A scoring system as a tool for antenatal care audit in family medicine

OBJECTIVE: To propose the antenatal assessment score (AAS) as a tool for auditing the process of antenatal care in family medicine, and to highlight its accessibility by applying it at 2 family health care centers.

METHODS: A descriptive study of an audit process was conducted in 2 primary health care centers (non commissioned officers' [NCO] and officers' health centers [OC]) belonging to the Department of Family Medicine, Armed Forces Hospital, Riyadh, Kingdom of Saudi Arabia from February 2001 to June 2002. A systematic random sample of patients registered at the maternal registers of both centers was selected. A score system of 100 points was developed containing items regarding history taking, examination, investigations, treatment, referral, health education, number of visits and record keeping. The information was gathered retrospectively from patients' files at both centers.

RESULTS: The total assessment score approached 67 out of 100 for NCO and 71 out of 100 for OC with a statistically significant difference (p<0.05). History taking in general was achieved to 77% in NCO and 86% in OC. Examination whether general (8% and 76%) or obstetric (67% and 72%) was achieved at a lesser level. All investigations were recorded equally in both centers (77%). Referrals, whether routine or emergency, were much less recorded 35-28%. The majority of antenatal records at both centers were partially completed (84.5% and 81%). Indications to any given medications (73% and 91%) and the total number of visits were higher among NCO records with statistically significant difference (p<0.05).

CONCLUSION: Antenatal assessment score is an accessible tool for the audit process of antenatal care in family medicine. In depth analysis and interpretation of the results could be of high importance to total antenatal care. Nationwide use of this audit tool is recommended.