From an evaluation of an Intermittent Preventive Treatment Programme, the data indicated that pregnant women often arrived late into their pregnancy for their first (and often only) antenatal care check during their pregnancy.

To provide insight into the bottlenecks causing late and sole visits to ante-natal care clinics, The Reproductive Child Health Unit of The Department of State for Health and Social Welfare and CIAM initiated a 3-armed study focusing on antenatal care service delivery, coverage and access in The Gambia.

We have just completed the data collection stage of all 3 arms:

• Qualitative data on the perspectives of men, pregnant women and service providers about access to and quality of antenatal care services. We used audio-recorded focus group discussions with community members and exit interviews with pregnant women. Further qualitative data was collected from service providers about their perspectives on quality and their views on motivating and de-motivating factors in their work using individual interviews and self-administered questionnaires
• Quantitative data on coverage and access to services in relation to socio-economic factors (using semi-structured individual interviews based on a national community-based cluster sample survey)
• Health facility data on the extent of late bookings, numbers of deliveries, distribution of bed nets to pregnant women and administering intermittent preventive treatment through extraction of data from ANC and delivery registers over 3 years (2004-6 inclusive).

Using GPS technology, we have also collected coordinates for all the health clinics and trekking posts (outreach health posts) in the country to cross-check coverage data from the 2nd arm and to provide information to map the facilities accurately.

Data-entry is just beginning and the initial results are due by the end of November 2007.