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LETTER TO EDITOR |
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| Year : 2017 | Volume
: 42
| Issue : 3 | Page : 185 |
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Evaluation of antenatal care services affecting neonatal health
Kishor Parashramji Brahmapurkar
Department of Community Medicine, LBRKM Government Medical College, Chhattisgarh, India
| Date of Submission | 03-Dec-2016 |
| Date of Acceptance | 01-May-2017 |
| Date of Web Publication | 3-Aug-2017 |
Correspondence Address:
Kishor Parashramji Brahmapurkar
Department of Community Medicine, LBRKM Government Medical College, Jagdalpur, Bastar, Chhattisgarh - 494 001
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/ijcm.IJCM_388_16
How to cite this article:
Brahmapurkar KP. Evaluation of antenatal care services affecting neonatal health. Indian J Community Med 2017;42:185 |
Sir,
The article published in this journal about evaluation of antenatal to neonatal continuum care services affecting neonatal health in a tertiary health-care setup[1] seems to be having minor issues.
Full antenatal care (ANC) coverage of 72% has been mentioned in the results without defining full ANC in the methodology. At some point, the authors have cited more than four ANC visits as full ANC, whereas in Table 1 of the article[1] the same is mentioned as more than three ANC visits.
As per National Family Health Survey-3 (NFHS-3), full ANC was not defined, only percentage of three or more than antenatal visits and percentage of ANC who has consumed iron folic acid (IFA) tablets for 90 or more days were mentioned.[2]
The study area for the study was SNCU of Maharaja Krishna Chandra Gajapati (MKCG) Medical College and Hospital,Berhampur.[1] As per Census 2011, it had predominance of rural population (78.24 %).[3]
As per NFHS-3, at national level, the ANC coverage with three or more visits was 51% in total and 43% for rural areas, only 23% ANC (19% in rural areas) had consumed IFA tablets for more than 90 days, and TT coverage was 75%.[4] Hence, it looks like overestimation of full ANC (72%), full course of IFA (58.7%), and TT coverage (100%) in the present study, which may be due to a recall bias.
Authors have assessed knowledge among mothers of sick neonates about maternal, newborn, and childcare as good, average, and poor but have failed to explain or mention the scoring method used for the same.
The limitations of the study are not mentioned, recall bias during interviews could be one of them.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
 Author Reply (Begum Jarina et al) | |  |
Full ANC means more than 3 antenatal check-ups and does not mean antenatal coverage. It was referred to as 4 visits, at some places. The discrepancies may be due to the sample taken - mothers of sick neonates coming to SNCU, most of whom were well aware of the services and utilized it. MKCG medical college is the only tertiary health care centre catering to the whole southern zone of Orissa where both rural and urban patients are referred. The sample included mothers of sick neonates, from both Urban and Rural areas, coming to the SNCU. In the study, we found prejudice towards taking injections over medicine in the studied sample. So, TT coverage was 100% while full IFA was only 58.7% and full ANC 72%.
Knowledge of mothers was assessed by a check list of danger signs of prenatal, intranatal, postnatal and neonatal period and adequate breast feeding practices (attachment, positioning, suckling and frequency). It was scored as follows: If no knowledge - Poor, if any one or two of the check list from each parameter - Average and idea about all those mentioned in check list - Good. One important limitation of study was that we took mothers of sick neonates who attended the SNCU. It could have been better if we took a larger sample including mothers not coming to SNCU as well. We don't think there should be any query regarding recall bias as we took mothers of sick neonates (28 days) who just went through the process of pregnancy and delivery.
| References | | |
| 1. | Begum J, Ali SI, Tripathy RM. Evaluation of antenatal to neonatal continuum care services affecting neonatal health in a tertiary health-care setup. Indian J Community Med 2016;41:213-8.  [ PUBMED] [Full text] |
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