Journal Reading

ANTENATAL CARE AND OPPORTUNITIES FOR QUALITY

IMPROVEMENT OF SERVICE PROVISION IN RESOURCE
LIMITED SETTINGS: A MIXED METHODS STUDY

Oleh
Fianirazha Primesa Caesarani, S.Ked 04054821820111
Muhamad Taufan Kurniawan, S.Ked 04054821820112
Evlin Kohar, S.Ked 04054821820019
Muhammad Fahmi, S.Ked 04084821820011
Nindy Lagundry Putry, S.Ked 04084821820016

Pembimbing
Dr. dr. Ferry Yusrizal, Sp.OG(K), M. Kes

DEPARTEMEN/BAGIAN OBSTETRI DAN GINEKOLOGI

FAKULTAS KEDOKTERAN UNIVERSITAS SRIWIJAYA
RUMAH SAKIT UMUM PUSAT DR. MOHAMMAD HOESIN PALEMBANG
2019
 HALAMAN PENGESAHAN

Journal Reading

Antenatal Care and Opportunities for Quality Improvement of

Service Provision in Resource Limited Settings: A Mixed
Methods Study Oleh:
Fianirazha Primesa Caesarani, S.Ked 04054821820111
Muhamad Taufan Kurniawan, S.Ked 04054821820112
Evlin Kohar, S.Ked 04054821820019
Muhammad Fahmi, S.Ked 04084821820011
Nindy Lagundry Putry, S.Ked 04084821820016

Telah diterima dan disetujui sebagai salah satu syarat dalam mengikuti ujian
Kepaniteraan Klinik di Bagian Obstetri dan Ginekologi Rumah Sakit Umum Pusat Dr.
Mohammad Hoesin Palembang Fakultas Kedokteran Universitas Sriwijaya Periode 24
Juni - 2 September 2019.

Palembang, Oktober 2019

Dr. dr. Ferry Yusrizal, Sp.OG(K), M. Kes

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 KATA PENGANTAR

Puji dan syukur penulis haturkan kepada Allah SWT karena atas rahmat dan
berkat-Nya journal reading yang berjudul “Antenatal Care and Opportunities for
Quality Improvement of Service Provision in Resource Limited Settings: A Mixed
Methods Study” ini dapat diselesaikan tepat waktu. Journal reading ini dibuat untuk
memenuhi salah satu syarat ujian kepaniteraan klinik senior di Bagian Ilmu Obstetri dan
Ginekologi Rumah Sakit Umum Pusat Dr. Mohammad Hoesin Palembang Fakultas
Kedokteran Universitas Sriwijaya. Penulis juga ingin menyampaikan terimakasih Dr.
dr. Ferry Yusrizal, Sp.OG(K), M.Kes atas bimbingannya sehingga penulisan ini menjadi
lebih baik.
Penulis menyadari masih banyak kekurangan dalam penulisan journal reading ini.
Oleh karena itu, saran dan kritik yang membangun sangat penulis harapkan untuk
penulisan yang lebih baik di masa yang akan datang.

Palembang, Oktober 2019

Penulis

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 CRITICAL APPRAISAL
PICO VIA (Population, Intervention, Comparison, Outcome, Validity,
Importancy, Applicability)
1. Population
This study took place in Magu district, in the region of Mwanza, Tanzania,.
Magudistrict has a population of 299,759, with 23% women of childbearing age. It
has 31 government health facilities that provide ANC services including a district
hospital, four health centers and 26 dispensaries.
Purposive sampling was used to select health facilities and villages in 9 of 18
wards of the district, and inclusion of different geographical locations in the district
covering both areas close to the lake as well as more in-land and close to the main
tarmac road. Health facilities included 13 dispensaries, one health centre and one
district hospital. For ANC observations a sample size was calculated to be 422 with
OpenEpi, version 3, open source calculator with a confidence interval of 95%
including an expected refusal rate of 10%. Health facilities were visited on a
minimum of two different occasions until the sample size was reached to ensure
observations at different clinic days during the week. In 2015 After the ANC
observations all women were approached for exit interviews and 286 (69%) agreed
to participate. Main reason for refusal was lack of time.
Participants for interviews were selected through convenience sampling and
included womenofreproductive age, pregnant women and women who recently gave
birth (N = 48), menincluding partners of pregnant women (N = 31) and health care
workers (N = 26). On average 8 participants participated in each focus group and
were held with women (N = 2), men(N=1),mixed gender (N= 2)and with health care
workers (N = 7).

2. Intervention
There are no intervention given to the subject, because this research design is
descriptive observational that use multiple data collection methods that collected
over several periods from 2012 to 2015. Quantitative methods included: facility
audits of supplies and services, ANC observations and exit interviews with pregnant

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women. Qualitative methods included participant observation, semi-structure
interviews and focus group discussions.