New Antenatal Care According to WHO Advisory

Abstract

Objective: There are many maternal and child health problems; late antennal care and not regular checkups,
iron deficiency anemia and iodine level less than standard. Low birth weight infants are more than the
target. Department of Health launched new antenatal care according to WHO advisory to voluntary provincial
hospitals to participate the programs. The objective of the program is to study the operations (->operational)
management and expand the area of the program by evaluate the output, problems, attitude and satisfaction
of providers.
Methodology: The study is action research. 5 voluntary purposive provincial areas is selected; Chiang Rai,
Maha Sarakam, Kanasin, Lopburi and Nakorn Srithamarat. There are 3 steps of work; 1) To make the
executives and provincial project directors understand the project. 2) To train provincial, district hospital
providers to run the project. To transfer the budget to buy drugs and instruments and operation manuals 3)
To evaluate the project by follow the output, outcome, problems, attitude and satisfaction of providers from
the content of project procedures and maternal and child meeting papers. Stratified sampling technical was
used to select provincial operation hospital. One hospital was appointed to be the center of operation, and 1-
2 hospital was random selected to participate in the project. Total target of 34 hospitals were recruited.
Interview the head of antenatal care clinics and group discussion with operation workers about the problems,
satisfaction and the output of new antenatal care project. To analysis of the data from the evaluation between
the first and second time by Mann-Whitne Test, Z-test and Chi Square test and content analysis.
Result: There are 3 operation steps: 1) To make understand the project with provincial doctors and regional
hospital directors. 2) Operation procedures are knowledge development, operation worker skill, support
enough drugs and equipment, 3) Evaluation the project, output, outcome, problems, obstacles, attitude and
satisfaction of providers. The results were the completion of services to the receivers were higher than before
the project. Satisfaction of maternal and child service was not statistic difference before and after the project.
The problems of operation could be resolved by the local health service. The doctors had positive attitude to
the project and no one rejected. So it can expand the project to cover every province.