Evaluation of the Quality of Focused Antenatal Care Consultations in the Maternity Ward of the Ouidah-Kpomassè-Tori-Bossito Health District in 2024, Benin

Introduction: Antenatal Care (ANC) is recognized as a key pillar in reducing maternal and neonatal mortality. Adopted in Benin since 2005 in its refocused form (FANC) providing for four (04) visits, the ANC model was updated by the WHO in 2016. This new model now recommends at least eight (08) contacts throughout pregnancy to improve the care experience. The absence of an assessment of the level of implementation and the quality of this model within the Ouidah-Kpomassè-Tori-Bossito Zone Hospital (HZ-OKT) justifies this study. Thus, the objective of this study is to evaluate the quality of FANC in the maternity service of the OKT zone hospital in 2024. Methods: This evaluative cross-sectional study was conducted from March 12 to April 05, 2024. In total, 150 pregnant women were surveyed regarding their satisfaction; information on FANC practices implemented by providers was collected; the women’s pregnancy monitoring records were reviewed; and data on the FANC environment were gathered. The quality level of the FANC was assessed using one hundred forty-four (144) normative criteria from national protocols. The binary scoring system (0/1) was supplemented by the application of discriminative criteria: the insufficiency of a single strategic sub-component (score < 60%) systematically results in the overall component being classified as “poor”, thus preventing average scores from masking critical gaps in maternal safety. Results: Our study revealed that while the raw scores for structure (73.33%), process (65.87%), and outcomes (68.89%) were acceptable, the application of discriminative criteria concludes poor quality for each of these dimensions. Overall, the quality of CPNR within HZ-OKT was therefore judged to be poor. Conclusion: The poor quality of FANC in this study was attributable to the absence of FANC protocol documents, inadequate training of qualified human resources, the lack of a waiting room in the FANC physical environment, failure to discuss the delivery and emergency plan, the absence of counseling and health promotion advice, and failure to reach a conclusion regarding the pregnant woman’s pregnancy status. These weaknesses should be addressed to improve FANC quality, thereby increasing satisfaction among pregnant women attending FANC.