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Feasibility and preliminary effectiveness of group antenatal care in Senegalese health posts: a pilot implementation trial.

08:00 EDT 10th March 2020 | BioPortfolio

Summary of "Feasibility and preliminary effectiveness of group antenatal care in Senegalese health posts: a pilot implementation trial."

Almost all pregnant women in Senegal receive some antenatal care (ANC), yet only around half receive four or more visits and provision of education and counselling during ANC is often inadequate and, in some cases, non-existent. This results in missed opportunities to provide support and to counsel women regarding appropriate care-seeking practices and health behaviours during pregnancy and across the continuum of care. This pilot effectiveness-implementation randomized controlled trial explored whether group ANC (G-ANC), a model that integrates standard individual pregnancy care with facilitated participatory group education activities and peer support, could potentially address some of these challenges. The G-ANC model adapted for Senegal builds on local healthcare delivery systems and aligns with World Health Organization recommendations for a shift towards women-centred models of maternity services. It was implemented at the health post level, and a total of 330 pregnant women participated in the study, of whom 85% were followed up at 6-10 weeks post-delivery. We assessed implementation outcomes (e.g. acceptability, cost) to establish the feasibility of the model in Senegal and explored effectiveness outcomes related to maternal and infant health for the planning of a large-scale trial. Results indicate that women and ANC providers were overwhelmingly enthusiastic about the G-ANC model, and exploratory analyses suggested improvements in exclusive breastfeeding, intention to use family planning, birth preparations and knowledge around maternal and newborn danger signs. This article provides timely and relevant evidence on the feasibility of G-ANC as an alternative model of care during pregnancy and a solid basis for recommending the conduct of a large-scale implementation study of G-ANC in Senegal. Key Messages Group antenatal care (G-ANC) is a model of care that integrates standard individual pregnancy care with facilitated participatory group education activities and peer support. We carried out a pilot effectiveness-implementation study of G-ANC in six health posts in Senegal's Kaolack district. Results suggested that an adapted G-ANC model was feasible to implement within the current health system and sociocultural context in Senegal. Feasibility and exploratory effectiveness results provide a solid basis for recommending the conduct of a large-scale implementation study of G-ANC in Senegal.

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Name: Health policy and planning
ISSN: 1460-2237
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