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ABSTRACT
The aim of this study was to assess the Service quality of focused antenatal care at health
care facilities in Bauchi State. Five research objectives were stated: to determine the
availability of material resources for focused antenatal care, to assess the capacity of human
resource for focused antenatal care, to assess the quality services of focused antenatal care,
to assess the focused antenatal care services utilization and to assess the level of clients‘
satisfaction with focused antenatal care services .A cross sectional descriptive design was
adopted. A total of three hundred and eighty four pregnant women that attended antenatal
care clinic in twenty two health care facilities in Bauchi State were recruited. Multi-stage
sampling technique was used. The data collected using semi-structured questionnaire and
observational checklist through face to face interview and audit observation check list
during the period of first May to the end August 2016. Descriptive statistics was used.
Donabedian Bruce quality model (1980) was adopted as a theoretical framework. The
result revealed that: Eighty percent of the respondents were over 35 years old, 66% of them
were Hausa/Fulani, almost half of them had secondary school certificate, and more than
half of them had parity above six times. Eighty percent of the sample utilized focused
antenatal care always. Only 43% of material resources in the health facilities were
available and functioning. The human resources rate in the health facilities were 0.81, 0.5,
2.7 and 1.8 Doctors, Nurses, Midwives and CHEW respectively. The quality of care in the
studied health facilities was 54.2% satisfactory. The total mean satisfaction was 2.3 /4 .It
can be concluded that: there were inadequate material resources, shortage of human
resources , high utilization of focused antenatal care services and the client satisfaction
was little bit low . Recommendations: Government should Ensure adequate material
resources for focused antenatal care services in each facility in Bauchi State, Ensure
ix
adequate health care providers to improve quality focused antenatal care services, Periodic
In-service training ,monitoring and evaluation to improve the quality services, Health
education for the clients to increase the awareness and the importance of focused antenatal
care and Regular assessment of the level of clients‘ satisfaction is needed to improve the
lacking areas
Keywords: Focused Antenatal care, Quality of services, client Satisfaction. Healthcare
services
CHAPTER ONE
INTRODUCTION
1.0 Background to the study
Maternal mortality is a global issue as a result of low focused antennal care; approximately
about 830 women die from pregnancy complications around the world every day (World
Health Organization, 2015). The differences between regions are stark: There are currently
12 maternal deaths per 100,000 live births in developed regions compared with 546 in sub-
saharan Africa. Nigeria is ranked the second in the world with maternal mortality rate (630
per 100,000 live births), Nigeria Demographic and Health Survey, (2013)
The goal established by United States to reduced the worldwide maternal mortality ratio
(MMR) –the number of maternal deaths per 100,000 live births by 75% between 1990 and
2015 was not achieved, but significant progress has been made (43.9% decline). The 2015
global MMR is estimated at 216 deaths per 100,000 live births, down from 385 in 1990.
(Zolat and pa,2016).
.Maternal morbidity and mortality has remained high in sub-Saharan Africa as a result of
poor antenatal cares, despite concerted efforts at its reduction, by various stakeholders and
development partners (Sholeye, Abosede, and Jeminusi, 2013).Seeing that it is possible to
accelerate the decline, countries have now united behind a new target to reduce maternal
mortality even further. One target under Sustainable Development Goal 3 is to reduce the
global maternal mortality ratio to less than 70 per 100 000 births, with no country having a
maternal mortality rate of more than twice the global average by focused antenatal care.
Focused Antenatal Care is a Goal oriented care that is client centered, timely, friendly,
simple, beneficial and safe to pregnant women. (United States Agency for International
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