Best Practices for the Design of Prenatal Care Interventions
Chedid and Phillips, 2017
MSc Thesis- Rebecca Chedid
Introduction Prenatal health programs provide health education, reproductive care and related services to women. Programs may be administered individually or collaboratively by agencies including public health units, hospitals, health clinics, community and non-governmental organizations. Prenatal health disparities among populations at-risk may be reduced through the provision of accessible health education, services and resources to help women mitigate modifiable risks to pregnancy. Although standardized guidelines inform clinical screening, testing and maternity care, gaps exist regarding the design, implementation and evaluation for comprehensive prenatal health programs. Methods Using a multijurisdictional approach, prenatal health guidance documents released by clinical associations and regional governments across Canada, Australia, the United States, the United Kingdom and Ireland were systematically evaluated to identify standards and practices regarding the design, implementation and evaluation of prenatal health programs. Results Evidence-based, surveillance/monitoring, and expert/stakeholder collaborations were principles affirmed by guidance documents across all jurisdictions. Each jurisdiction described tailored strategies to optimize prenatal health in their respective communities. Divergence between jurisdictions was noted for patient care models and promotion of providers and companions of choice. Discussion A best practices model is proposed describing recommendations as follows: prenatal health programs should be grounded in a theoretical approach, fundamentally woman-centered and designed to address interacting prenatal health determinants across the lifespan. Accessible and inclusive prenatal health care can be achieved through provider training and community stakeholder collaborations. Identification of best practices for prenatal health program design, implementation and evaluation ensures that service standards are harmonized across communities, thereby optimizing maternal and child health.
Optimizing prenatal care...
Prenatal health care interventions include policies, programs, education, health services and outreach designed to help women optimize their pregnancy outcomes. The World Health Organization (WHO, 2015) has developed recommendations for health promotion interventions specific for maternal and newborn health and suitable for all member countries. Using this framework, we have performed an international comparison of prenatal care guidelines, policies and practices developed by governmental jurisdictions and professional associations from Canada, United States, Australia and Europe.
WHO recommendations on health promotion interventions for maternal and newborn health: evidence base. WHO, 2015
1. Birth preparedness and complication readiness
2. Male involvement interventions for maternal and newborn health
3. Interventions to promote awareness of human, sexual and reproductive rights and the right to access quality skilled care
4. Maternity waiting homes
5. Community-organized transport scheme
6. Partnership with traditional birth attendants
7. Providing culturally appropriate skilled maternity care
8. Companion of choice at birth
9. Community mobilization through facilitated participatory learning and action cycles with women’s groups
10. Community participation in maternal death surveillance and responses
11. Community participation in quality-improvement processes
12. Community participation in programme planning and implementation