The success of foetal life determines not only the health of the new-born, but also has a major impact on adult health. With access to antenatal and with regular monitoring, early detection of complications and treatment, these risks can be prevented. Thus, attending antenatal care (ANC) is mandatory for all pregnant mothers mainly the 1st ANC in the first trimester, the 4th ANC but also completing all the mandatory 8 antenatal visits.

The health sector performance report 2020 indicated that antenatal care (ANC) coverage for the fourth visit stagnated at 42% short of the HSDP target of 47.5% in 2020. For that reason, health facilities have become more innovative in attracting mothers to come for these ANC visits thereby seeing a sharp increase. Case in point is during the month of September, Alero HC III in Nwoya District registered a total of 488 mothers visiting the facility for ANC as per the maternity register. 

Mercy 27, mother of 4 children is 8 months pregnant with her 5th child. She says, she went for her antenatal after missing her periods for 2 months after her body became weak.  “I started going for ANC at 2 months, I went with my husband, they tested our blood and because my husband is already on ART, my test also turned out positive. I was advised to be enrolled on ART, keep appointment dates and to take my drugs on time. I was also advised to eat healthy and not to share sharp objects with children. I have already attended my 4th visit where I was told about birth preparation”.

For Monica 19 and 7 months with her first child. It is the husband who told her to go for the ANC after he attended one of the community outreaches and the VHT told them that once a mother misses her periods, she should go for a test at the health facility. “They tested our blood, checked the foetal heart beat and I was also given some drugs”. Since then, Monica has been going to Kochi Li for ANC monthly and during the 4th visit, the midwife emphasised that she should not miss her scheduled appointment dates. During her last visit in September, she was told to prepare for delivery and advised to deliver at the health facility.

Health facilities have become deliberate in attracting pregnant mothers to attend ANC visits through organising targeted community outreaches, community dialogues for far way and hard to reach areas. During these outreaches, community leaders attract mothers to come for services including immunisation, family planning, growth monitoring, screening for HIV, malaria.

It is also during these outreaches that facility staff tell mothers about the services offered at the facility and encourage them to come for scheduled antenatal appointments every month. Bella, enrolled midwife at Lalogi HC IV emphasises that “during integrated outreaches and community dialogues we emphasise mothers to come for the 1st ANC in the first trimester and when they come we encourage them to come 8 times. She says, these days, health facilities provide holistic services and ANC is done daily Monday to Friday unlike in the past when they had specific days for antenatal.

With additional RBF funding, some facilities have also acquired a telephone set for tracking mothers for ANC visits. The midwife calls mothers reminding them when they are due for ANC and when they come they are told about the different packages offered at ANC. According to Milton Steven, RBF Focal Person Amuru District, “we decided to buy a telephone line at the facility which we use to call/remind mothers about their scheduled ANC. We also use the same line to call mothers after delivery when they are back to their homes to find out how they and the babies are doing”.

Additionally, the availability of midwives at all times (day and night) has given mothers assurance that whenever they come, there is someone to attend to them. After the RBF training we attended, we came back and decided to be available for mothers. Today you come any time day/night we will be available to help, Holga, enrolled midwife. Likewise, administration changed the way they treat midwives. Staffing was an issue in the past, we had one midwife doing maternity and ANC, but with RBF funding, we attracted a volunteer nurse who is hired to concentrate only on ANC Dr. Agnes, RBF Focal Person Omoro District

To some facilities increase in ANC is as a result of referrals. They coordinate with lower facilities, in case they have a foetal heart beat that they don’t understand, they are encouraged to refer that mother for ultra-scan services. Lucy – enrolled comprehensive nurse at Lalogi HC IV says, “we get referrals from lower facilities of Awoo II, Acet III, Odek III, Layoajong III for scan services.

To Koch Li, the sharp increase of mothers coming for ANC is attributed to the facility’s upgrade to HC III, the construction of the maternity and the increase in staff had a remarkable effect as confirmed by Charles, In Charge Kochi Li. “after the upgrade to HC III and the construction of the maternity, mothers started coming in big numbers”.