Improving Health Literacy through Group Antenatal Care: Results from a Cluster Randomized Controlled Trial in Ghana

The purpose of this study was to address the enormous gaps in health literacy and the resulting poor outcomes among pregnant women in Ghana to determine the efficacy of group-based antenatal care (ANC) on increasing health literacy and improving maternal and newborn outcomes. The objective was to examine women's understanding of health messages, their appraisal of health information, and their engagement with the health system using a multidimensional, validated tool - the Maternal Health Literacy (MaHeLi) 12-point scale. We hypothesized that pregnant women randomized into group ANC will exhibit a greater increase in health literacy than women who received routine, individual ANC.

Effect of Group Antenatal Care Versus Individualized Antenatal Care on Birth Preparedness and Complication Readiness: A Cluster Randomized Controlled Study among Pregnant Women in Eastern Region of Ghana 

As utilization of individualized antenatal care (ANC) has increased throughout sub-Saharan Africa, prolonged waiting times, lack of caregiver continuity, and over-stretched staff have combined to limit its effectiveness in many settings. We implemented a trial of group-based antenatal care (G-ANC), an alternative service delivery model, to determine the impact on birth preparedness and complication readiness (BPCR) among pregnant women in Eastern Region, Ghana.

Adaptation of the Group Antenatal Care Model to the Indian Setting: Lessons Learned from Rajasthan, India 

Antenatal care is an essential bundle of services to identify high-risk conditions. Despite increased utilization, ANC quality in India is known to be suboptimal. Group antenatal care (G-ANC) has been suggested in the context of rigorous research (WHO 2016) as a novel way to encourage ANC attendance in groups that also promotes empowerment, peer interaction, and health literacy. In this paper, we report on the process undertaken to contextualize and adapt two G-ANC models in Rajasthan and explore the feasibility and acceptability of a heterogeneous model where pregnant women of different gestational ages and a homogeneous model where women with similar gestational ages were grouped together.

Group Antenatal Care Implementation: Providing Technical Assistance for Innovative and Sustainable Maternal and Child Health Service Delivery in a Northern Nigeria State 

Nigeria has a low antenatal care (ANC) coverage, leading to poor uptake of critical life-saving maternal and child health interventions. While progress has been made around antenatal visits, gaps remain in quality of care, completion of the recommended eight ANC visits, uptake of delivery by skilled birth attendants, uptake of intermittent preventive treatment of malaria in pregnancy (IPTp), and postpartum contraceptives. Group antenatal care (G-ANC) has the potential to improve uptake of maternal, neonatal, and child health (MNCH) services in low-income countries, but has been scarcely implemented in Nigeria. This study describes the implementation and outputs of the G-ANC model in Kaduna State, one of the pioneered states that scaled up G-ANC after a successful randomized control trial in Nigeria.