Effectiveness of Implementing Udonthani model classifying pregnancy 2016 in 32 Primary care units, Muang, Udonthani

Abstract

This Participatory Action Research (PAR) aimed to explore the effectiveness of using Udonthani Criteria for antenatal care classifying pregnant woman in terms of basic component model version 2016 for risk screening, quality of data record, referral system in case of emer- gency and standard protocol. Thirty two nurses had been selected by purposive sampling, all of them worked at primary care sectors. This research had been conducted from May – August 2018. The respondents attended the short course training for improving competencies related to high risk pregnancy issues. The Udonthani antenatal guideline had been addressed during the training course. The questionnaires composed of 5 sections. There were general information, the pre and post-test related to the knowledge of high risk pregnancies, the perspectives of respondents for the guideline, the referral system and road map from primary care sectors to delivery rooms and emergency rooms. The major descriptive statistics such as frequency, percentage, mean and standard deviation were calculated by SPSS version 16. Paired t-test had been used to compare means of the knowledge score before and after attend the training course. Reliability had been validated by using Cronbach’s Coefficient of Alpha that found 0.86.

                The results shown that all of nurses were female, meanage 46.53 years old (range 35-57). Most respondents graduated undergraduate levels and nearly half of them with 43.80% had experiences working at antenatal clinic more than 10 years. Compared the average mean score of knowledge of high risk pregnancies before and after attending the short course training found different significant at 0.05. The average mean score of the perspectives of respondents for the guidelinewas high level in all items ( X =4.43, S.D.=0.56). The averages mean score of referring patients from primary care sectors to delivery rooms and emergency rooms found 150 cases. With 68.70% in case of referral cases were low risks of pregnancy. Risk screening had been reports for 99.30% of referral cases, 90.66% of cases had been investigated basic blood screen test, 96.00% had been reports of causes, sign and symptoms of health prob- lems, and 94.70% of cases were referred in time effectively. With 2 cases had been referred to the emergency room at Udonthani hospital and they had no reports of attending antenatal care unit. The recommendations were maternal and child health care services should provide knowledge and self-care skills for pregnant women. Strengthening capacities of primary care services to investigate high risk pregnancy should be concern. Maternal and child health staff should be monitored continually about classifying pregnant woman. Qualitative research should be addressed focusing on quality of maternal and child health care. Participatory methods should be applied for other researches related health issues.