WHO recommendations on antenatal care for a positive pregnancy experience

Recommendations

Info

are indicated by a footnote in the ANC guideline text specifying that the recommendation has been “adapted and integrated from” the specific guideline. An example of where this was done is for the recommendation on task shifting, where the <strong>recommendations</strong> on multiple interventions were adapted to apply to the task shifting of routine ANC interventions only. In all instances, guideline users are referred to the specific <strong>WHO</strong> guidance for more details, including implementation considerations, for these <strong>recommendations</strong>. Implementation of the ANC guideline and <strong>recommendations</strong> is discussed in Chapter 4, and implementation considerations related to each GDG recommendation can be found in Annex 4. <strong>WHO</strong> <strong>recommendations</strong> on antenatal care for a positive pregnancy experience 12
3. Evidence and <strong>recommendations</strong> This ANC guideline includes 39 <strong>recommendations</strong> adopted by the Guideline Development Group (GDG), and 10 <strong>recommendations</strong> relevant to ANC that have been consolidated into this guideline from other existing <strong>WHO</strong> guidelines that have been recently approved by the Guidelines Review Committee (GRC). Evidence on the effectiveness of interventions was derived from 47 systematic reviews (41 Cochrane systematic reviews, 2 test accuracy reviews and 4 non-Cochrane reviews of nonrandomized studies) and was summarized in GRADE tables. A scoping review of what women want from ANC and what outcomes matter to women informed the values domain. Two qualitative systematic reviews on women’s and providers’ views and a review of country case studies contributed evidence on the acceptability and feasibility of interventions. Evidence and considerations on equity and resources also informed the GDG <strong>recommendations</strong>. The corresponding GRADE tables for <strong>recommendations</strong> are referred to in this chapter as “evidence base” (EB) tables, numbered according to the specific <strong>recommendations</strong> they refer to. These tables are presented separately in the Web supplement to this document. 3 Evidence-todecision tables with GDG judgements related to the evidence and considerations for all domains are presented in Web annex 3 of this guideline. In addition, implementation considerations and research priorities related to these <strong>recommendations</strong>, based on the GDG discussions during the Technical Consultations, can be found in the next chapters of the guideline (Chapter 4: Implementation of the ANC guideline and <strong>recommendations</strong>; Chapter 5: Research implications). This chapter provides the <strong>recommendations</strong> with the corresponding narrative summaries, grouped according to the type of intervention, namely: A. Nutritional interventions B. Maternal and fetal assessment C. Preventive measures D. Interventions for common physiological symptoms E. Health systems interventions to improve the utilization and quality of ANC. 3 Available at: www.who.int/reproductivehealth/publications/ maternal_perinatal_health/anc-positive-pregnancy-experience/ en/ Chapter 3. Evidence and <strong>recommendations</strong> 13
Page 1: WHO recomm
Page 4 and 5: WHO Library Catalo
Page 6 and 7: « To achieve the Every Woman Every
Page 8 and 9: Funding was provided for this guide
Page 10 and 11: WHO recomm
Page 12 and 13: Evaluation (GRADE) and Confidence i
Page 14 and 15: Zinc supplements Multiple micronutr
Page 16 and 17: Ultrasound scan Doppler ultrasound
Page 18 and 19: Task shifting components of antenat
Page 20 and 21: expect from ANC is to have a “pos
Page 22 and 23: 2. Methods WHO <st
Page 24 and 25: a list of ANC outcomes was prioriti
Page 26 and 27: content experts among the GDG membe
Page 28 and 29: • nFeasibility: Feasibility is in
Page 32 and 33: A. Nutritional interventions <stron
Page 36 and 37: A.1.2: Nutrition education on energ
Page 38 and 39: A.1.3: Energy and protein dietary s
Page 40 and 41: A.1.4: High-protein supplements REC
Page 44 and 45: Summary of evidence and considerati
Page 50 and 51: Equity Effective interventions to i
Page 52 and 53: A.7: Vitamin B6 (pyridoxine) supple
Page 54 and 55: only a quarter of the planned sampl
Page 56 and 57: A.10: Restricting caffeine intake R
Page 58 and 59: B. Maternal and fetal assessment B.
Page 62 and 63: to produce results than urine dipst
Page 66 and 67: B.1.4: Gestational diabetes mellitu
Page 68 and 69: B.1.6: Substance use RECOMMENDATION
Page 70 and 71: on screening, please refer to the 2
Page 72 and 73: Women’s values A scoping review o
Page 74 and 75: B.2.2: Symphysis-fundal height (SFH
Page 76 and 77: B.2.4: Ultrasound scan RECOMMENDATI
Page 80 and 81:
are willing to be screened and test
Page 82 and 83:
Women’s values A scoping review o
Page 84 and 85:
WHO recomm
Page 86 and 87:
C.4: Preventive anthelminthic treat
Page 88 and 89:
C.5: Tetanus toxoid vaccination REC
Page 90 and 91:
C.6: Intermittent preventive treatm
Page 92 and 93:
D. Interventions for common physiol
Page 94 and 95:
WHO recomm
Page 96 and 97:
Values See “Women’s values” a
Page 98 and 99:
D.4: Interventions for low back and
Page 100 and 101:
Acceptability Qualitative evidence
Page 102 and 103:
Additional considerations • nComp
Page 104 and 105:
WHO recomm
Page 106 and 107:
Senegal, Sri Lanka, Yemen and Zambi
Page 108 and 109:
WHO recomm
Page 110 and 111:
WHO recomm
Page 112 and 113:
WHO recomm
Page 114 and 115:
WHO recomm
Page 116 and 117:
may help to address inequalities. H
Page 118 and 119:
E.6: Recruitment and retention of s
Page 120 and 121:
WHO recomm
Page 122 and 123:
visits (high confidence in the evid
Page 124 and 125:
WHO recomm
Page 126 and 127:
WHO recomm
Page 128 and 129:
WHO recomm
Page 130 and 131:
WHO recomm
Page 132 and 133:
WHO recomm
Page 134 and 135:
WHO recomm
Page 136 and 137:
5. Research implications During the
Page 138 and 139:
6. Dissemination, applicability and
Page 140 and 141:
espectively. Any concern about the
Page 142 and 143:
WHO recomm
Page 144 and 145:
WHO recomm
Page 146 and 147:
WHO recomm
Page 148 and 149:
105. Systematic screening for activ
Page 150 and 151:
WHO recomm
Page 152 and 153:
WHO recomm
Page 154 and 155:
WHO recomm
Page 156 and 157:
WHO recomm
Page 158 and 159:
WHO headquarters (
Page 160 and 161:
WHO recomm
Page 162 and 163:
Dr Erika Ota Nutrition, evidence sy
Page 164 and 165:
WHO recomm
Page 166 and 167:
WHO recomm
Page 168 and 169:
WHO recomm
Page 170:
WHO recomm
show all

WHO recommendations on antenatal care for a positive pregnancy experience

Create successful ePaper yourself

Delete template?

Save as template?