ArticleBMC health services research2019
Examining the impact of WHO's Focused Antenatal Care policy on early access, underutilisation and quality of antenatal care services in Malawi: a retrospective study.
Article in BMC health services research, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 1 of them a synthesis that pooled it.
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Who cites it
26 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Evaluating the Adoption of mHealth Technologies by Community Health Workers to Improve the Use of Maternal Health Services in Sub-Saharan Africa: Systematic Review.JMIR mHealth and uHealth · 2024Pooled it
- Enhancing nutrition knowledge and dietary diversity among rural pregnant women in Malawi: a randomized controlled trial.BMC pregnancy and childbirth · 2021Trial
- Epidemiology of soil-transmitted helminths following sustained implementation of routine preventive chemotherapy: Demographics and baseline results of a cluster randomised trial in southern Malawi.PLoS neglected tropical diseases · 2021Trial
- WHO recommendations for pregnancy and postpartum care should include hypertensive disorders of pregnancy.Bulletin of the World Health Organization · 2026Article
- A qualitative study to explore women's perceptions of pregnancy and antenatal care in Chizenga village, Chikwawa, Malawi.PLOS global public health · 2026Article
- The impact of multidimensional poverty on antenatal care service utilisation in Malawi.Health economics review · 2025Article
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- Factors influencing antenatal care attendance in the eight contact era policy: a case of selected maternal health service facilities in Blantyre, Malawi.BMC pregnancy and childbirth · 2024Article
- WHO antenatal care policy and prevention of malaria in pregnancy in sub-Saharan Africa.Malaria journal · 2024Article
- Multilevel modelling of factors associated with eight or more antenatal care contacts in low and middle-income countries: findings from national representative data.Annals of medicine and surgery (2012) · 2024Article
- Time to antenatal care booking and its predictors among pregnant women in East Africa: a Weibull gamma shared frailty model using a recent demographic and health survey.Frontiers in global women's health · 2024Article
- Determinants of neonatal mortality among hospitalised neonates with sepsis at Queen Elizabeth Central Hospital, Blantyre, Malawi: A mixed-methods study.PLOS global public health · 2024Article
- Assessment of quality of antenatal care services and associated factors in Malawi: Insights from a nationwide household survey.PloS one · 2024Article
- Magnitude, disparity, and predictors of poor-quality antenatal care service: A systematic review and meta-analysis.SAGE open medicine · 2024Review
- Determinants of antenatal care utilization - contacts and screenings - in Sao Tome & Principe: a hospital-based cross-sectional study.Archives of public health = Archives belges de sante publique · 2023Article
- Article
- Improving WHO's understanding of WHO guideline uptake and use in Member States: a scoping review.Health research policy and systems · 2022Article
- Identifying the determinants of patient satisfaction in the context of antenatal care in Kenya, Tanzania, and Malawi using service provision assessment data.BMC health services research · 2022Article
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3 authors.
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Abstract
backgroundA variety of antenatal care models have been implemented in low and middle-income countries over the past decades, as proposed by the World Health Organisation (WHO). One such model is the 2001 Focused Antenatal Care (FANC) programme. FANC recommended a minimum of four visits for women with uncomplicated pregnancies and emphasised quality of care to improve both maternal and neonatal outcomes. Malawi adopted FANC in 2003, however, up to now no study has been done to analyse the model's performance with regards to antenatal care service quality and utilisation patterns.
methodsThe paper is based on data pooled from three comparable nationally representative Malawi Demographic and Health Survey (MDHS) datasets (2000, 2004 and 2010). The DHS collects data on demographics, socio-economic indicators, antenatal care, and the fertility history of reproductive women aged between 15 and 49. We pooled a sample of 8545 women who had a live birth in the last 5 years prior to each survey. We measure the impact of FANC on early access to care, underutilisation of care and quality of care with interrupted time series analysis. This method enables us to track changes in both levels and the trends of our outcome variables.
resultsWe find that FANC is associated with earlier access to care. However, it has also been associated with unintended increases in underutilisation. We see no change in the quality of ANC services.
conclusionIn light of the WHO 2016 ANC guidelines, which recommend an increase of visits to eight, these results are important. Given that we find underutilisation when the benchmark is set at four visits, eight visits are unlikely to be feasible in low-resource settings.
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