Enhancing Antenatal Care Services Within Primary Health Care

Antenatal care is an essential component of primary health care but is often overlooked in discussions about universal health coverage. This comprehensive approach emphasizes promoting health, preventing diseases, providing treatment, and offering palliative care as close to individuals' daily environments as possible. Despite the importance of antenatal care, there are challenges in ANC attendance and service provision, with opportunities for improvement highlighted through statistics and surveys.

• Antenatal care
• Primary health care
• Universal health coverage
• Maternal health
• Health services

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1. ANTENATAL CARE WITHIN PRIMARY HEALTH CARE RBM MIP WG Annual Meeting 2023 Ashley Malpass, USAID/PMI U.S. PRESIDENT S MALARIA INITIATIVE 1

2. WHAT IS PRIMARY HEALTH CARE (PHC)? "PHC is a whole-of-society approach to health that aims at ensuring the highest possible level of health and well-being and their equitable distribution by focusing on people s needs and as early as possible along the continuum from health promotion and disease prevention to treatment, rehabilitation and palliative care, and as close as feasible to people s everyday environment." WHO and UNICEF, 1 April 2021 (emphasis added) U.S. PRESIDENT S MALARIA INITIATIVE 2

3. ANTENATAL CARE IS PRIMARY HEALTH CARE But it is often not included in conversations about Primary Health Care or Universal Health Coverage U.S. PRESIDENT S MALARIA INITIATIVE 3

4. ANC ATTENDANCE Average % of recently pregnant women who attended at least 1 ANC visit In SSA, almost 90% of recently pregnant women received ANC services from a skilled provider at least once in their pregnancy. No ANC However ANC from a skilled provider U.S. PRESIDENT S MALARIA INITIATIVE U.S. PRESIDENT S MALARIA INITIATIVE 4 Source: statcompiler.com accessed 1 September 2023

5. ANC ATTENDANCE Average percentage of recently pregnant women who attended 4+ ANC visits across SSA less than 60% attended 4+ ANC visits. And only 8% attended 8+ visits U.S. PRESIDENT S MALARIA INITIATIVE U.S. PRESIDENT S MALARIA INITIATIVE 5 Source: statcompiler.com accessed 1 September 2023

6. SERVICE PROVISION ASSESSMENT (SPA) SURVEYS Since 2010, only 18 SPAs have been conducted globally, with 6 being in countries with medium- to high malaria transmission U.S. PRESIDENT S MALARIA INITIATIVE 6

7. 79% Average availability of ANC Services at facilities across countries with recent SPA surveys U.S. PRESIDENT S MALARIA INITIATIVE 7

8. 50% Of countries with recent SPA surveys do not offer ANC services at least 5 days per week in a majority of facilities U.S. PRESIDENT S MALARIA INITIATIVE 8

9. What can we do? ADVOCATE ANC is a key component of Primary Health Care Universal Health Coverage cannot be achieved without access to ANC Improving ANC availability is within our control U.S. PRESIDENT S MALARIA INITIATIVE 9

10. THANK YOU! U.S. PRESIDENT S MALARIA INITIATIVE 10

11. REFERENCES Agence Nationale de la Statistique et de la D mographie (ANSD) [S n gal], et ICF. 2020. S n gal : Enqu te Continue sur la Prestation des Services de Soins de Sant (ECPSS) 2019. Dakar, S n gal, et Rockville, Maryland, USA : ANSD et ICF. DHS Program, Where We Work - Service Provision Assessment Surveys https://dhsprogram.com/Countries/index.cfm [accessed 1 September 2023] Ecole de Sant Publique de l Universit de Kinshasa (ESPK) [R publique D mocratique du Congo] et ICF. 2019. R publique D mocratique du Congo: Evaluation des Prestations des Services de soins de Sant (EPSS RDC) 2017-2018. Kinshasa, RDC et Rockville, Maryland, USA : ESPK et ICF. Ethiopian Public Health Institute (EPHI) [Ethiopia], Ministry of Health (MoH) [Ethiopia] and ICF. 2023. Ethiopia Service Provision Assessment 2021 22 Final Report. Addis Ababa, Ethiopia, and Rockville, Maryland, USA: EPHI, MoH and ICF. Ministry of Health (MoH) [Malawi] and ICF International. 2014. Malawi Service Provision Assessment (MSPA) 2013-14. Lilongwe, Malawi, and Rockville, Maryland, USA: MoH and ICF International. Ministry of Health and Social Welfare (MoHSW) [Tanzania Mainland], Ministry of Health (MoH) [Zanzibar], National Bureau of Statistics (NBS), Office of the Chief Government Statistician (OCGS), and ICF International 2015. Tanzania Service Provision Assessment Survey (TSPA) 2014-15. Dar es Salaam, Tanzania, and Rockville, Maryland, USA: MoHSW, MoH, NBS, OCGS, and ICF International. National Coordinating Agency for Population and Development (NCAPD) [Kenya], Ministry of Medical Services (MOMS) [Kenya], Ministry of Public Health and Sanitation (MOPHS) [Kenya], Kenya National Bureau of Statistics (KNBS) [Kenya], ICF Macro. 2011. Kenya Service Provision Assessment Survey 2010. Nairobi, Kenya: National Coordinating Agency for Population and Development, Ministry of Medical Services, Ministry of Public Health and Sanitation, Kenya National Bureau of Statistics, and ICF Macro. WHO, Primary health care fact sheet, https://www.who.int/news-room/fact-sheets/detail/primary-health-care [accessed 1 September 2023] U.S. PRESIDENT S MALARIA INITIATIVE 11