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  • Malawi Group Antenatal Care Effectiveness Dataset

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    Creator:
    Patil, Crystal
    Description:
    We conducted a hybrid effectiveness-implementation trial at seven clinics in Blantyre District, Malawi, comparing outcomes for 1887 pregnant women randomly assigned to Group ANC or Individual ANC. The seven study clinics were selected in consultation with the Blantyre District health team to represent a diversity of clinics and communities served. The catchment areas and populations served by the clinics differ socioeconomically. Three clinics serve the urban population of Blantyre city, the rapidly-growing second largest city in Malawi. Two clinics serve the peri-urban communities adjacent to metropolitan Blantyre, and two clinics primarily serve a rural and predominately agricultural community. The clinics varied in volume and number of working midwives. , To be eligible to participate in this study, participants had to be pregnant, over the age of 14, have a gestational age of less than 24 weeks, and be capable of making an informed choice about participation. Those aged 15-17 assented with consent from a legal guardian. Those who did not meet all criteria were excluded. All pregnant women presenting for their first antenatal visit received the same standard individual intake visit that included a health assessment with the midwife, laboratory tests, and HIV testing. , and After completing the intake visit, midwives directed clients to study team members so that eligibility could be assessed. Interested women then learned the information needed to give informed consent and sign a consent form. They then completed the baseline self-report survey using Audio Computer-Assisted Self-Interview software. The study statistician determined the randomization order list for each site before recruitment, and assignments were placed in order in sealed envelopes. After completing the baseline survey, the woman selected the next sealed envelope in that clinic’s box to reveal the type of ANC assignment, Group ANC or Individual ANC. Seven individual-level demographic and socioeconomic variables were treated as covariates in all analyses. Two clinic-level variables were also included as covariates, catchment area (rural, peri-urban, or urban) and midwife ANC workloads. Midwife ANC workloads were captured by a ratio of the average number of new ANC clients served each month divided by the number of midwives, with a higher ratio indicating a higher workload. The ratio was highest in two rural-serving clinics and substantially lower in peri-urban and urban communities.
    Keyword:
    Group antenatal care, Malawi, pregnancy, and woman-centered
    Citation to related publication:
    Group antenatal care positively transforms the care experience: Results of an effectiveness trial in Malawi Crystal L. Patil, Kathleen F. Norr, Esnath Kapito, Li C. Liu, Xiaohan Mei, Elizabeth T. Abrams, Elizabeth Chodzaza, Genesis Chorwe-Sungani, Ursula Kafulafula, Allissa Desloge, Ashley Gresh, Rohan D. Jeremiah, Dhruvi R. Patel, Anne Batchelder, Heidy Wang, Jocelyn Faydenko, Sharon S. Rising, Ellen Chirwa medRxiv 2024.12.25.24319635; doi:  https://doi.org/10.1101/2024.12.25.24319635
    Discipline:
    Health Sciences