ArticleBMJ open2023
Development of indicators for integrated antenatal care service provision: a feasibility study in Burkina Faso, Kenya, Malawi, Senegal and Sierra Leone.
Article in BMJ open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Determinants of quality antenatal care among adolescent girls and women in Sierra leone: insights from the 2019 demographic health survey.Reproductive health · 2025Article
- Factors associated with adequate antenatal care use among women of childbearing age in Burkina Faso: finding from the 2010 and 2021 demographic and health surveys.Frontiers in public health · 2025Article
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Authors and funding
4 authors.
Funding
Abstract
objectivesWhile service integration has gained prominence as an objective of many global initiatives, there is no widely recognised single definition of integration nor a clear understanding of how programmes are integrated into health systems to achieve improved health outcomes. This study aims to review measurement approaches for integrated antenatal care (ANC) services, propose and operationalise indicators for measuring ANC service integration and inform an integrated ANC indicator recommendation for use in low-income and middle-income countries (LMICs).
designFeasibility study.
settingBurkina Faso, Kenya, Malawi, Senegal and Sierra Leone.
methodsOur six-step approach included: (1) conceptualise ANC service integration models; (2) conduct a targeted literature review on measurement of ANC service integration; (3) develop criteria for ANC service integration indicators; (4) propose indicators for ANC service integration; (5) use extant data to operationalise the indicators; and (6) synthesise information to make an integrated ANC indicator recommendation for use in LMICs.
resultsGiven the multidimensionality of integration, we outlined three models for conceptualising ANC service integration: integrated health systems, continuity of care and coordinated care. Looking across ANC service integration estimates, there were large differences between estimates for ANC service integration depending on the model used, and in some countries, the ANC integration indicator definition within a model. No one integrated ANC indicator was consistently the highest estimate for ANC service integration. However, continuity of care was consistently the lowest estimate for ANC service integration.
conclusionsIntegrated ANC services are foundational to ensuring universal health coverage. However, our findings demonstrate the complexities in monitoring indicators of ANC service quality using extant data in LMICs. Given the challenges, it is recommended that countries focus on monitoring measures of service quality. In addition, efforts should be made to improve data collection tools and routine health information systems to better capture measures of service integration.
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