Impact of the Information Revolution on Antenatal Care Quality in the Oromia and Gambella Regional States, Ethiopia: A Comparative Cross- Sectional Study

Abstract

Abstract Background: High-quality antenatal care (ANC) is crucial for ensuring the health of both pregnant women and newborns.  Health Information Systems (HIS) interventions are believed to play a pivotal role in enhancing ANC quality by and facilitating better use of data related to ANC services. This study was planned to evaluate the impact of HIS interventions on ANC quality. Methods: A comparative cross-sectional survey was conducted from October 15 to25, 2023. Data were collected on socio-demographic factors and the use of essential ANC services from mothers who visited Health Facilities (HFs) that implemented HIS intervention. HFs were classified as "models" if individuals scored above 90% and "candidates" if they scored between 65% and 90% for the 2015 EFY. A two-stage sampling technique was used to select 840 study participants. The outcome variable was good-quality ANC. It is coded as 1 if they have received all eight components and   as zero (0) if individuals received fewer than eight of the recommended essential ANC components. The components included BP measurement, blood and urine tests, iron supplements, and tetanus injections, counseling on nutrition and a birth preparedness plan, and being informed of danger signs. The data were analyzed using SPSS, version 25. To determine the significance of independent variables, bivariable and multivariate logistic regression analyses were performed by, adjusting the odds ratios and calculating 95% confidence intervals. Results: The proportion of mothers who had received all eight essential ANC components was 54% (95% CI: 50.6% to 57.4%). Moreover, 97.4% had at least one ANC visit, with 66.8% attending four or more visits. Nearly two-thirds (61.7%) of visits occurred within the first 4 months. TT immunization (95.0% (CI: 93.3%, 96.3%), BP measurements (92.5% (CI: 90.6%, 94.2%), and IFA supplements (90.6% CI: 88.4% to 92.5%) were the most delivered components.  In multivariable logistic regression, mothers attending model health centers were more likely to receive good-quality ANC service than those attending candidate health centers (AOR = 9.23; 95% CI: 5.65, 15.1). Married women are more likely to receive good-quality ANC services than non-married women (AOR = 8.16; 95% CI: 1.62, 41.2).  Conclusion: Mothers in model health Facility catchments received high-quality ANC. Sustaining and improving the status of HFs is important to deliver quality health services; furthermore, HIS interventions should prioritize quality improvement and creating demand. [Ethiop. J. Health Dev. 2024; 38(SI-2)]    Keywords: Antenatal Care, Health Information Systems, Quality Improvement, Ethiopia