Taking this as a foundation, the GDG reviewed how ANC should be delivered in terms of both the timing and content of each of the ANC contacts, and arrived at a new model – the 2016 WHO ANC model – which replaces the previous four-visit focused ANC (FANC) model. In a survey conducted among a subset of WHO recommendations on antenatal care for a positive pregnancy experience 102 women participating in the WHO trial, fewer women were satisfied with the frequency of visits in the FANC model than in the standard model (77.4% versus 87.2%) and women in the FANC model were less likely to be satisfied with the spacing between visits compared with the standard model (72.7% versus 81%). Up-to-date systematic reviews were used to prepare evidence profiles for priority questions. Antenatal care models with a minimum of eight contacts are recommended to reduce perinatal mortality and improve women’s experience of care. To screen the high risk cases. How much time do health services spend on antenatal care? antenatal care. Optimizing service delivery within health systems. The GRADECERQual Project Group; 2016 (. 2016. Outline. However, if this element is neglected, a poorly executed FANC model may then simply represent reduced health provider contact, and a reduced opportunity to detect risk factors and complications, and to address women’s concerns. Guidance on implementation of the FANC model in such settings was found to be inadequate, as was the amount of time allowed within the four-visit model to provide integrated care. 2012;17:300–7. 2016 WHO Antenatal Care Guidelines: Malaria in Pregnancy Frequently Asked Questions (FAQ) 1 March 2018 www.mcsprogram.org Introduction In 2016, the World Health Organization (WHO) published Recommendations on Antenatal Care for a Positive Pregnancy Experience (WHO 2016), which outlines a new set of evidence-based global guidelines on recommended content and scheduling for antenatal care … Pattinson R. 2016. Qualitative evidence suggests that some providers in LMICs feel that the reduced visit schedule is a more efficient use of staff time and is less likely to deplete limited supplies of equipment and medicine (moderate confidence in the evidence) (15). Evidence from high-, medium- and low-resource settings suggests that women do not like reduced visit schedules and would prefer more contact with antenatal services (moderate confidence in the evidence) (14). The successful introduction of evidence-based policies related to antenatal care into national programmes and health care services depends on well-planned and participatory consensus-driven processes of adaptation and implementation. malaria, TB, sexually transmitted infections, helminthiasis). WHO antenatal care randomised trial for the evaluation of a new model of routine antenatal care. Emotional and psychosocial needs are variable and the needs of vulnerable groups (including adolescent girls, displaced and war-affected women, women with disabilities, women with mental health concerns, women living with HIV, sex workers, ethnic and racial minorities, among others) can be greater than for other women. In summary, the process included: identification of priority questions and outcomes, retrieval of evidence, assessment and synthesis of the evidence, formulation of recommendations, and planning for the implementation, dissemination, impact evaluation and updating of the guideline. Background. Four individual RCTs were conducted in HICs (the United Kingdom and the USA) and three large cluster-RCTs were conducted in LMICs, including one conducted in Argentina, Cuba, Saudi Arabia and Thailand (7), and two conducted in Zimbabwe. I welcome these guidelines, which aim to put women at the centre of care, enhancing their experience of pregnancy and ensuring that babies have the best possible start in life. Programme reports from Ghana and Kenya stress that inadequate equipment, supplies, infrastructure and training may hamper implementation (12, 13). With regard to maternal satisfaction, outcomes were reported narratively in the review, as data were sparse. The focused ANC (FANC) model, also known as the basic ANC model, includes four ANC visits occurring between 8 and 12 weeks of gestation, between 24 and 26 weeks, at 32 weeks, and between 36 and 38 weeks. Integration of services was found to be particularly challenging, especially in settings with a high prevalence of endemic infections (e.g. Costs per pregnancy to both women and providers were lower with the reduced visits models in both settings. An enabling environment should be created for the use of this recommendation, including changes in the behaviour of health care practitioners to enable the use of evidence-based practices. no additional peaks at 30 and 37 weeks. The median number of visits achieved in the FANC arms of these trials ranged from four to five visits and the median number of visits achieved in the standard ANC arms ranged from four to eight visits. The GDG prefers the word “contact” to “visit”, as it implies an active connection between a pregnant woman and a health-care provider that is not implicit with the word “visit”. GUIDELINES FOR MATERNITY CARE IN SOUTH AFRICA GUIDELINES FOR MATERNITY CARE IN SOUTH AFRICA Fourth Edition 2016 3 GUIDELINES FOR MATERNITY CARE IN SOUTH AFRICA GUIDELINES …

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