Group antenatal care positively transforms the care experience: Results of an effectiveness trial in Malawi
PMCID: PMC12176302
PMID: 40531963
DOI: 10.1371/journal.pone.0317171
Journal: PloS one
Publication Date: 2025-6-18
Authors: Patil CL, Norr KF, Kapito E, Liu LC, Mei X, et al.
Key Points
- Group ANC participants had significantly higher peer connectedness (Estimate = 1.43, 99% CI = 1.02, 1.84)
- 95% of Group ANC participants preferred this model for future pregnancies, compared to 81% in Individual ANC
- The model demonstrates potential for scalable, patient-centered antenatal care in resource-limited settings
Summary
This hybrid effectiveness-implementation trial in Malawi evaluated a Centering-based Group Antenatal Care (ANC) model against traditional Individual ANC, focusing on integrating health promotion for HIV prevention and mental health. The study randomized 1,887 pregnant women across seven clinics, comparing outcomes through a comprehensive theory of change framework that examined supportive relationships, empowered learning, and meaningful service delivery.
Group ANC demonstrated significant improvements across multiple domains, including increased peer connectedness, pregnancy-related empowerment, and satisfaction with care. Women in Group ANC experienced more ANC contacts, shorter wait times, and reported higher engagement in health-promoting behaviors. Notably, the intervention showed positive effects on dietary diversity, birth preparedness, partner communication, and reduced mental distress, while maintaining comparable clinical outcomes for facility-based delivery, breastfeeding, and infant health.
The study's findings suggest Group ANC can be an effective model for improving maternal healthcare experiences and outcomes in low-resource settings, with potential for broader implementation. The Malawi Ministry of Health is now exploring nationwide adoption of this approach, recognizing its flexibility in addressing local and global maternal health needs.