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ABSTRACT: Objective
Antenatal (ANC) and postnatal care (PNC) are logical entry points for prevention and treatment of pregnancy-related illness and to reduce perinatal mortality. We developed signal functions and assessed availability of the essential components of care.Design
Cross-sectional survey.Setting
Afghanistan, Chad, Ghana, Tanzania, Togo.Sample
Three hundred and twenty-one healthcare facilities.Methods
Fifteen essential components or signal functions of ANC and PNC were identified. Healthcare facility assessment for availability of each component, human resources, equipment, drugs and consumables required to provide each component.Main outcome measure
Availability of ANC PNC components.Results
Across all countries, healthcare providers are available (median number per facility: 8; interquartile range [IQR] 3-17) with a ratio of 3:1 for secondary versus primary care. Significantly more women attend for ANC than PNC (1668 versus 300 per facility/year). None of the healthcare facilities was able to provide all 15 essential components of ANC and PNC. The majority (>75%) could provide five components: diagnosis and management of syphilis, vaccination to prevent tetanus, BMI assessment, gestational diabetes screening, monitoring newborn growth. In Sub-Saharan countries, interventions for malaria and HIV (including prevention of mother to child transmission [PMTCT]) were available in 11.7-86.5% of facilities. Prevention and management of TB; assessment of pre- or post-term birth, fetal wellbeing, detection of multiple pregnancy, abnormal lie and presentation; screening and support for mental health and domestic abuse were provided in <25% of facilities.Conclusions
Essential components of ANC and PNC are not in place. Focused attention on content is required if perinatal mortality and maternal morbidity during and after pregnancy are to be reduced.Tweetable abstract
ANC and PNC are essential care bundles. We identified 15 core components. These are not in place in the majority of LMIC settings.
SUBMITTER: Madaj B
PROVIDER: S-EPMC9541911 | biostudies-literature | 2022 Aug
REPOSITORIES: biostudies-literature
Madaj Barbara B Gopalakrishnan Somasundari S Quach Alexandre A Filiaci Simone S Traore Adama A Bakusa Dankom D Mdegela Mselenge M Yousofzai Abdul Wali AW Rahmanzai Ahmed Javed AJ Kodindo Grace G Gami Jean-Pierre JP Rostand Njiki Dounou ND Kessely Hamit H Addo Stephen Ayisi SA Abbey Mercy M Sapali Mary M Omar Ali A Ernest Alex A Mtandu Rugola R Agossou Abram A Ketoh Guillaume K GK Furtado Nicholas N Mangiaterra Viviana V van den Broek Nynke N
BJOG : an international journal of obstetrics and gynaecology 20220217 9
<h4>Objective</h4>Antenatal (ANC) and postnatal care (PNC) are logical entry points for prevention and treatment of pregnancy-related illness and to reduce perinatal mortality. We developed signal functions and assessed availability of the essential components of care.<h4>Design</h4>Cross-sectional survey.<h4>Setting</h4>Afghanistan, Chad, Ghana, Tanzania, Togo.<h4>Sample</h4>Three hundred and twenty-one healthcare facilities.<h4>Methods</h4>Fifteen essential components or signal functions of AN ...[more]