Facilitators and barriers to implementation of obstetric ultrasound scanning intervention by midwives within maternal and child health departments of the selected healthcare facilities in four districts of Zambia: experiences of healthcare workers.

BACKGROUND

In Zambia's maternal and child health departments, midwives offer compulsory and free obstetric ultrasound scans during antenatal care (ANC). These scans monitor fetal growth and development and identify any possible pregnancy-related complications or abnormalities. However, the normalization of obstetric ultrasound scans (USS) by midwives in Zambia is still in progress. The study sought to assess the facilitators and barriers to the implementation of obstetric ultrasound scans by midwives during antenatal care within 11 healthcare facilities in Zambia: experiences of healthcare workers (HCWs).

METHODS

This was an explorative qualitative study with 28 healthcare workers from 11 healthcare facilities in four districts of Zambia. In-depth interviews were conducted in English, guided by an interview guide. The interviews were recorded with audio recorders, transcribed in verbatim, coded with Nvivo version 12, and analysed using an inductive thematic analysis approach.

RESULTS

Healthcare workers highlighted that pregnant women who accessed ultrasound scans during antenatal care within maternal and child health departments were more inclined to follow through with their ANC appointments. The availability of free ultrasound scans encouraged pregnant women to accept and utilize these services, leading to enhanced quality of ANC care provided by healthcare workers. Obstetric ultrasounds during ANC expedited decision-making processes about specialized pregnancy care by midwives. The main facility barriers were inadequate space in maternal and child health departments, heightened workloads for midwives leading to burnout, and lengthy waiting queues that discouraged pregnant women from utilizing ultrasound scan services.

CONCLUSION

The study underscores the significance of obstetric ultrasound scans in improving antenatal care within Zambia's healthcare facilities. Recommendations include prioritizing infrastructure upgrades to accommodate ultrasound services within MCH, implementing workload management strategies for midwives, and reducing waiting times for pregnant women to access the service. Furthermore, providing continuous training and support for midwives in ultrasound scanning technology will enhance the delivery of quality and normalisation of antenatal care in Zambia.