Feasibility and preliminary effectiveness of group antenatal care in Senegalese health posts

A pilot implementation trial

Bibliographic Data

ID11491095
AuthorsBritt Mckinnon (0000-0002-3109-5474, Centre for Global Child Health, The Hospital for Sick Children, 686 Bay Street, Toronto, ON M5G 0A4, Canada, corresponding author), Mohamadou Sall (0000-0002-8384-1686, Institut de Recherche et Formation en Population, Développement et Santé de la Reproduction, Université Cheik Anta Diop, P.O. Box 45 550 Dakar Fann, Dakar, Senegal), Ashley Vandermorris (0000-0002-6976-8590, Division of Adolescent Medicine, The Hospital for Sick Children, 686 Bay Street, Toronto, ON M5G 0A4, Canada), Mahamadou Traoré (Institut de Recherche et Formation en Population, Développement et Santé de la Reproduction, Université Cheik Anta Diop, P.O. Box 45 550 Dakar Fann, Dakar, Senegal), Fatma Lamesse-Diedhiou (Institut de Recherche et Formation en Population, Développement et Santé de la Reproduction, Université Cheik Anta Diop, P.O. Box 45 550 Dakar Fann, Dakar, Senegal), Fatma Lamesse‐Diedhiou (Cheikh Anta Diop University), Katie McLaughlin (0000-0003-4988-0013, Centre for Global Child Health, The Hospital for Sick Children, 686 Bay Street, Toronto, ON M5G 0A4, Canada), Diego G Bassani (0000-0001-6704-3820, Centre for Global Child Health, The Hospital for Sick Children, 686 Bay Street, Toronto, ON M5G 0A4, Canada)
Year2020
Volume35
Issue5
Pages587-599
Publication date2020-06-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueHealth Policy and Planning (JOURNAL)
Journal identifiersISSN: 0268-1080 • E-ISSN: 1460-2237
PublisherOxford University Press (PUBLISHER • GB)
DOI10.1093/heapol/czz178
PMID32155254
OpenAlexW3011119856
LanguageEN
Citations received3
References cited28

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

Developing country · Economic growth · Family medicine · Group (periodic table) · Child Nutrition and Water Access · Global Health and Epidemiology · Global Maternal and Child Health · Medicine · Nursing