New antenatal care model in Africa and India (NAMAI) study: an implementation research trial to improve antenatal care using WHO recommendations

HRP Project Brief

27 February 2023

| Technical document

New antenatal care model in Africa and India (NAMAI) study: an implementation research trial to improve antenatal care using WHO recommendations

Overview

Four countries, including Burkina Faso, India, Rwanda and Zambia, were prioritized to participate in a focused effort leading to a mixed methods implementation trial, aimed to improve understanding of and evidence base on how to design and implement an antenatal care (ANC) platform within each country’s health systems.[1] In addition, Rwanda and Zambia will implement and test the adapted version of the WHO digital ANC module for health workers.[2] The ongoing research seeks to demonstrate how quality, integrated and person-centred care can be implemented and eventually lead to better maternal and perinatal outcomes with pathways to scale up within and beyond the selected countries for lessons, to be shared globally.

The overall purpose of the trial is to use implementation science for systematically introducing and testing the applicability of the adapted WHO ANC package for a positive pregnancy experience. Four main co-interventions addressing: 1) staff training on the updated ANC service package and ultrasonography, 2) supportive supervision of ANC care providers, 3) supply and equipment provision and 4) community sensitization are the core components of the trial. The costs associated with the implementation of the adapted packages are being documented in standardize manner. Study results aim to inform pathways to scale and sustainability which ultimately lead to stronger health systems with better maternal and perinatal outcomes nationally. Learnings are being disseminated to ensure country, regional and global knowledge transfer and standardize approaches to adapting and implementing WHO evidence-based recommendations. A number of strategic global goods are being developed as part of this initiative, including a communication guide for community mobilization activities, and updating the WHO ANC recommendations adaptation toolkit to include the postnatal care recommendations. The latter is being translated to French, and will be tested in 3 countries.

[1] ISRCTN registry. Improving antenatal care using WHO recommendations: an implementation research study in Africa and India 2022 [Available from: https://www.isrctn.com/ISRCTN16610902].

[2] Muliokela R, Uwayezu G, Tran Ngoc C, Barreix M, Tamrat T, Kashoka A, et al. Integration of new digital antenatal care tools using the WHO SMART guideline approach: Experiences from Rwanda and Zambia. Digit Health. 2022;8:20552076221076256.

WHO Team

Sexual and Reproductive Health and Research (SRH)

Editors

HRP

Number of pages

World Health Organization