Jhpiego’s leadership in supporting antenatal care (ANC) is a prime example of how we translate policy recommendations into everyday practices to save lives. Since 2001, when the World Health Organization recommended the use of a new, evidence-based model of ANC it called focused antenatal care (FANC), Jhpiego has supported more than 20 countries to introduce and/or expand this model.
Referred to as “focused antenatal care” because it tailors care to a woman’s individual needs, FANCtargets interventions known to improve maternal and newborn outcomes in a framework of four visits, compared to the traditional model of more frequent visits. This approach, which emphasizes quality over quantity, recognizes three key realities:
- Frequent visits do not necessarily improve pregnancy outcomes, and in developing countries they are often logistically and financially impossible for women and health care systems to manage.
- Although the majority of pregnancies progress without complications, every pregnant woman benefits from an integrated package of services that includes blood pressure measurement; tetanus toxoid immunization; and prevention, early detection and treatment of anemia, sexually transmitted infections, HIV, TB and malaria.
- All women, including healthy women, are at risk of developing complications that cannot be predicted.
Therefore, all women need the basic package of care, which includes health education and monitoring for complications, with timely referral when necessary. And, when care is personalized, women are more likely to attend four ANC visits and to give birth with a skilled provider, which is linked to decreased maternal and newborn morbidity and mortality.
Taking a systems approach, Jhpiego worked hand in hand with the Ministry of Health and Social Welfare (MOHSW) in Tanzania to introduce focused antenatal care in 2001. Jhpiego enabled the MOHSW to include FANC in its national reproductive health guidelines, and then to institutionalize the guidelines through in-service training systems and pre-service education. With scale-up, all ANC providers in the country—over 7,000 women and men from 3,500 facilities—were trained in FANC. In addition, all pre-service midwifery education curricula have been revised and 85 tutors received knowledge updates. As a result, 100 percent of Tanzania’s 130 districts are now incorporating focused antenatal care into their annual plans, ensuring that all pregnant women have access to this lifesaving intervention.