title: Effect of a new antenatal care programme on the attitudes of pregnant women and midwives towards antenatal care in Harare.
abstract: OBJECTIVE
  The aim was to study the effect of a new antenatal care (ANC) programme on the attitudes of pregnant women and midwives towards antenatal care.
  
  
  METHODS
  This was a controlled trial in which the attitudes of women and staff using the standard programme of ANC were compared to those using a new one. The new programme contained fewer but objective oriented visits, and was designed to improve consumer and provider satisfaction with ANC.
  
  
  METHODS
  Antenatal sessions at primary care clinics in Harare.
  
  
  METHODS
  200 pregnant women and 65 midwives.
  
  
  METHODS
  The satisfaction of pregnant women and staff with ANC, reasons for lack of satisfaction, and time spent waiting for consultations.
  
  
  RESULTS
  The new programme did not make any impact on the time spent by women waiting to be seen at the clinics, nor on the time made available for the consultations. There was no significant impact on the degree of satisfaction with the care among the women. In the control clinics, significantly more staff wished the women to make fewer visits, and in the study clinics, significantly more staff thought the use of appointments was appropriate. The major problem limiting access to ANC was lack of money to pay for the booking fees. Other problems mentioned by the women were ignorance regarding the best time to book, lack of privacy and insufficient staff at the clinics.
  
  
  CONCLUSIONS
  The solutions to some of the problems identified require infrastructural changes at policy making level, rather than changes within the antenatal care programmes.
authors.affiliation: Department of Obstetrics and Gynaecology, University of Zimbabwe, Avondale, Harare, Zimbabwe.
authors.forename: N
authors.initials: N
authors.lastname: Murira
authors.forename: S P
authors.initials: SP
authors.lastname: Munjanja
authors.forename: I
authors.initials: I
authors.lastname: Zhanda
authors.forename: L
authors.initials: L
authors.lastname: Nystrom
authors.forename: G
authors.initials: G
authors.lastname: Lindmark
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D005260:Female; D006801:Humans; D008427:Maternal Health Services / Q000592:standards*; D009035:Mothers / Q000523:psychology*; D009721:Nurse Midwives / Q000523:psychology*; D017060:Patient Satisfaction; D011247:Pregnancy; D011295:Prenatal Care / Q000592:standards*; D015397:Program Evaluation; D014504:Urban Health; D015030:Zimbabwe