Shaping Group Antenatal Care in Brussels Metropolitan Region: A Descriptive Multi-Case Study.

Group Antenatal Care (GANC) provides a person-centred approach to prenatal care, integrating health care delivery with health promotion, while empowering participants and building a sense of community. GANC has proven to be effective and positively experienced by both participants and care providers and is also feasible to implement. However, introducing such innovative care models in a metropolitan city like Brussels involves navigating both challenges and opportunities. This study explores how GANC facilitators implement sessions in Brussels, the extent to which the core components are incorporated, and the rationale behind the chosen approaches. We used a descriptive multiple case study design grounded in constructivism and conducted reflexive thematic analysis. We collected data from four settings offering GANC, including 21 observations of four series of sessions and four in-depth interviews with GANC-facilitators. The findings indicate that settings shape the format of the sessions through the creation of a supportive atmosphere, the structure of content, and the integration of health assessments, which creates the format of the sessions. Furthermore, two key dynamics were identified: participant engagement and interaction, and facilitator responsiveness. Our study demonstrates that the settings can uphold the foundational principles of GANC, while addressing the opportunities and challenges within Brussels' complex urban environment.