Impact of group prenatal care on key prenatal services and educational topics in Malawi and Tanzania

Abstract

Objective: To examine whether group prenatal care (PNC) increased key services and educational topics women reported receiving, compared with individual PNC in Malawi and Tanzania.

Methods: Data come from a previously published randomized trial (n=218) and were collected using self-report surveys. Late pregnancy surveys asked whether women received all seven services and all 13 topics during PNC. Controlling for sociodemographics, country, and PNC attendance, multivariate logistic regression used forward selection to produce a final model showing predictors of receipt of all key services and topics.

Results: In multivariate logistic regression, women in group PNC were 2.49 times more likely to receive all seven services than those in individual care (95% confidence interval [CI] 1.78-3.48) and 5.25 times more likely to have received all 13 topics (95% CI 2.62-10.52).

Conclusion: This study provides strong evidence that group PNC meets the clinical standard of care for providing basic clinical services and perinatal education for pregnant women in sub-Saharan Africa. The greater number of basic PNC services and educational topics may provide one explanatory mechanism for how group PNC achieves its impact on maternal and neonatal outcomes. ClinicalTrials.gov: NCT03673709, NCT02999334.

Keywords: Group prenatal care; Malawi; Maternal health; Pregnancy; Prenatal care; Prenatal education; Sub-Saharan Africa; Tanzania.

Conflict of interest statement

CONFLICTS OF INTEREST

KFN serves as a volunteer member of the Advisory Board for Group Care Global, a non-profit organization dedicated to promoting a group care model based on CenteringPregnancy; there is no compensation for this service. The other authors declare that they have no competing interests.

© 2020 International Federation of Gynecology and Obstetrics.