Abstract
Provision and uptake of routine antenatal services: a qualitative evidence synthesis.
Highlights
Antenatal care (ANC) is a core component of maternity care
It complements existing e ectiveness reviews of models of ANC provision and adds essential insights into why a particular type of ANC provided in specific local contexts may or may not be acceptable, accessible, or valued by some pregnant women and their families/communities
Using guidelines developed by the Cochrane Qualitative and Implementation Methods Group for searching for qualitative evidence (Booth 2011), we developed search strategies for each database.We did not impose any language or geographic limit on the searches, but to capture views and experiences of women and healthcare providers since the introduction of focused antenatal care (FANC) programmes, we limited our strategies to publication year 2000 and onwards
Summary
Antenatal care (ANC) is a core component of maternity care. both quality of care provision and rates of attendance vary widely between and within countries. A Cochrane Review of three cluster-randomised controlled trials (cluster-RCTs) (including the original WHO trial), published in 2015, suggested that reduced models of antenatal care might be associated with increased risk of perinatal mortality (Dowswell 2015) This led to a secondary analysis of the results of the original WHO trial, which indicated that in some cases the WHO FANC programme might be associated with higher levels of perinatal mortality. Anecdotal accounts and local audits suggested that the care package was not always delivered with fidelity to the original, tested protocol Under these conditions, while women may attend for the requisite number of visits, the content or quality of care, or both, may not be appropriate for their needs. The qualitative analysis undertaken for the 2016 WHO guidelines, and updated to 2019, is the basis for this review
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