Implementing focussed antenatal care in sub-Saharan Africa: an important and necessary stride towards achieving the MDGs.

Abstract

Antenatal care programmes in sub-Saharan Africa are patterned after the Western world model that was developed in Europe around the 1900s. Their components are not backed by evidence because they have not been scientifically tested. The implementation of this model in the developing countries is even of poor quality and is fraught with many problems including irregular clinic visits, long waiting times and poor feedback mechanism. The World Health Organisation has piloted a new model with reduced number of visits in low-risk pregnancies that is cost-effective, safe, more sustainable and equally effective as models with a higher number of visits. This is a review that looked at the new WHO Antenatal care model within the context of a resourceconstrained setting, and explored the issues that are likely to influence its widespread implementation in sub-Saharan Africa given the region's manpower and infrastructural constraints and the high maternal and neonatal morbidity and mortality figures. A SWOT Analysis framework was used to assess the situational analysis of antenatal care programmes in sub-Saharan Africa while the Walt and Gilson policy analysis triangle was used to analyse the feasibility of introducing the new WHO ANC model into the sub-region. The content of the WHO model may need to be adapted to suit the prevailing context in the sub-Saharan region. Emphasis must also be placed on carefully handling the processes of the introduction by advocacy to the different actors that would be involved in the implementation of the new model.

Keyword: Focused antenatal care, sub-Saharan Africa, implementation.