Evaluation of antenatal services in a primary health care setting in Riyadh

Introduction: Antenatal care is one of the major functions of primary health services being provided as a part of maternity health. There are many activities and services that are provided within this care. Evaluation is found to be the best way to assess, and improve the quality of health services in a systematic and professional way. Objectives: To evaluate two elements: the structure and the process of antenatal care in Al-Rabwa primary care center, Riyadh. Materials and methods: (a) The structure of antenatal care was evaluated in the different activities in the center during the period from May-December 1995, Items required of an antenatal care setting were derived from the Quality Assurance Manual 1994. Grading of the structure was done according to a detailed scoring system. (b) The process evaluation was carried out by looking retrospectively into the antenatal cards of a sample of 132 pregnant women, that were seen in the center in 1415H (1994/1995). Every item of information was given an equal score of one in the data collection form. Subsequently a scoring system was developed and used as an evaluation tool. Results: The structure of care was found to be good according to set criteria. The average age of the studied sample was 27 with majority in the age group 20-39 years. The majority were Saudis 90%. Only 33% were working mothers. The majority visited the center more than three times throughout their pregnancy. Only half of the total information required from the antenatal cards was actually recorded. The mean antenatal score of the studied sample was 52 (SD +/- 10). Of notable process deficiencies were records of personal data, follow up and health education.