Group antenatal care models in low- and middle-income countries: a systematic evidence synthesis
Abstract In high-income countries, group antenatal care (ANC) offers an alternative to individual care and is associated with improved attendance, client satisfaction, and health outcomes for pregnant women and newborns. In low- and middle-income country (LMIC) settings, this model could be adapted...
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doaj-336f2379829d4389970a87fab909c6802020-11-24T21:38:58ZengBMCReproductive Health1742-47552018-03-0115111210.1186/s12978-018-0476-9Group antenatal care models in low- and middle-income countries: a systematic evidence synthesisJigyasa Sharma0Meaghan O’Connor1R. Rima Jolivet2Department of Global Health and Population, Harvard T. H. Chan School of Public HealthMaternal Health Task Force, Women & Health Initiative, Harvard T.H. Chan School of Public HealthMaternal Health Task Force, Women & Health Initiative, Department of Global Health and Population, Harvard T.H. Chan School of Public HealthAbstract In high-income countries, group antenatal care (ANC) offers an alternative to individual care and is associated with improved attendance, client satisfaction, and health outcomes for pregnant women and newborns. In low- and middle-income country (LMIC) settings, this model could be adapted to address low antenatal care uptake and improve quality. However, evidence on key attributes of a group care model for low-resource settings remains scant. We conducted a systematic review of the published literature on models of group antenatal care in LMICs to identify attributes that may increase the relevance, acceptability and effectiveness of group ANC in such settings. We systematically searched five databases and conducted hand and reference searches. We also conducted key informant interviews with researchers and program implementers who have introduced group antenatal care models in LMICs. Using a pre-defined evidence summary template, we extracted evidence on key attributes—like session content and frequency, and group composition and organization—of group care models introduced across LMIC settings. Our systematic literature review identified nine unique descriptions of group antenatal care models. We supplemented this information with evidence from 10 key informant interviews. We synthesized evidence from these 19 data sources to identify attributes of group care models for pregnant women that appeared consistently across all of them. We considered these components that are fundamental to the delivery of group antenatal care. We also identified attributes that need to be tailored to the context in which they are implemented to meet local standards for comprehensive ANC, for example, the number of sessions and the session content. We compiled these attributes to codify a composite “generic” model of group antenatal care for adaptation and implementation in LMIC settings. With this combination of standard and flexible components, group antenatal care, a service delivery alternative that has been successfully introduced and implemented in high-income country settings, can be adapted for improving provision and experiences of care for pregnant women in LMIC. Any conclusions about the benefits of this model for women, babies, and health systems in LMICs, however, must be based on robust evaluations of group antenatal care programs in those settings.http://link.springer.com/article/10.1186/s12978-018-0476-9Antenatal carePrenatal careGroup care during pregnancySystematic reviewQualitative evidence synthesis |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Jigyasa Sharma Meaghan O’Connor R. Rima Jolivet |
spellingShingle |
Jigyasa Sharma Meaghan O’Connor R. Rima Jolivet Group antenatal care models in low- and middle-income countries: a systematic evidence synthesis Reproductive Health Antenatal care Prenatal care Group care during pregnancy Systematic review Qualitative evidence synthesis |
author_facet |
Jigyasa Sharma Meaghan O’Connor R. Rima Jolivet |
author_sort |
Jigyasa Sharma |
title |
Group antenatal care models in low- and middle-income countries: a systematic evidence synthesis |
title_short |
Group antenatal care models in low- and middle-income countries: a systematic evidence synthesis |
title_full |
Group antenatal care models in low- and middle-income countries: a systematic evidence synthesis |
title_fullStr |
Group antenatal care models in low- and middle-income countries: a systematic evidence synthesis |
title_full_unstemmed |
Group antenatal care models in low- and middle-income countries: a systematic evidence synthesis |
title_sort |
group antenatal care models in low- and middle-income countries: a systematic evidence synthesis |
publisher |
BMC |
series |
Reproductive Health |
issn |
1742-4755 |
publishDate |
2018-03-01 |
description |
Abstract In high-income countries, group antenatal care (ANC) offers an alternative to individual care and is associated with improved attendance, client satisfaction, and health outcomes for pregnant women and newborns. In low- and middle-income country (LMIC) settings, this model could be adapted to address low antenatal care uptake and improve quality. However, evidence on key attributes of a group care model for low-resource settings remains scant. We conducted a systematic review of the published literature on models of group antenatal care in LMICs to identify attributes that may increase the relevance, acceptability and effectiveness of group ANC in such settings. We systematically searched five databases and conducted hand and reference searches. We also conducted key informant interviews with researchers and program implementers who have introduced group antenatal care models in LMICs. Using a pre-defined evidence summary template, we extracted evidence on key attributes—like session content and frequency, and group composition and organization—of group care models introduced across LMIC settings. Our systematic literature review identified nine unique descriptions of group antenatal care models. We supplemented this information with evidence from 10 key informant interviews. We synthesized evidence from these 19 data sources to identify attributes of group care models for pregnant women that appeared consistently across all of them. We considered these components that are fundamental to the delivery of group antenatal care. We also identified attributes that need to be tailored to the context in which they are implemented to meet local standards for comprehensive ANC, for example, the number of sessions and the session content. We compiled these attributes to codify a composite “generic” model of group antenatal care for adaptation and implementation in LMIC settings. With this combination of standard and flexible components, group antenatal care, a service delivery alternative that has been successfully introduced and implemented in high-income country settings, can be adapted for improving provision and experiences of care for pregnant women in LMIC. Any conclusions about the benefits of this model for women, babies, and health systems in LMICs, however, must be based on robust evaluations of group antenatal care programs in those settings. |
topic |
Antenatal care Prenatal care Group care during pregnancy Systematic review Qualitative evidence synthesis |
url |
http://link.springer.com/article/10.1186/s12978-018-0476-9 |
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