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Open Access

Integrated Person-Centered Health Care for All Women During Pregnancy: Implementing World Health Organization Recommendations on Antenatal Care for a Positive Pregnancy Experience

Sarah de Masi, Maurice Bucagu, Özge Tunçalp, Juan Pablo Peña-Rosas, Theresa Lawrie, Olufemi T Oladapo and Metin Gülmezoglu
Global Health: Science and Practice June 2017, 5(2):197-201; https://doi.org/10.9745/GHSP-D-17-00141
Sarah de Masi
aUNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland.
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Maurice Bucagu
bDepartment of Maternal, Newborn, Child and Adolescent Health, World Health Organization, Geneva, Switzerland.
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  • For correspondence: bucagum@who.int
Özge Tunçalp
aUNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland.
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Juan Pablo Peña-Rosas
cDepartment of Nutrition for Health and Development, World Health Organization, Geneva, Switzerland.
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Theresa Lawrie
aUNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland.
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Olufemi T Oladapo
aUNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland.
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Metin Gülmezoglu
aUNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland.
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    TABLE. Health Systems Interventions to Improve the Use and Quality of Antenatal Care as Recommended by the 2016 WHO Guideline on Routine Antenatal Care5
    Recommended InterventionsDescription
    Midwife-led continuity of careMidwife-led continuity-of-care models, in which a known midwife or small group of known midwives supports a woman throughout the antenatal, intrapartum, and postnatal continuum, are recommended for pregnant women in settings with well-functioning midwifery programs.
    Group antenatal careGroup antenatal care provided by qualified health care professionals may be offered as an alternative to individual antenatal care for pregnant women in the context of rigorous research, depending on a woman's preferences and provided that the infrastructure and resources for delivery of group antenatal care are available.
    Task shifting components of antenatal care deliveryaTask shifting the promotion of health-related behaviors for maternal and newborn healthb to a broad range of cadres, including lay health workers, auxiliary nurses, nurses, midwives, and doctors, is recommended.
    Task shifting the distribution of recommended nutritional supplements and intermittent preventive treatment in pregnancy for malaria prevention to a broad range of cadres, including auxiliary nurses, nurses, midwives, and doctors, is recommended.
    Recruitment and retention of staff in rural and remote areascPolicymakers should consider educational, regulatory, financial, and personal and professional support interventions to recruit and retain qualified health workers in rural and remote areas.
    Community-based interventions to improve communication and supportThe implementation of community mobilization through facilitated participatory learning and action cycles with women's groups is recommended to improve maternal and newborn health, particularly in rural settings with low access to health services.d Participatory women's groups represent an opportunity for women to discuss their needs during pregnancy, including barriers to reaching care, and to increase support to pregnant women.
    Packages of interventions that include household and community mobilization and antenatal home visits are recommended to improve antenatal care utilization and perinatal health outcomes, particularly in rural settings with low access to health services.
    Women-held case notesIt is recommended that each pregnant woman carries her own case notes during pregnancy to improve continuity, quality of care, and her pregnancy experience.
    Antenatal care contact schedulesAntenatal care models with a minimum of 8 contacts are recommended to reduce perinatal mortality and improve women's experience of care.
    • ↵a Recommendations adapted and integrated from WHO (2012).7

    • ↵b Including promotion of the following: care-seeking behavior and antenatal care utilization, birth preparedness and complication readiness, sleeping under insecticide-treated bed nets, skilled care for childbirth, companionship in labor and childbirth, nutritional advice, nutritional supplements, other context-specific supplements and interventions, HIV testing during pregnancy, exclusive breastfeeding, postnatal care and family planning, and immunization according to national guidelines.

    • ↵c Recommendation adapted and integrated from WHO (2010).8

    • ↵d Integrated from WHO (2014).9

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Global Health: Science and Practice: 5 (2)
Global Health: Science and Practice
Vol. 5, No. 2
June 27, 2017
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Integrated Person-Centered Health Care for All Women During Pregnancy: Implementing World Health Organization Recommendations on Antenatal Care for a Positive Pregnancy Experience
Sarah de Masi, Maurice Bucagu, Özge Tunçalp, Juan Pablo Peña-Rosas, Theresa Lawrie, Olufemi T Oladapo, Metin Gülmezoglu
Global Health: Science and Practice Jun 2017, 5 (2) 197-201; DOI: 10.9745/GHSP-D-17-00141

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Integrated Person-Centered Health Care for All Women During Pregnancy: Implementing World Health Organization Recommendations on Antenatal Care for a Positive Pregnancy Experience
Sarah de Masi, Maurice Bucagu, Özge Tunçalp, Juan Pablo Peña-Rosas, Theresa Lawrie, Olufemi T Oladapo, Metin Gülmezoglu
Global Health: Science and Practice Jun 2017, 5 (2) 197-201; DOI: 10.9745/GHSP-D-17-00141
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    • DELIVERY OF ANTENATAL CARE SERVICES
    • IMPLEMENTING THE NEW RECOMMENDATIONS
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US AIDJohns Hopkins Center for Communication ProgramsUniversity of Alberta

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