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 Berendes^{^ 13}

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

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

³Centro Rosarino de Estudios Perinatales, Rosario, Argentina

⁴Fundación Mexicana para la Salud, Mexico City, Mexico

⁵Khon Kaen University, Khon Kaen, Thailand

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

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

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

⁹Ministry of Health, Riyadh, Saudi Arabia

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

¹¹National Institute of Public Health, Oslo, Norway

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

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

author email corresponding author email^Deceased

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

Published:	19 July 2002

Abstract

Background

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.

Methods

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

Results

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.

Conclusions

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.