Is antenatal care effective in reducing maternal morbidity and mortality

Datos Bibliográficos

ID11490249
AutoresMARILYN MCDONAGH (Save the Children, autor de correspondencia)
Año1996
Volumen11
Número1
Páginas1-15
Fecha de publicación1996-01-01
Peer ReviewedSí
Open AccessSí
TipoARTICLE
RevistaHealth Policy and Planning (JOURNAL)
Identificadores de la revistaISSN: 0268-1080 • E-ISSN: 1460-2237
EditorialOxford University Press (PUBLISHER • GB)
DOI10.1093/heapol/11.1.1
PMID10155875
OpenAlexW2139743450
IdiomaEN
Citas recibidas34
Referencias citadas19

Women in developing countries are dying from simple preventable conditions but what impact can the procedures collectively called antenatal care having in reducing maternal mortality and morbidity? More importantly what is antenatal care? This review found that questions have been raised about the impact of antenatal care (specifically on maternal mortality) since its inception in developed countries, and that although the questions continue to be asked there is very little research trying to find answers. Many antenatal procedures are essentially screening tests yet it was found that there were very few results showing sensitivity and specificity, and that they rarely complied with the established criteria for the effectiveness of a screening test. The acknowledged gold standard measurement of effectiveness is the randomized controlled trial, yet the only results available referred to nutritional supplementation. This service of flawed methodology has been exported to developing countries and is being promoted by WHO and other agencies. This paper argues that there is insufficient evidence to reach a firm decision about the effectiveness of antenatal care, yet there is sufficient evidence to cast doubt on the possible effect of antenatal care. Research is urgently required in order to identify those procedures which ought to be included in the antenatal process. In the final analysis the greatest impact will be achieved by developing a domiciliary midwifery service supported by appropriate local efficient obstetric services. That this domiciliary service should provide care for women in pregnancy is not disputed but the specific nature of this care needs considerable clarification.

Business · Developed country · Developing country · Economic growth · Environmental health · Family medicine · Gold standard (test) · Population · Pregnancy · Randomized controlled trial · Service (business) · Child Nutrition and Water Access · Global Health Care Issues · Global Maternal and Child Health · Medicine · Nursing