Role of Focused Counseling in Adequate Utilization of Recommended Antenatal Services-A Non Randomized Controlled Trial from Tamil Nadu

Abstract

Background: Positive birth outcome is often the result of adequate utilization of recommended antenatal services. Time of first antenatal visit, number of recommended visits and the content of care are the determinants of adequacy of care. National Family Health Survey III reveals a gap between availability of services and utilization of the services by antenatal women in Chennai.

Objective: This research was taken up to evaluate the role of focused counseling of antenatal women and their family members on adequate utilization of antenatal services.

Materials and Methods: This is a non randomized controlled study carried out in Chennai, Tamil Nadu, with 150 women in each of the intervention and control group. Antenatal women registering within 12 weeks of pregnancy were enrolled and followed throughout pregnancy. Women in the intervention group received both focused counseling and routine care given by the health centre, while women in the control group received routine care given by the health centre alone.

Observation: The number of women who had all five recommended visits and those who had at least one visit per month in the third trimester was higher in the intervention group. Hemoglobin estimation was done in 66% and 54% of antenatal visits in the intervention and control groups. Urine analysis was done in only 50% of visits in both groups. Mann Whitney U test was done to compare the overall utilization of recommended services during the antenatal visits between the study groups. Utilization of services by the intervention group (Mean rank 162.76) was higher than the control group (Mean rank = 129.35) with a statistically significant difference between the two groups (p = 0.001).

Conclusion: Utilization of recommended services was higher among women who were given focused counseling. Maternal education status is more pertinent than the education of the spouse in influencing utilization of services However laboratory services like hemoglobin estimation, blood sugar estimation, and urine analysis for albumin and sugar were suboptimal in both groups. Focused counseling, if provided as part of routine health care services to antenatal women and their family members will not only give them better understanding on the importance of recommended services to be availed, but also empower them to demand the services.