WHO recommendations on antenatal care for a positive pregnancy experience

Implementation considerations for ANC guideline <strong>recommendations</strong>
Need to know Need to do Need to have Consider
E.2. Midwife-led continuity of
care (MLCC)
• What model of care is
currently being used
• Whether there are sufficient
numbers of trained midwives
• Whether resources are
available or can be shifted to
facilitate this model
• Consult all relevant
stakeholders, including human
resource departments and
professional bodies
• Assess the need for additional
training in MLCC
• Ensure that that there is a wellfunctioning
referral system in
place
• Monitor midwife workload and
burnout
• A well functioning midwifery
programme
• Strategies to scale up the quality and
number of practising midwives
• Ways of providing continuity of care
through other care providers, e.g. lay
health workers
• Whether a caseload or team MLCC
model is more appropriate
E.3. Group ANC • Cultural norms and women’s
preferences regarding group
ANC
• Consider evaluating in
research context
• Appropriate facilities to deal with group
sessions, including access to large, well
ventilated rooms, or sheltered spaces
and adequate seating, and a private
area for individual examination
• Providers trained in group facilitation
and communication
• Research context
E.4. Community-based
interventions to improve
communication and support
• Community demographics and
cultural norms
• Who are the key stakeholders
in the community
• Train facilitators in group
facilitation, convening public
meetings, and communication
techniques
• Ensure sufficient facilitators
and resources to support them
• Train community volunteers/
lay health workers to identify
pregnant women in the
community and enourage their
attendance
• Ensure that the individual
woman’s preferences are
respected, e.g. with regard to
partner involvment
• Group spaces to hold meetings
• Culturally and educationally
appropriate educational material, e.g.
videos, flip charts, pictorial booklets
and/or cards
• Ongoing supervision and monitoring of
facilitators
• Resources, e.g. additional staff,
transport and budget for material, for
community mobilization initiatives
• Appropriate format and language of
communication
• Whether meetings should include men
and women together or separately
• Offering women a range of
opportunities for communication
and support, so that their individual
preferences and circumstances can be
catered for
• Implementing health system
strengthening interventions, such
as staff training, and improving
equipment, transport, supplies, etc.
Annex 4: Implementation considerations
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