Bridging gaps in antenatal care: Implementation of the WHO ANC model using a web-based mobile application at different levels of the healthcare system

Abstract

IntroductionAntenatal care (ANC) is crucial for ensuring positive maternal and perinatal outcomes.The World Health Organization (WHO) has released comprehensive guidelines on ANC with the aim of providing a “positive pregnancy experience”. While mobile health (mHealth) technology shows immense potential in improving healthcare services, evidence of its effectiveness remains limited. ObjectivesThis study aimed to develop a mobile application aligned with the WHO antenatal care model and follow a group of antenatal women using that and compare it to the conventional care provided. MethodsA prospective open-label study was carried out at three health centers, where patients with singleton/twin pregnancies and access to smartphones were recruited after obtaining informed consent. The study group was followed using the mobile application, while the control group received conventional care. A recall-based questionnaire was used to assess the content of care, including comprehensive history, examination, and patient counselling. Patient satisfaction and the feasibility of using the application were also evaluated. ResultsA total of 85 patients in the study group and 73 controls were followed until delivery. Baseline demographic details were comparable, while the number of antenatal visits were higher in the intervention group. Patients in the study group had significantly higher mean scores compared to the controls in terms of comprehensive history (8.26 ± 2.26 vs 3.58 ± 2.30; p < 0.001), physical examination (4.26 ± 1.03 vs 3.66 ± 1.09; p = 0.001) and patient counselling (6.09 ± 1.65 vs 4.33 ± 1.69; p < 0.001).Among the recommended investigations, a hemogram (100 % vs 93.2 %; p = 0.02) and ultrasound prior to 24 weeks (89.4 % vs 56.2 %; p < 0.001) were carried out in a larger number of patients in the study group.Patient satisfaction scores, calculated using the PreMAPeQ questionnaire, were higher in the intervention group. ConclusionThis study highlights the effectiveness of an m-health application in enhancing the quality of antenatal care and facilitating standardized ANC visits. Further research is necessary to establish mHealth technology as a cost-effective intervention in this area.