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Open Access Highly Accessed Research article

Are women and providers satisfied with antenatal care? Views on a standard and a simplified, evidence-based model of care in four developing countries

Ana Langer1*, José Villar2, Mariana Romero3, Gustavo Nigenda4, Gilda Piaggio2, Chusri Kuchaisit5, Georgina Rojas6, Muneera Al-Osimi7, José Miguel Belizán7, Ubaldo Farnot8, Yagob Al-Mazrou9, Guillermo Carroli3, Hassan Ba'aqeel11, Pisake Lumbiganon5, Alain Pinol2, Per Bergsjö10, Leiv Bakketeig11, Jo Garcia12 and Heinz Berendes13

Author Affiliations

1 Regional Office for Latin America and the Caribbean, The Population Council, Mexico City, Mexico

2 Special Programme of Research, Development and Research Training in Human Reproduction, World Health Organization, Geneva, Switzerland

3 Centro Rosarino de Estudios Perinatales, Rosario, Argentina

4 Fundación Mexicana para la Salud, Mexico City, Mexico

5 Khon Kaen University, Khon Kaen, Thailand

6 Hospital Gineco-Obstétrico "América Arias", Havana, Cuba

7 Latin American Centre for Perinatology and Human Development, Montevideo, Uruguay

8 Hospital Gineco-Obstétrico "América Arias", Havana, Cuba

9 Ministry of Health, Riyadh, Saudi Arabia

10 Department of Obstetrics and Gynaecology, University of Bergen, Bergen, Norway

11 National Institute of Public Health, Oslo, Norway

12 National Perinatal Epidemiology Unit, Oxford University, Oxford, England

13 National Institute of Child Health and Human Development. Bethesda, Maryland, USA

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BMC Women's Health 2002, 2:7  doi:10.1186/1472-6874-2-7

Published: 19 July 2002



This study assessed women and providers' satisfaction with a new evidence-based antenatal care (ANC) model within the WHO randomized trial conducted in four developing countries. The WHO study was a randomized controlled trial that compared a new ANC model with the standard type offered in each country. The new model of ANC emphasized actions known to be effective in improving maternal or neonatal health, excluded other interventions that have not proved to be beneficial, and improved the information component, especially alerting pregnant women to potential health problems and instructing them on appropriate responses. These activities were distributed within four antenatal care visits for women that did not need any further assessment.


Satisfaction was measured through a standardized questionnaire administered to a random sample of 1,600 pregnant women and another to all antenatal care providers.


Most women in both arms expressed satisfaction with ANC. More women in the intervention arm were satisfied with information on labor, delivery, family planning, pregnancy complications and emergency procedures. More providers in the experimental clinics were worried about visit spacing, but more satisfied with the time spent and information provided.


Women and providers accepted the new ANC model generally. The safety of fewer visits for women without complications with longer spacing would have to be reinforced, if such a model is to be introduced into routine practice.