Table 1 Summary of evidence from published literature describing group models for antenatal care delivery in low- and middle-income countries
From: Group antenatal care models in low- and middle-income countries: a systematic evidence synthesis
Study Citation | Sultana et al. (2017) [26] | Ruhl et al. (2015) [27] | Penna et al. (2008) [28] | Patil et al. (2013) [29] | Lori et al. (2016) [30] | Jafari et al. (2010) [31] | Ghani (2014) [32] | Arnold et al. (2014) [33] | Nair et al. (2015) [34] |
|---|---|---|---|---|---|---|---|---|---|
Panel I: Study or Program Characteristics | |||||||||
Group ANC or Participatory Group | Group ANC | Group ANC | Group ANC | Group ANC | Group ANC | Group ANC | Group ANC | Group ANC | Participatory Group |
Country | Bangladesh | Kenya | Brazil | Malawi, Tanzania | Ghana | Iran | Egypt | Botswana | India |
Setting | - Public/Nonhospital | – | – | - PublicHospital | UrbanPublicHospital | UrbanPublicNon-hospital | Urban-Hospital | - Private Hospital | Rural-- |
Is the model informed by an existing group format? | No | No | No | CP | No | No | CP | CP | No |
Panel II: Model Attributes | |||||||||
(a) Group | |||||||||
How many women are in a group? | 6–10 women | 15–20 women | – | 12 women | 12 women | 8–10 women | – | 12 mother/father pairs | – |
How are women grouped? | Gestational age | Gestational age | – | Availability and willingness to attend | Gestational age | Gestational age | Gestational age | Gestational age | Gestational age |
Is the composition of the group stable? | – | – | – | Yes | Yes | – | Yes | Yes | – |
(b) Leaders | |||||||||
How many leaders does the group have? | 2 | 2 | – | 2 | – | 1 | – | – | – |
What cadre of care providers typically leads the group? | 1 Qualified HCP/1 Nurse | 1 Qualified HCP/1 CHW | – | Midwives | Midwives | Midwife | – | Midwife or Women’s Health Nurse Practitioner | CHW |
Is the group leadership the same throughout all sessions? | – | – | – | Yes | – | – | Yes | Yes | – |
Do group leaders use a facilitative leadership style? | – | – | – | Yes | – | Yes | Yes | Yes | Yes |
(c) Content | |||||||||
Does the model include a clinical assessment component? | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | No |
Does the model include an education or skill-building component? | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes |
Does the model include a support group or counselling component? | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes |
Does the health assessment occur within the group space? | – | – | Yes | Yes | Yes | No | Yes | Yes | No |
Do the women participate in self-care activities? | – | – | Yes | Yes | – | Yes | Yes | Yes | No |
Are sessions guided by an overall plan or outline? | Yes | – | – | Yes | Yes | Yes | Yes | Yes | – |
Do sessions follow the core content but allow flexibility to tailor the session to the group’s needs? | – | – | – | Yes | Yes | – | Yes | Yes | – |
Does the model include a postnatal care component? | No | Yes (4 PNC) | – | No | No | No | – | Yes (1 PNC) | – |
(d) Dynamics and Environment | |||||||||
Does the group promote (through shared guidelines) respect and sharing among one another? | – | – | Yes | Yes | – | Yes | Yes | Yes | – |
Does the group allow for the participation of support persons? | – | – | – | Yes | – | – | Yes | Noa | – |
Are participants provided with the opportunity for socializing within the group? | – | – | – | Yes | Yes | – | Yes | Yes | – |
Are discussions and activities conducted in a circle? | – | – | – | Yes | Yes | – | Yes | Yes | – |
(e) Logistics | |||||||||
What is the total number of group sessions? | 4–6 ANC | 4 ANC + 4 PNC | – | – | 7 ANC | 10 ANC | – | 9 ANC | 20 |
How frequently do the group sessions occur? | – | Monthly | – | – | – | – | – | – | Monthly |
How long is each group session? | 120 min | 120 min | – | – | – | 90–120 min | – | 120 min | – |
Do the leaders and/or participants regularly evaluate the group experience? | – | – | – | Yes | Yes | – | Yes | Yes | – |