of the world participating in the WHO ANC randomized controlled trial. The health care units surveyed are providing most of the activities, screening, laboratory tests and interventions recommended as effective based on the Cochrane Pregnancy and Childbirth Database (PCD), although some of these are not available in some clinics. Some tests and interventions that are considered ineffective according to the PCD criteria are reportedly offered. A variation is observed across sites in the availability and offer to low-risk women of vaginal exam, pelvic size assessment, dental exam, external version for breech presentation, and formal risk score classification. Moreover, there is a significant difference in the type of principal ANC provider and a great variation in the actual performance of screening and laboratory tests and interventions that should be provided to all women according to these criteria. This is partly due to the unavailability of these services in the site, or only a fraction of women attending the clinics are receiving them. The participating clinics all declared to follow the traditional Western schedule for ANC; however, three clinics are found to have a high percentage of women who begin their ANC after the first trimester of pregnancy. It is generalized that the variability and heterogeneity of ANC services offered in the four sites are annoying to the profession and cast doubts on the rationale behind routine ANC.
|
| pubmed:meshHeading |
pubmed-meshheading:9805726-Argentina,
pubmed-meshheading:9805726-Cuba,
pubmed-meshheading:9805726-Developing Countries,
pubmed-meshheading:9805726-Female,
pubmed-meshheading:9805726-Health Services Research,
pubmed-meshheading:9805726-Humans,
pubmed-meshheading:9805726-Multicenter Studies as Topic,
pubmed-meshheading:9805726-Patient Acceptance of Health Care,
pubmed-meshheading:9805726-Physician's Practice Patterns,
pubmed-meshheading:9805726-Pregnancy,
pubmed-meshheading:9805726-Prenatal Care,
pubmed-meshheading:9805726-Questionnaires,
pubmed-meshheading:9805726-Randomized Controlled Trials as Topic,
pubmed-meshheading:9805726-Saudi Arabia,
pubmed-meshheading:9805726-Thailand,
pubmed-meshheading:9805726-World Health Organization
|
| pubmed:year |
1998
|
| pubmed:articleTitle |
The practice of antenatal care: comparing four study sites in different parts of the world participating in the WHO Antenatal Care Randomised Controlled Trial.
|
| pubmed:affiliation |
UNDP/UNFPA/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction, World Health Organisation, Geneva, Switzerland.
|
| pubmed:publicationType |
Journal Article,
Comparative Study,
Research Support, U.S. Gov't, P.H.S.,
Research Support, Non-U.S. Gov't
|