New Avenues to Increase the Quality of Antenatal Care in Ghana

Presentation at the Global Maternal Newborn Health Conference, October 21, 2015

Background: Progress has been slow in improving quality of antenatal care in low-resource settings. Facilitated group focused antenatal care (FANC) has potential to improve the ability of women to understand and use information from antenatal care to promote and maintain their health.

Methodology: Using a cross-sectional, two group comparison design, women were randomized into group FANC (n=120) or the standard individual FANC (n=120) at one district hospital in the Ashanti Region of Ghana. Women in both arms were surveyed at the health facility within 90-days postpartum. Data were also collected from midwives (n=6) using a focus group.

Results: Preliminary results indicate a significant association between group care and birth preparedness, knowledge of danger signs, and uptake of family planning. Women randomized into group care reported being better prepared for delivery by: arrangement for emergency transport χ2 (1) = 10.68, p=.001), setting aside money for delivery χ2 (1) = 11.61, p=.001, cleaning an area in the home for the newborn χ2 (1) = 5.76, p=.016, keeping themselves clean χ2 (1) = 7.99, p=.005, and eating and drinking light foods during early labor χ2 (1) = 7.56, p=.006. When asked about danger signs, women in group care identified: pain in breast or abdomen χ2 (1) = 4.49, p=.034 and headache and blurred vision χ2 (1) = 6.49, p=.011 significantly more often than women in individual care. Women attending group FANC were twice as likely (29.1% vs 58.8%) to use family planning following delivery χ2 (2) = 12.13, p=.002. Midwives reported: (1) improved communication through the use of picture cards, (2) enhanced information sharing and peer support, and (3) improved understanding of patient’s concerns.

Conclusion: Delivering life-saving information in a format that is truly understandable will improve women’s birth preparedness and potentially affect the long term outcomes for themselves and their newborns.