QI Story: Enhancing Antenatal Care Waiting Period Assessments To Improve Neonatal Health

Percentage of ANC Waiting Women Receiving Thorough Assessment During The Waiting Period

Presented by: Alex Mwale, Nurse Midwife Technician


In a remarkable effort to elevate maternity care and improve the overall well-being of expectant mothers, Nasawa Health Centre’s maternity department embarked on a mission to address a persistent issue—a thorough assessment of antenatal care (ANC) waiting for women during their waiting period. The situation, where almost all pregnant women in the ANC waiting area were not receiving the necessary assessments, posed a significant challenge to maternal and neonatal health. This concern came to light during a data review meeting, prompting action. “In January 2022, we met as data reviewers at the facility. We came about a problem of low percentage of waiting mothers receiving examination,” says Alex.

The Challenge: A Start from Ground Zero

At the heart of the issue was the lack of thorough assessments for waiting mothers, with the baseline showing a shocking 0% compliance—far below the standard of ensuring that every waiting mother is assessed daily. The consequences of this deficiency were far-reaching, potentially contributing to an increase in neonatal complications, including macerated stillbirths. Recognizing the gravity of the situation, Nasawa Health Centre’s maternity department took on the challenge with determination and a clear purpose.

A Clear Aim: Elevating Assessment Rates

The maternity department at Nasawa Health Centre set a robust goal—increasing the percentage of ANC waiting women receiving thorough assessments during their waiting period to a substantial 70%. This transformative initiative was set in motion on February 1, 2023, with an endpoint on April 30, 2022. The healthcare team aimed to ensure that every waiting mother received the attention and assessments they deserved at least once every 24 hours.

Initial Hurdles and Valuable Lessons

The journey to improve maternity care, however, encountered some initial setbacks. Shortages of necessary assessment sheets hindered the first change idea from delivering the expected results. Despite this, the commitment to quality care and the drive for improvement remained unwavering. The team learned valuable lessons from this initial phase, primarily understanding that continuous quality improvement thrives with sustained support from donors and collaborative teamwork.

Sustaining Progress: The Way Forward

Nasawa Health Centre’s maternity department remains determined to make further strides in enhancing maternity care. Their recommendation is to continue monitoring the project’s progress and to advocate for the necessary assessment sheets from relevant authorities. The project’s success is a testament to the potential of continuous quality improvement in healthcare, driven by unwavering teamwork and the support of dedicated donors.

The pursuit of improving maternity care for waiting mothers at Nasawa Health Centre stands as a shining example of the positive impact that dedicated healthcare professionals can make when they work together to tackle crucial challenges. Maternity care is an essential component of healthcare, and efforts like these contribute significantly to better maternal and neonatal outcomes.

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This is part of the storytelling contest submission for World Patient Safety Month. Read more here.

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