title: Compliance with focused antenatal care services: do health workers in rural Burkina Faso, Uganda and Tanzania perform all ANC procedures?
abstract: OBJECTIVE
  To assess health workers' compliance with the procedures set in the focused antenatal care (ANC) guidelines in rural Uganda, Tanzania and Burkina Faso; to compare the compliance within and among the three study sites; and to appraise the logistic and supply of the respective health facilities (HF).
  
  
  METHODS
  The cross-sectional study was conducted in the rural HF in three African countries. This descriptive observational study took place in HF in Nouna, Burkina Faso (5), Iganga, Uganda (6) and Rufiji, Tanzania (7). In total, 788 ANC sessions and service provisions were observed, the duration of each ANC service provision was calculated, and the infrastructures of the respective HF were assessed.
  
  
  RESULTS
  Health workers in all HF performed most of the procedures but also omitted certain practices stipulated in the focused ANC guidelines. There was a substantial variation in provision of ANC services among HF within and among the country sites. The findings also revealed that the duration of first visits was <15 min and health workers spent even less time in subsequent visits in all three sites. Reagents for laboratory tests and drugs as outlined in the focus ANC guidelines were often out of stock in most facilities.
  
  
  CONCLUSIONS
  Health workers in all three country sites failed to perform all procedures stipulated in the focused ANC guideline; this could not be always explained by the lack of supplies. It is crucial to point out the necessity of the core procedures of ANC repeatedly.
authors.affiliation: Institute of Public Health, University of Heidelberg, Heidelberg, Germany.
authors.forename: Paul
authors.initials: P
authors.lastname: Conrad
authors.forename: Gerhrd
authors.initials: G
authors.lastname: Schmid
authors.forename: Justin
authors.initials: J
authors.lastname: Tientrebeogo
authors.forename: Arinaitwe
authors.initials: A
authors.lastname: Moses
authors.forename: Silvia
authors.initials: S
authors.lastname: Kirenga
authors.forename: Florian
authors.initials: F
authors.lastname: Neuhann
authors.forename: Olaf
authors.initials: O
authors.lastname: Müller
authors.forename: Malabika
authors.initials: M
authors.lastname: Sarker
mesh_terms: D002050:Burkina Faso; D002983:Clinical Competence; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care / Q000592:standards*; D004864:Equipment and Supplies / Q000600:supply & distribution; D005260:Female; D019983:Guideline Adherence; D006268:Health Facilities / Q000592:standards* / Q000600:supply & distribution; D006282:Health Personnel; D006801:Humans; D008428:Maternal Mortality; D009819:Office Visits; D004364:Pharmaceutical Preparations / Q000600:supply & distribution; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011248:Pregnancy Complications / Q000401:mortality / Q000517:prevention & control*; D011295:Prenatal Care / Q000592:standards*; D012424:Rural Population; D013636:Tanzania; D014454:Uganda
chemical_list: D004364:Pharmaceutical Preparations