Appropriate Antenatal Counseling Questions for Pregnant Women with fetal Congenital Anomalies at Selected Hospitals in Addis Ababa: Clients’ and Counselors’ Perspectives
DOI:
https://doi.org/10.69614/ejrh.v18i01.997Keywords:
Antenatal counseling, QUOTE prenatal, congenital anomaly, EthiopiaAbstract
ABSTRACT
Objective: To evaluate clients’ and counselors’ perspectives on appropriate antenatal counselling questions for pregnant women with fetal congenital anomalies in Ethiopia.
Methods: A facility based mixed qualitative and quantitative cross-sectional study, conducted in three high volume hospitals in Addis Ababa, Ethiopia. Eight clients and 251 counselors were included in the study. Counselors had graded each question from an internationally validated QUOTE prenatal questionnaire in a 1 to 4 scale based on their judgment as to the relevance of each question in the context of our clients. Clients also had undergone an in-depth interview about the components of the questionnaire to check for its applicability. Descriptive statistics, Cronbach’s coefficient alpha reliability analysis and face validity tests were used for quantitative data and thematic analysis was done for the qualitative data.
Result: The response rate was 88%, Cronbach’s alpha was 0.914 making all of the questions reliable. From the 38 questions, 32 were labeled as valid by our counselors and we identified three themes: (1) Questions from the tool which are asked and got understood by the clients, (2) Questions which are asked but was not clear for the clients and (3) Questions which are not asked to the clients at all. Questions which were valid by the counselors were also well understood by the clients.
Conclusion: Most of the counseling questions from QUOTE prenatal questionnaire were found to be appropriate for use in our setting by our counselors. Additionally, the questions considered important were also well understood by the clients.
References
References
World Health Organization. Department of Making Pregnancy Safer, World Health Organization. Counselling for maternal and newborn health care: A handbook for building skills. World Health Organization; 2010.
Gagnon A, Wilson RD, Allen VM, Audibert F, Blight C, Brock JA, et al. RETIRED: Evaluation of Prenatally Diagnosed Structural Congenital Anomalies. J Obstet Gynaecol Can. 2009;31(9):875–81.
Dobrescu MA, Burada F, Cucu MG, Riza AL, Chelu G, Plesea RM, et al. Prenatal Genetic Counseling in Congenital Anomalies. In: Congenital Anomalies-From the Embryo to the Neonate. IntechOpen; 2018.
Mengistu GT, Mengistu BK. Counseling of pregnancy danger signs and associated factors among pregnant mothers in Ethiopia: Study based on Ethiopian mini demographic and health survey, 2019. Int J Afr Nurs Sci. 2024;20:100703.
Peters I, Posthumus A, Reijerink-Verheij J, Van Agt H, Knapen M, Denkta? S. Effect of culturally competent educational films about prenatal screening on informed decision making of pregnant women in the Netherlands. Patient Educ Couns. 2017;100(4):776–82.
Berhane Defaye F, Danis M, Wakim P, Berhane Y, Norheim OF, Miljeteig I. Bedside rationing under resource constraints—a national survey of Ethiopian physicians’ use of criteria for priority setting. AJOB Empir Bioeth. 2019;10(2):125–35.
Kahissay MH, Fenta TG, Boon H. Beliefs and perception of ill-health causation: a socio-cultural qualitative study in rural North-Eastern Ethiopia. BMC Public Health. 2017;17:1–10.
Marokakis S, Kasparian NA, Kennedy SE. Prenatal counselling for congenital anomalies: a systematic review. Prenat Diagn. 2016;36(7):662–71.
Jacobs MF, O’Connor BC, Weldetsadik AY, Tekleab AM, Bekele D, Hanson E, et al. Knowledge and attitudes about genetic counseling in patients at a major hospital in Addis Ababa, Ethiopia. J Genet Couns. 2021;30(2):544–52.
Quinonez SC, O’Connor BC, Jacobs MF, Mekonnen Tekleab A, Marye A, Bekele D, et al. The introduction of genetic counseling in Ethiopia: Results of a training workshop and lessons learned. Plos One. 2021;16(7):e0255278.
Disassa GA. Counseling and counseling services status in Ethiopia. COUNS-EDU Int J Couns Educ. 2020;5(3):101–6.
Walsh JC, Dicks LV, Raymond CM, Sutherland WJ. A typology of barriers and enablers of scientific evidence use in conservation practice. J Environ Manage. 2019;250:109481.
Smaby MH, Maddux CD, LeBeauf I, Packman J. Evaluating counseling process and client outcomes. 2008;
Zhong A, Xia K, Hadjis Z, Lifman G, Njambi L, Dimaras H. Opportunities and barriers for genetic service delivery in Kenya from a health personnel perspective. J Community Genet. 2021;12:525–38.
Martin L, Hutton EK, Spelten ER, Gitsels-van der Wal JT, van Dulmen S. Midwives’ views on appropriate antenatal counselling for congenital anomaly tests: Do they match clients’ preferences? Midwifery. 2014;30(6):600–9.
Gitsels-van der Wal JT, Martin L, Manniën J, Verhoeven P, Hutton EK, Reinders HS. Antenatal counselling for congenital anomaly tests: Pregnant Muslim Moroccan women? s preferences. Midwifery. 2015;31(3):e50–7.
Martin L, Gitsels-van der Wal JT, Hitzert M, Henrichs J. Clients’ perspectives on the quality of counseling for prenatal anomaly screening. A comparison between 2011 and 2019. Patient Educ Couns. 2021;104(7):1796–805.
Brooks D, Asta K, Sturza J, Kebede B, Bekele D, Nigatu B, et al. Patient preferences for prenatal testing and termination of pregnancy for congenital anomalies and genetic diseases in Ethiopia. Prenat Diagn. 2019;39(8):595–602.
Fitie GW, Endris S, Abeway S, Temesgen G. Pregnant mother’s knowledge level and its determinant factors towards preventable risk factors of congenital anomalies among mothers attended health institutions for antenatal care, Ethiopia. Clin Epidemiol Glob Health. 2022;14:100973.
Martin L, Gitsels-van der Wal JT, Pereboom MT, Spelten ER, Hutton EK, van Dulmen S. Midwives’ perceptions of communication during videotaped counseling for prenatal anomaly tests: How do they relate to clients’ perceptions and independent observations? Patient Educ Couns. 2015;98(5):588–97.
Smets E, van Zwieten M, Michie S. Comparing genetic counseling with non-genetic health care interactions: two of a kind? Patient Educ Couns. 2007;68(3):225–34.
Ephi I. Ethiopian public health Institute (EPHI)[Ethiopia] and ICF. Ethiop Mini Demogr Health Surv. 2019;
Legas AM, Mengistu AA. The practice of guidance and counselling service in Amhara regional state public universities, Ethiopia. Perspectives (Montclair). 2018;8(3):119–27.
Brooks LA, Manias E, Bloomer MJ. Culturally sensitive communication in healthcare: A concept analysis. Collegian. 2019;26(3):383–91.
Martin L, Van Dulmen S, Spelten E, De Jonge A, De Cock P, Hutton E. Prenatal counseling for congenital anomaly tests: parental preferences and perceptions of midwife performance. Prenat Diagn. 2013;33(4):341–53.
Sium AF, Wolderufael M, Lucero-Prisno III DE, Grentzer JM. The impact of having a dedicated obstetrics and gynecology resident to provide contraceptive counseling on immediate postpartum family planning uptake: a “pre–post” study. Reprod Health. 2022;19(1):59.
Teshome A, Birara M, Rominski SD. Quality of family planning counseling among women attending prenatal care at a hospital in Addis Ababa, Ethiopia. Int J Gynecol Obstet. 2017;137(2):174–9.
Little C, Packman J, Smaby MH, Maddux CD. The skilled counselor training model: Skills acquisition, self?assessment, and cognitive complexity. Couns Educ Superv. 2005;44(3):189–200.
Abacan M, Alsubaie L, Barlow-Stewart K, Caanen B, Cordier C, Courtney E, et al. The global state of the genetic counseling profession. Eur J Hum Genet. 2019;27(2):183–97.
Dobrescu MA, Burada F, Cucu MG, Riza AL, Chelu G, Plesea RM, et al. Prenatal Genetic Counseling in Congenital Anomalies. In: Congenital Anomalies-From the Embryo to the Neonate. IntechOpen; 2018.
