Kouanda, S;
Ouedraogo, AM;
Sogo, AE;
Bagaya, O;
Sorgho, TEV;
Hien, YC;
Gbenou, DV;
... Lorencatto, F; + view all
(2023)
New Antenatal Model in Africa and India (NAMAI) study: implementation research to improve antenatal care using WHO recommendations.
Health Research Policy and Systems
, 21
, Article 82. 10.1186/s12961-023-01014-5.
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Abstract
Background: In 2020, an estimated 287 000 women died globally from pregnancy‐related causes and 2 million babies were stillborn. Many of these outcomes can be prevented by quality healthcare during pregnancy and childbirth. Within the continuum of maternal health, antenatal care (ANC) is a key moment in terms of contact with the health system, yet it remains an underutilized platform. This paper describes the protocol for a study conducted in collaboration with Ministries of Health and country research partners that aims to employ implementation science to systematically introduce and test the applicability of the adapted WHO ANC package in selected sites across four countries. Methods: Study design is a mixed methods stepped-wedge cluster randomized implementation trial with a nested cohort component (in India and Burkina Faso). The intervention is composed of two layers: (i) the country- (or state)-specific ANC package, including evidence-based interventions to improve maternal and newborn health outcomes, and (ii) the co-interventions (or implementation strategies) to help delivery and uptake of the adapted ANC package. Using COM-B model, co-interventions support behaviour change among health workers and pregnant women by (1) training health workers on the adapted ANC package and ultrasound (except in India), (2) providing supplies, (3) conducting mentoring and supervision and (4) implementing community mobilization strategies. In Rwanda and Zambia, a fifth strategy includes a digital health intervention. Qualitative data will be gathered from health workers, women and their families, to gauge acceptability of the adapted ANC package and its components, as well as experience of care. The implementation of the adapted ANC package of interventions, and their related costs, will be documented to understand to what extent the co-interventions were performed as intended, allowing for iteration. Discussion: Results from this study aim to build the global evidence base on how to implement quality ANC across different settings and inform pathways to scale, which will ultimately lead to stronger health systems with better maternal and perinatal outcomes. On the basis of the study results, governments will be able to adopt and plan for national scale-up, aiming to improve ANC nationally. This evidence will inform global guidance. Trial registration number: ISRCTN, ISRCTN16610902. Registered 27 May 2022. https://www.isrctn.com/ISRCTN16610902.
| Type: | Article |
|---|---|
| Title: | New Antenatal Model in Africa and India (NAMAI) study: implementation research to improve antenatal care using WHO recommendations |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1186/s12961-023-01014-5 |
| Publisher version: | https://doi.org/10.1186/s12961-023-01014-5 |
| Language: | English |
| Additional information: | Open Access Creative Commons Attribution licence CC BY 3.0 IGO: The Article is licensed under the terms of the Creative Commons Attribution 3.0 IGO Licence (https://creativecommons.org/licenses/by/3.0/igo), which permits use, sharing, adaptation, distribution, and reproduction in any medium or format, as long as appropriate credit is given to the IGO, a link is provided to the Creative Commons licence, and any changes made are indicated. |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences > Clinical, Edu and Hlth Psychology |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10178108 |
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