Enablers and barriers associated with successful implementation of group antenatal care in primary care facilities in Suriname: a qualitative evaluation study

Abstract

BackgroundIn 2019, group antenatal care (GANC) was introduced in four primary care facilities in Suriname, aiming to improve health and psychosocial wellbeing of pregnant women in vulnerable circumstances. This study aims to evaluate the implementation of GANC in primary care and provides insights into enablers and barriers of successful implementation.MethodsThis qualitative evaluation study is part of the ‘Group Care in the first 1000 days: GC_1000’ project. Data were collected through semi-structured (group-)interviews with relevant stakeholders: midwives from the four facilities who were trained for GANC (n = 10), healthcare management (n = 2), other health professionals (n = 3), and parents participating in GANC (n = 7). A thematic analysis was conducted, in which five moderating factors that influence adherence to an implementation served as an analytical framework.ResultsEnablers for successful implementation of GANC mentioned by interviewees were the organisation of antenatal care close to home, motivated midwives, support from colleagues and higher-level management, and the opportunity for parents to gain more knowledge compared to regular one-on-one care. Barriers mentioned were a lack of financial compensation for midwives, practical barriers related to finding adequate space and suitable time for group sessions, a perceived lack of communication between different stakeholders and contextual factors such as the current economic situation in Suriname and the position of midwives within the Surinamese healthcare system.ConclusionSuccessful implementation of GANC in primary care facilities in Suriname depends on several enablers and barriers. Motivated facilitators are a key enabler in successful implementation of GANC. Some form of financial compensation could increase such motivation.