| dc.description.abstract |
Background: The Global Network for Women’
s and Children
’
s Health Research is one of the largest international
networks for testing and generating evidence-based reco
mmendations for improvement of maternal-child health in
resource-limited settings. Since 2009, Global Network sites in six low and middle-income countries have collected
information on antenatal care practices, which are importan
t as indicators of care and have implications for programs to
improve maternal and child health. We sought to: (1) describe the quantity of antenatal care attendance over a four-year
period; and (2) explore the quality of coverage for selected p
reventative, screening, and birth preparedness components.
Methods:
The Maternal Newborn Health Registry (MNHR) is a prospective, population-based birth and pregnancy
outcomes registry in Global Network sites, including: Argentina, Guatemala, India (Belgaum and Nagpur), Kenya,
Pakistan, and Zambia. MNHR data from these sites were prospectively collected from January 1, 2010
–
December
31, 2013 and analyzed for indicators related to quantity and patterns of ANC and coverage of key elements of
recommended focused antenatal care. Descriptive statistics were generated overall by global region (Africa, Asia,
and Latin America), and for each individual site.
Results:
Overall, 96% of women reported at least one antenatal care visit. Indian sites demonstrated the highest
percentage of women who initiated antenatal care during the first trimester. Women from the Latin American and
Indian sites reported the highest number of at least 4 visits. Overall, 88% of women received tetanus toxoid. Only
about half of all women reported having been screened for syphilis (49%) or anemia (50%). Rates of HIV testing
were above 95% in the Argentina, African, and Indian sites. The Pakistan site demonstrated relatively high rates for
birth preparation, but for most other preventative and screening interventions, posted lower coverage rates as
compared to other Global Network sites.
Conclusions:
Results from our large, prospective, population-based observational study contribute important
insight into regional and site-specific patterns for antenatal care access and coverage. Our findings indicate a
quality and coverage gap in antenatal care services, particularly in regards to syphilis and hemoglobin screening. We have identified site-specific gaps in access to, and delivery of, antenatal care services that can be targeted for improvement in future research and implementation efforts. |
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