Group Antenatal Care Start-Up in the Indian Private Sector: An Implementation Journey to Improve Quality of Care.

Abstract

Introduction: The introduction of the innovative group antenatal and postnatal care model into the private health sector in India has the potential to pivot the experiences of families during pregnancy and beyond. Growing evidence worldwide shows this model moves fragmented healthcare systems toward a more integrated model to improve quality in care and outcomes for mothers and children. The aim of this study was to better understand the challenges and benefits of implementation of the group model of antenatal care in the Indian private health sector for the purpose of improving quality of care.

Methods: Through a collaborative innovation project led by a master's student of public health and an international organization with expertise in implementing this model, an urban 35-bed private hospital in Pune was identified with readiness to explore the model with stakeholders, train hospital staff as facilitators, and initiate group antenatal care. Semi-structured interviews with facilitators, along with feedback from participants in cohorts and observation of the groups by the trainer, were done for qualitative analysis of themes related to the strengths and barriers in implementing the model.

Results: A total of 31 pregnant women participated in two cohorts over their second to third trimesters for group antenatal care with a team of three facilitators from November 2022 to June 2023. On review of experiences in implementing the model, the top strengths demonstrated were meeting of felt needs of the participants, high engagement, and relative advantage of the model. Challenges for implementation included for scheduling and attendance, adapting the model for compatibility, capacity-building, and need for more ongoing planning, monitoring, and evaluation.

Conclusions: Through this innovation project, important lessons were learned for robust planning for a future pilot study. Patient-centered and integrated antenatal care are markers of quality of care that this group model can bring not only in the private healthcare sector but throughout India.