Women’s recall of provision of antenatal care in Papua New Guinea: findings of a maternal and infant health survey conducted in three provinces

ABSTRACT

@#SUMMARY Antenatal care from a trained health care worker provides the opportunity to promote favourable outcomes for both the woman and her unborn infant. The greatest benefit of antenatal care is seen when the first visit is initiated early in the pregnancy and continued with at least four antenatal visits throughout the pregnancy. In Papua New Guinea (PNG), 66% of women attend for antenatal care at least once during their pregnancy and 51% attend four antenatal visits. We conducted a maternal and infant health survey among 482 women in three sites in PNG, Hiri, Karkar and Asaro, to explore uptake and provision of antenatal care from women’s perspectives. Most women attended for antenatal care (95%; 459/482) at least once and 73% (313/431) attended the recommended minimum four antenatal visits. Women in Hiri (77%) and Asaro (78%) were more likely to attend four or more antenatal visits than women in Karkar (66%). No woman in any site reported receiving the full range of antenatal care, as indicated in the PNG national guidelines. Coverage for tetanus toxoid, malaria prophylaxis and provision of iron supplements were similar in all sites. Women in Asaro were more likely to report being advised about a supervised birth (91%) than women in Karkar (86%) or Hiri (68%). Our findings suggest that the opportunity to monitor for risk factors in pregnancy were missed, including the opportunity to provide messages relating to the importance of supervised, health facility births. There is a need for renewed commitment and resources to enable optimal antenatal care to be provided in accordance with established guidelines if PNG is to make significant improvements in maternal and newborn health.