Implementation Experiences of the Group Antenatal Care (ANC) Model for Adolescent Girls and Young Women in Public Health Facilities in Kampala, Uganda: A Qualitative Study

Teenage pregnancies are a public health problem in Uganda, associated with adverse maternal and perinatal outcomes. Pregnant teenagers have special reproductive health needs and social and emotional requirements, yet adolescent-friendly maternal services are limited. Group antenatal care (G-ANC) is provided to groups of adolescent girls and young women (AGYW) with similar gestation and/or client age and is designed to provide health education, social support, and training on self-care to address the unique needs of AGYW. The U.S. Agency for International Development (USAID) Maternal Child Health and Nutrition (MCHN) Activity seeks to strengthen maternal and newborn health service delivery to adolescent mothers by functionalizing group ANC in seven public facilities in Kampala. The purpose of documenting the implementation experiences of G-ANC is to inform scale-up.

Leveraging Digital Health Coaching to Improve Exercise Regimens in Pregnant Women 

Exercise during pregnancy can prevent and limit adverse maternal and fetal morbidities and provide long-term benefits through reduction of maternal weight gain during pregnancy and improvement in cardiovascular fitness. Regular exercise during pregnancy has shown benefits to the mother and the fetus in several ways, for example, it reduces back pain, eases constipation, and decreases the risk of gestational diabetes, gestational hypertension, pre-eclampsia, and caesarean birth. The World Health Organization (WHO) suggests that pregnant women get at least 150 minutes of moderate-intensity aerobic activity every week. In Nigeria, studies have shown that 47.6% of pregnant women have minimal knowledge about exercise while 15.8% of them showed a negative attitude towards exercise. In this presentation, we will describe how we have leveraged a virtual self-care health coaching platform to support low-income pregnant women to follow exercise regimens. The objective was to evaluate the impact of digital health coaching on exercise in pregnant women in Nigeria.

Improved Blood Pressure Outcomes through Digital Health Coaching via CompleteHealth™ in Nigerian Women with Hypertensive Disorders in Pregnancy 

Hypertensive disorders in pregnancy are known contributory factors to increased morbidity and mortality of both mother and baby, especially in sub-Saharan Africa. They cause 16% of maternal deaths within the region. Early detection, management, and compliance to treatment are critical to improving pregnancy outcomes. The principle of health coaching has been known to improve patients' compliance with therapy, including hypertension treatment. The application of digital technologies that offer health coaching services is still an evolving concept. At mDoc Healthcare, self-efficacy in managing chronic disease is afforded to members registered on the CompleteHealth^TM platform through the receipt of nudges from health coaches via voice calls and messages. Pregnant women registered on the platform receive these services and also access their imputed health metrics such as weight, blood pressure, and exercise to monitor their health progress.

Demand-Side Interventions Improve Adherence to Iron and Folic Acid (IFA) Supplements in Pregnancy in Bangladesh, Burkina Faso, Ethiopia, and India 

Adequate iron intake during pregnancy is essential to meet the needs of a growing fetus, blood volume expansion, and replacement of blood loss during childbirth. A daily iron and folic acid (IFA) supplement during pregnancy is recommended by the World Health Organization, however, adherence is universally low. Strategies have failed to adequately address adherence. Our aim was to draw lessons from developing and operationalizing demand-side adherence interventions in Bangladesh, Burkina Faso, Ethiopia, and India.