Analysis of Midwife Performance, Family Support, and Health Facilities on Antenatal Care Visits
DOI:
https://doi.org/10.53713/htechj.v4i2.671Keywords:
Midwives Performance, , Family Support, Health Facilities, ANC VisitsAbstract
Antenatal care (ANC) utilization is a key indicator of maternal health outcomes; however, coverage remains suboptimal, with many pregnant women failing to meet recommended visit standards. This study aimed to examine the influence of midwives' performance, family support, and the availability of health facilities on compliance with ANC visits among pregnant women. A quantitative, observational, cross-sectional study was conducted involving 147 pregnant women selected by simple random sampling. Data were obtained from medical records and structured questionnaires and analyzed using univariate, bivariate (chi-square test), and multivariate (logistic regression) techniques. The results demonstrated that midwives' performance was significantly associated with ANC visit completeness (χ² = 228.766; p < 0.001). Similarly, family support (χ²=208.597; p<0.001) and the availability of health facilities (χ²=164.881; p<0.001) were significantly associated with ANC compliance. Multivariate analysis confirmed that these factors were significant predictors of ANC utilization. midwives' performance, family support, and the availability of health facilities all play critical roles in improving compliance with ANC visits. Strengthening healthcare provider performance, enhancing family involvement, and ensuring adequate health service infrastructure are essential strategies to increase ANC coverage and improve maternal health outcomes.
References
Abdissa, Z., Alemu, K., Lemma, S., Berhanu, D., Defar, A., Getachew, T., ... & Persson, L. A. (2024). Effective coverage of antenatal care services in Ethiopia: a population-based cross-sectional study. BMC pregnancy and childbirth, 24(1), 330. https://doi.org/10.1186/s12884-024-06536-6
Abdo, R., Demelash, M., Seid, A. M., & Mussema, A. (2023). First trimester antenatal care contact in Africa: a systematic review and meta-analysis of prevalence and contributing factors. BMC Pregnancy and Childbirth, 23(1), 742. https://doi.org/10.1186/s12884-023-06034-1
Alibhai, K. M., Ziegler, B. R., Meddings, L., Batung, E., & Luginaah, I. (2022). Factors impacting antenatal care utilization: a systematic review of 37 fragile and conflict-affected situations. Conflict and health, 16(1), 33. https://doi.org/10.1186/s13031-022-00459-9
Barbano, L. (2026). A Bioecological Framework for Supporting Mothers From Pregnancy to Workforce Reintegration. Journal of Family Theory & Review, 18(1), 118-129. https://doi.org/10.1111/jftr.70039
Bhutada, K., Venkateswaran, M., Atim, M., Munabi-Babigumira, S., Nankabirwa, V., Namagembe, F., ... & Papadopoulou, E. (2024). Factors influencing the uptake of antenatal care in Uganda: a mixed methods systematic review. BMC Pregnancy and Childbirth, 24(1), 730. https://doi.org/10.1186/s12884-024-06938-6
Chewe, V. M., & Mathibe-Neke, J. M. (2025). A holistic approach to providing quality care for pregnant women: A systematic review. International Journal of Africa Nursing Sciences, 25, 101043. https://doi.org/10.1016/j.ijans.2026.101043
Dayyani, I., Lou, S., & Jepsen, I. (2022). Midwives’ provision of health promotion in antenatal care: A qualitative explorative study. Women and Birth, 35(1), e75-e83. https://doi.org/10.1016/j.wombi.2021.01.010
Demeke, H. S., Gebremariam, K., & Abreha, G. F. (2025). Quality of antenatal care and associated factors in public and private facilities of Western Hararghe Zone Ethiopia using WHO framework. Scientific Reports, 15(1), 27881. https://doi.org/10.1038/s41598-025-09030-x
Fangkingan-Faba-an, D., Joel A. Valencia, Eva Felipe Dimog, Lolita I. Dicang, & Josephine K. Bay-ed. (2025). Continuing professional development and its perceived benefits among midwives. Nursing and Health Sciences Journal (NHSJ), 5(4), 452–463. https://doi.org/10.53713/nhsj.v5i4.569
Gao, Z. H., Qiao, Y. Y., Liu, Y. X., Zhou, Z. B., & Yang, Y. (2025). Maternal perceptions of medical service quality: evidence from a SERVQUAL-IPA model at a hospital in Beijing. BMC Pregnancy and Childbirth, 25(1), 1100. https://doi.org/10.1186/s12884-025-08252-1
Habte, A., Tamene, A., & Melis, T. (2024). Compliance towards WHO recommendations on antenatal care for a positive pregnancy experience: Timeliness and adequacy of antenatal care visit in Sub-Saharan African countries: Evidence from the most recent standard Demographic Health Survey data. PLOS ONE, 19(1), e0294981. https://doi.org/10.1371/journal.pone.0294981
Hibusu, L., Sumankuuro, J., Gwelo, N. B., & Akintola, O. (2024). Pregnant women’s satisfaction with the quality of antenatal care and the continued willingness to use health facility care in Lusaka district, Zambia. BMC Pregnancy and Childbirth, 24(1), 20. https://doi.org/10.1186/s12884-023-06181-5
Hofmeyr, G. J., Black, R. E., Rogozińska, E., Heuer, A., Walker, N., Ashorn, P., Ashorn, U., Bhandari, N., Bhutta, Z. A., Koivu, A., Kumar, S., Lawn, J. E., Munjanja, S., Näsänen-Gilmore, P., Ramogola-Masire, D., & Temmerman, M. (2023). Evidence-based antenatal interventions to reduce the incidence of small vulnerable newborns and their associated poor outcomes. The Lancet, 401(10389), 1733-1744. https://doi.org/10.1016/S0140-6736(23)00355-0
Kathuria, K. (2023). Impact of maternal health and disease on neonatal outcome. In Clinical Anesthesia for the Newborn and the Neonate (pp. 11-27). Singapore: Springer Nature Singapore. https://doi.org/10.1007/978-981-19-5458-0_2
Linasari, D., Judistiani, R. T. D., Sunjaya, D. K., & Handono, B. (2025). Enhancing General Practitioners’ Compliance with Antenatal Care Standards and Pregnant Women’s Satisfaction Through Point-of-Care Quality Improvement in Indonesian Community Health Centers. Patient Preference and Adherence, 19, 3913–3929. https://doi.org/10.2147/PPA.S548768
McCauley, H., Lowe, K., Furtado, N., & Mangiaterra, V. (2022). What are the essential components of antenatal care? A systematic review of the literature and development of signal functions to guide monitoring and evaluation. BJOG: An International Journal of Obstetrics & Gynaecology, 129(6), 855-867. https://doi.org/10.1111/1471-0528.17029
Meinawati, L. (2024). Self-Efficacy and The Assertive of Midwives Towards Early Detection of Preeclampsia among Pregnant Women. Nursing and Health Sciences Journal (NHSJ), 4(3), 293–299. https://doi.org/10.53713/nhsj.v4i3.387
Morgan, A. K., Awafo, B. A., Quartey, T., & Cobbold, J. (2022). Husbands’ involvement in antenatal-related care in the Bosomtwe District of Ghana: Inquiry into the facilitators and barriers. Reproductive Health, 19, 216. https://doi.org/10.1186/s12978-022-01506-7
Mwenebanda, E., Machado, A., Patel, A. I., Nyondo-Mipando, A. L., & Chiumia, I. K. (2024). Factors influencing antenatal care attendance in the eight contact era policy: a case of selected maternal health service facilities in Blantyre, Malawi. BMC pregnancy and childbirth, 24(1), 704. https://doi.org/10.1186/s12884-024-06895-0
Saaka, M., & Sulley, I. (2023). Independent and joint contributions of inadequate antenatal care timing, contacts and content to adverse pregnancy outcomes. Annals of Medicine, 55(1). https://doi.org/10.1080/07853890.2023.2197294
Setyowati, D., Nurrahmania, A. P., Ummah, N. I., Prasasti, A. R., Aditya, C., Rahmi, Z. A., Apriliani, R. R., Hemadi, A. S., Kamila, N. N., & Ulhaq, A. D. (2024). Behavior of pregnant women to improve oral health knowledge during pregnancy according to Lawrence Green theory in Pakis Public Health Service Area. Indonesian Journal of Dental Medicine, 7(1), 20–24. https://doi.org/10.20473/ijdm.v7i1.2024.20-24
Tesfay, N., Hailu, G., & Woldeyohannes, F. (2023). Effect of optimal antenatal care on maternal and perinatal health in Ethiopia. Frontiers in Pediatrics, 11, 1120979. https://doi.org/10.3389/fped.2023.1120979
Yasin, R., Azhar, M., Allahuddin, Z., Das, J. K., & Bhutta, Z. A. (2025). Antenatal care strategies to improve perinatal and newborn outcomes. Neonatology, 122(Suppl. 1), 13-31. https://doi.org/10.1159/000542702
Zielinski, R., Kukula, V., Apetorgbor, V., Awini, E., Moyer, C., Badu-Gyan, G., Williams, J., Lockhart, N., & Lori, J. (2023). “With group antenatal care, pregnant women know they are not alone”: The process evaluation of a group antenatal care intervention in Ghana. PLOS ONE, 18(11), e0291855. https://doi.org/10.1371/journal.pone.0291855
