title: A cross-sectional assessment of primary healthcare facilities for provision of antenatal care: calling for improvements in Basic Health Units in Punjab, Pakistan.
abstract: BACKGROUND
  There are two types of barriers to the utilisation of maternal health and antenatal care (ANC) services, including the supply-side barriers operating at the health facility level and demand-side, affecting the utilisation ANC services by pregnant women. The purpose of the study was to assess the essential resources required for the provision of ANC services in primary healthcare facilities in Punjab, Pakistan.
  
  
  METHODS
  A cross-sectional facility assessment was conducted in primary healthcare facilities across Punjab. A multi-stage sampling was used to randomly select nine districts from three stratifications and 19 primary healthcare facilities in the public sector (17 Basic Health Units (BHUs) and two Rural Health Centres (RHCs)) from each district. A total of 171 health facilities were included. Data on infrastructure and availability of equipment, essential supplies, medicines, treatment protocols, and infection control items was collected through pre-tested, semi-structured questionnaires. Univariate analysis was carried out to describe the frequency and percentages of facilities across three ratings (good, average, and poor) by type of facility.
  
  
  RESULTS
  Overall, 28% of facilities had poor infrastructure and the availability of equipment was poor in 16% of the health facilities. Essential supply items, such as urine strips for albumin, blood sugar testing strips, and haemoglobin reagents, were particularly poorly stocked. However, infrastructure and the availability of equipment and supplies were generally better in RHCs compared to BHUs.
  
  
  CONCLUSIONS
  Health facilities lacked the resources required to provide quality ANC services, particularly in terms of infrastructure, equipment, supply items, and medicines. The availability of these resources needs to be urgently addressed.
authors.affiliation: Professor & HOD Community Medicine, Services Institute of Medical Sciences (SIMS) Lahore, 34-B, Jatala House, Atchison Housing Society Raiwind Road, Lahore, Pakistan. majrooh58@yahoo.com.
authors.forename: Muhammad Ashraf
authors.initials: MA
authors.lastname: Majrooh
authors.affiliation: Allama Iqbal Medical College, Lahore, Pakistan. drseemahasnain@yahoo.com.
authors.forename: Seema
authors.initials: S
authors.lastname: Hasnain
authors.affiliation: Allama Iqbal Medical College, Lahore, Pakistan.
authors.forename: Javaid
authors.initials: J
authors.lastname: Akram
authors.affiliation: Allama Iqbal Medical College, Lahore, Pakistan.
authors.forename: Arif
authors.initials: A
authors.lastname: Siddiqui
mesh_terms: D003430:Cross-Sectional Studies; D005260:Female; D006268:Health Facilities / Q000592:standards*; D006297:Health Services Accessibility / Q000592:standards*; D006801:Humans; D008427:Maternal Health Services / Q000592:standards; D010154:Pakistan; D011247:Pregnancy; D011295:Prenatal Care / Q000592:standards*; D011320:Primary Health Care / Q000592:standards*; D017150:Public Sector; D011787:Quality of Health Care; D019035:Rural Health Services / Q000592:standards*; D011795:Surveys and Questionnaires