الفهرس 
Introduction and rationaleOnly 14 pages are availabe for public view
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Abstract
The present study was conducted aiming to assess quality of antenatal care provided at Al-Arbeen District health care.
It is a cross sectional study aimed to describe quality of antenatal care services at this district through assessing the quality of the process of antenatal care through medical records, assessing provider satisfaction regards the antenatal service and assessing pregnant women satisfaction.
The total quality score of client satisfaction in Al-Arbeen District health care was 79.2±23.5 with statistically difference between the five centers (p value<0.001), the highest score was in both Al-Mahrousa (90.6±13.9) and Al-Hawes (90.4±18.3) units and the lowest score was in Al-Sadat unit (67.7±26.5).
In conclusion the current study showed that the most dissatisfaction items for clients were:
1: Registration process and waiting area by 24%.
2: Relation with nurses and medical assistant staff by 20%
3: Waiting time by 15.4%
In current study the main areas of improvement needed, as suggested by clients, include decrease the waiting time and presence of the service of delivery in the centers.
The total quality score of physicians’ satisfaction in Al-Arbeen District health care was 61.0% with no statistically difference between the five centers (p value0.572), the highest score was in both Al-Mahrousa (79.2±19.1) and the lowest score was in Al-Hawuis (46.9±42.5).
In conclusion the current study showed that the most dissatisfaying items for providers were:
1: Unsuitability of the work place than it was 12 months ago by 64.7%
2: The available tools, equipment and encouragement they had by 64.7%.
3: Un- respectful treatment they had by 47.1%.
In the current study the main areas for improvement needed as suggested by providers were: better tools and equipment, training for doctors and nurses and better place for patient, good salary and incentive, better place to work in, training for doctors and nurses and better tools and equipments.
The total quality score of file auditing in Al-Arbeen District health care (in four unites only) was (76.5±5.6) with statistically difference between the four centers (p value<0.001), the highest score was in Al-Eman (79.8±4.5) while the lowest score was in Al-Hawuis (73.1±6.2).
The current study showed that the most deficient items in the file registration were:
1: Recording of the immunization status of the pregnant women (28.8%).
2: Recording of the fetal heart sound (18.3%)
3: Recording of the ultra sound (11.3%)
4: Recording of screening of diabetes in pregnant women (2.5%)
5: Recording of the diagnosis according to the clinical guide line (12.4%)
6: Referral of high risk pregnancies to specialist according to clinical guide line (4.1%)
In the current study, comparison between accredited center (Al-Arbeen) and non accredited center and units (Al-Haues, Al-Eman, Al-Mahrosa and Al-Sadat) showed that client satisfaction score was higher in accredited centers than non accredited centers with significant difference (p value 0.002) and also comparison showed that provider satisfaction score was higher in non accredited center than accredited unites with insignificant difference (p value 0.533) between centers.
In conclusion there was suboptimal quality of registration as compared with the standard of accreditation especially in units and centers accredited twice (Al-Haues, Al-Eman, and Al-Sadat) which require attention to improve the quality of service provided.
The overall clients’ satisfaction in accredited units and center was 82.36 ± 22.9 which is accepted in comparison to literature but in the non accredited center was 70.12 ± 23.06 which require attention for improvement to meet customer needs as it influence their satisfaction with the service provided.
The overall providers’ satisfaction in Al-Arbeen District health care was 61.0±26.5 which is accepted in comparison to literature but improvement to increase providers’ satisfaction is suggested as healthcare providers’ satisfaction is an important element on how to improve the quality of service provided at PHC level.
It is expected that the finding of the study could help Al-Arbeen District health care managers for planning and implementing effective improvement in order to meet the PHC providers’ and clients needs and so improve quality of antenatal care in Al-Arbeen District health care.