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Examining the impact of WHO’s Focused Antenatal Care policy on early access, underutilisation and quality of antenatal care services in Malawi : a retrospective study

dc.contributor.authorMchenga, Martinaen_ZA
dc.contributor.authorBurger, Ronelleen_ZA
dc.contributor.authorVon Fintel, Dieteren_ZA
dc.date.accessioned2019-06-26T06:34:18Z
dc.date.available2019-06-26T06:34:18Z
dc.date.issued2019-05-08
dc.identifier.citationMchenga, M., Burger, R. & Von Fintel, D. 2019. Examining the impact of WHO’s Focused Antenatal Care policy on early access, underutilisation and quality of antenatal care services in Malawi : a retrospective study. BMC Health Services Research, 19:295, doi:10.1186/s12913-019-4130-1
dc.identifier.issn1472-6963 (online)
dc.identifier.otherdoi:10.1186/s12913-019-4130-1
dc.identifier.urihttp://hdl.handle.net/10019.1/106293
dc.descriptionCITATION: Mchenga, M., Burger, R. & Von Fintel, D. 2019. Examining the impact of WHO’s Focused Antenatal Care policy on early access, underutilisation and quality of antenatal care services in Malawi : a retrospective study. BMC Health Services Research, 19:295, doi:10.1186/s12913-019-4130-1.
dc.descriptionThe original publication is available at https://bmchealthservres.biomedcentral.com
dc.description.abstractBackground: A variety of antenatal care models have been implemented in low and middle-income countries over the past decades, as proposed by the World Health Organisation (WHO). One such model is the 2001 Focused Antenatal Care (FANC) programme. FANC recommended a minimum of four visits for women with uncomplicated pregnancies and emphasised quality of care to improve both maternal and neonatal outcomes. Malawi adopted FANC in 2003, however, up to now no study has been done to analyse the model’s performance with regards to antenatal care service quality and utilisation patterns. Methods: The paper is based on data pooled from three comparable nationally representative Malawi Demographic and Health Survey (MDHS) datasets (2000, 2004 and 2010). The DHS collects data on demographics, socio-economic indicators, antenatal care, and the fertility history of reproductive women aged between 15 and 49. We pooled a sample of 8545 women who had a live birth in the last 5 years prior to each survey. We measure the impact of FANC on early access to care, underutilisation of care and quality of care with interrupted time series analysis. This method enables us to track changes in both levels and the trends of our outcome variables. Results: We find that FANC is associated with earlier access to care. However, it has also been associated with unintended increases in underutilisation. We see no change in the quality of ANC services. Conclusion: In light of the WHO 2016 ANC guidelines, which recommend an increase of visits to eight, these results are important. Given that we find underutilisation when the benchmark is set at four visits, eight visits are unlikely to be feasible in low-resource settings.en
dc.description.urihttps://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-019-4130-1
dc.format.extent14 pages ; illustrations
dc.language.isoen_ZAen_ZA
dc.publisherBMC (part of Springer Nature)
dc.subjectWorld Health organization -- Focused Antenatal Care Model
dc.subjectPrenatal care -- Effectiveness -- Malawien_ZA
dc.subjectMaternal health services -- Effectiveness -- Malawien_ZA
dc.titleExamining the impact of WHO’s Focused Antenatal Care policy on early access, underutilisation and quality of antenatal care services in Malawi : a retrospective studyen_ZA
dc.typeArticle
dc.date.updated2019-06-25T16:58:31Z
dc.description.versionPublisher's version
dc.rights.holderAuthors retain copyright


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