Antenatal care

Antenatal care (ANC) coverage is a success story in Africa, since over two-thirds of pregnant women (69 percent) have at least one ANC contact. However, to achieve the full life-saving potential that ANC promises for women and babies, four visits providing essential evidence based interventions – a package often called focused antenatal care – are required. Essential interventions in ANC include identification and management of obstetric complications such as pre-eclampsia, tetanus toxoid immunisation, intermittent preventive treatment for malaria during pregnancy (IPTp), and identification and management of infections including HIV, syphilis and other sexually transmitted infections (STIs). ANC is also an opportunity to promote the use of skilled attendance at birth and healthy behaviours such as breastfeeding, early postnatal care, and planning for optimal pregnancy spacing. Many of these opportunities continue to be missed, even though over two-thirds of pregnant women receive at least one antenatal visit. How can we strengthen ANC to provide the priority interventions, especially given Africa's current critical shortage of human resources for health? Are there particular barriers or challenges to increasing coverage and quality that could be overcome? How can the multiple programmes that rely on ANC – malaria, HIV/AIDS, tetanus elimination, control of STIs – be integrated and strengthen the " vehicle " of ANC, rather than adding to the current overload?