Implementation challenges and outcomes of a randomized controlled pilot study of a group prenatal care model in Malawi and Tanzania

• Published in: International journal of gynecology and obstetrics 2017-12, Vol.139 (3), p.290-296
• Main Authors: Patil, Crystal L., Klima, Carrie S., Steffen, Alana D., Leshabari, Sebalda C., Pauls, Heather, Norr, Kathleen F.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; CenteringPregnancy; Feasibility Studies; Female; Group healthcare models; Group prenatal care; Health Plan Implementation; Humans; Malawi; Patient Acceptance of Health Care - statistics & numerical data; Pilot Projects; Postnatal Care - methods; Pregnancy; Prenatal care; Prenatal Care - methods; Psychotherapy, Group - methods; Quality of care; Randomized Controlled Trials as Topic - methods; Respectful care; Sub‐Saharan Africa; Tanzania; Young Adult
• ISSN: 0020-7292; 1879-3479
• DOI: 10.1002/ijgo.12324

Objective To identify implementation challenges associated with conducting a randomized controlled trial (RCT) of group prenatal care (PNC) and report outcomes of the pilot. Methods A multi‐site randomized pilot was conducted in Malawi and Tanzania between July 31, 2014, and June 30, 2015. Women aged at least 16 years with a pregnancy of 20–24 weeks were randomly assigned using sealed envelopes (1:1) to individual or group PNC. Structured interviews were conducted at baseline, in the third trimester and 6–8 weeks after delivery. The primary outcomes were attendance at four PNC visits and attendance at the 6‐week postnatal visit. Results The pilot showed that an RCT with individual randomization can be conducted in these two low‐resource settings. Significantly more women in group PNC than in individual PNC completed at least four PNC visits (96/102 [94.1%] vs 53/91 [58.2%]) and attended the postnatal visit (76/102 [74.5%] vs 45/90 [50.0%]; both P