Antenatal Care (ANC) Profile in Kenya: Ensuring a healthy pregnancy

Pregnant woman giving a blood sample for Antenatal profile tests

Introduction

The ANC profile refers to a number of laboratory tests performed during pregnancy. They form part of a comprehensive package of care for pregnant women aimed at ensuring a healthy pregnancy and newborn.

Why are ANC tests done?

  • Monitor the health of the mother and the unborn baby through the pregnancy
  • Diagnose and manage transmissible diseases.
  • Identify any complications and intervene early
  • Promote the health of the mother and the fetus.
  • Prevent both maternal and child morbidity and mortality.
  • Screen for inheritable diseases and advice the mother /family accordingly.
  • Determine the mother’s blood group to detect Rh-negative status.

When are ANC Profile Tests done?

In Kenya, ANC tests should ideally be done earliest during pregnancy, within the first and second visit. Otherwise, the next best time is the first contact with a healthcare provider at any time during the pregnancy.

Components of ANC profiles.

In Kenya, the basic ANC profile constitutes the following:-

ANC profile page on the mother/child booklet( source: Ministry of Health, Kenya)
  1. Hemoglobin levels
  2. Syphilis (VDRL)
  3. HIV Test
  4. Blood glucose level
  5. Urine analysis
  6. TB screening
  7. ABO/Rh Blood group.

It’s important to note this panel is for the bare minimum in public hospital settings. Additional tests may be necessary on a case-by-case basis. Other countries include more sophisticated tests as part of a routine panel.

Where are ANC Profile tests done in Kenya?

The ANC profile tests are widely available within the public, private hospitals and stand-alone laboratories in Kenya. A directory of laboratories in Kenya can be found here.

Client/ Patient preparation

The pregnant woman should be counseled on the importance of the tests and informed consent obtained. This is usually done by a nurse in the ANC clinic.

How are ANC Profile Tests Performed?

The collection of samples depends on the specific test( see above). More details about each test can be found here. Most ANC profiles tests can be performed within a single clinic visit.

  1. Hemoglobin levels
  2. Syphilis (VDRL)
  3. HIV Test
  4. Blood glucose level
  5. Urine analysis
  6. TB screening
  7. ABO/Rh Blood group.

How The Tests Are Interpreted

Each test is interpreted according to set reference values. If a test is found to be abnormal, the pregnant woman is referred to the clinician for further evaluation and care. Details of the individual tests can be found above.

Challenges of ANC Profile Tests in Kenya

  1. Cost – Some of the tests are not available in public hospitals and have to be paid for out of pocket in private laboratories
  2. Non-attendance of ANC clinic. Almost 40% of pregnant women in Kenya do not attend ANC clinics.
  3. Limited panel of tests. The number of tests in the national program is quite limited. There is a need to expand to cater to prevalent diseases eg hepatitis B and hereditary disorders eg sickle cell disease.
  4. Inaccessibility. Some folks live in inaccessible areas, especially in the Northern and coastal areas of the country. There’s need for outreach and mobile laboratory services to reach people living in these areas

Conclusion

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