Where is the ‘C’ in antenatal care and postnatal care: A multi‐country survey of availability of antenatal and postnatal care in low‐ and middle‐income settings

Abstract

Objective: Antenatal (ANC) and postnatal care (PNC) are logical entry points for prevention and treatment of pregnancy-related illness and to reduce perinatal mortality. We developed signal functions and assessed availability of the essential components of care.

A Scoping Review on Influence of Socioeconomic Status on Antenatal Care Utilization and Pregnancy Outcomes in Sub-Saharan Africa

“…Income was also revealed to be another limiting SES to the utilization of ANC due to limited access to appropriate medical treatment, which invariably exposes women to bad pregnancy outcomes (perinatal and maternal mortality) [71]. A significant inverse relationship between income and maternal mortality establishes that money is a considerable barrier to assessing comprehensive care in pregnancy and preventing birth complications to both mother and baby, many women may not be able to afford necessary care because of their personal limited income and that of their spouse [4,62,76].…”

“…Categorizing these regions into two communities of rural and urban, overall, mortalities are higher in rural communities than in urban areas. Commonly in rural communities, there is a depleted healthcare system and the people are not able to transport to bigger cities for proper care, and this may invariably limit the ANC services provided, hence reducing utilization [26,71]. It is, therefore, essential that programs to empower and prompt better utilization of ANC should be focused on making it more accessible to the burdened communities [72].…”

Demographic and pregnancy‐related predictors of postnatal contraception uptake: A cross‐sectional study

“…Despite family planning provision being identified as a key element of antenatal care, a previous systematic review proposed that the unmet need for PNC may be as high as 59.4% across some parts of the low-and middle-income world, and another study has highlighted shortcomings in PNC services in these settings. [27][28][29] The LOWE (LARC fOrWard counsElling) trial in Sweden has identified the potential impact for structured contraceptive counselling to increase LARC and reduce the risk of short pregnancy intervals. 30 In global settings, where maternal mortality and morbidity remains a serious threat, the need for effective evidence-based approaches to PNC provision is more urgent still.…”

“…The relatively low uptake of PNC in this UK‐based high‐income cohort reflects some of the challenges of providing comprehensive postnatal family planning care in global settings. Despite family planning provision being identified as a key element of antenatal care, a previous systematic review proposed that the unmet need for PNC may be as high as 59.4% across some parts of the low‐ and middle‐income world, and another study has highlighted shortcomings in PNC services in these settings 27–29 . The LOWE (LARC fOrWard counsElling) trial in Sweden has identified the potential impact for structured contraceptive counselling to increase LARC uptake and reduce the risk of short interpregnancy intervals 30 .…”

Aspirin for preeclampsia prevention in low- and middle-income countries: mind the gaps

“…However, many women fail to attend antenatal care in early pregnancy. 9 , 35 Ultrasonographic assessment of gestational age was available in 38% of facilities, but in some countries, availability was as low as <10%. These factors pose a challenge to screening and initiating treatment with low-dose aspirin early in pregnancy in LMIC.…”