Cluster randomized control trial to evaluate Group Antenatal Care (G-ANC) compared with routine individual antenatal care in Kenya and Nigeria
This trial seeks to evaluate the effectiveness, feasibility and acceptability of a Group Antenatal Care (G-ANC) model in Kenya and Nigeria, compared to traditional ANC provided by a skilled provider to one individual woman at a time.
Ultimately, the findings will be used to improve the quality and experience of facility-based ANC and promote retention in care thus optimizing health outcomes.
ANC in low-resource settings is often characterized with missed opportunities to provide information and optimal care to pregnant women in a timely manner. In busy ANC settings, women experience long waiting times for short, often rushed interactions with the health care provider leading to client dissatisfaction and sub-optimal care which may lead to reduced use of services in the future. Most women do not receive quality ANC under these circumstances - as defined by the proportion of pregnant women who received all eight recommended evidence-based interventions. Group ANC model of care originated in the United States as an innovative alternative to the traditional ANC model (i.e., provided by a skilled provider to one individual woman at a time) and as a means to improve womens knowledge, attendance, satisfaction, and health outcomes. In this proposed model, ANC is provided in facility-based groups of 8 -15 women of similar gestational age (sometimes with their partners or birth companions) through a series of meetings, usually provided by skilled health care providers (often midwives) in 1 -2 hour sessions. While there is growing evidence of the benefits of group ANC, the group care model has not yet been studied adequately to determine feasibility of implementation in a variety of settings; and if continued group care of the mother and baby during the first year after delivery also improves quality of care, satisfaction, and access to infant health and nutrition education, counseling, and care.
Two-arm, two-phase, cluster randomized controlled trial (cRCT); non-blinded.
Participants included pregnant women attending first ANC at gestational age <24 weeks, health care providers, and sub-national health managers.
Overall 1,075 and 1,013 pregnant women were enrolled in Nigeria and Kenya, respectively.