Overview

High-quality, person-centered antenatal care (ANC) is critical for maternal and newborn survival and well-being. In Kenya, just over half of women complete four or more ANC visits, which is the long-standing recommendation of the World Health Organization, and only two-thirds of  women deliver with a skilled birth attendant present. Traditional one-on-one ANC, the standard of care in Kenya, often does not meet women’s and adolescents’ needs for information, support, and high-quality clinical care.

To address this need, we collaborated with Scope, a social impact company, to use human-centered design methods to develop a contextualized group ANC model that promotes self-care and social support while taking into account national standards and guidelines for maternal and newborn health.

In partnership with the Kenya Progressive Nurses Association and the County Health Management Team, we implemented this group ANC model, called Lea Mimba, in six facilities across Kakamega County, Kenya, between August 2017 and March 2019.

With funding from the Foreign, Commonwealth & Development Office through the County Innovation Challenge Fund, Lea Mimba pregnancy clubs aim to improve maternal and newborn health by providing a safe space where pregnant women can share experiences, receive essential health information from a midwife or other skilled provider and track and better understand the progress of their pregnancies. Over the course of 10 months, more than 1,600 women enrolled in 177 Lea Mimba clubs across the six project sites.

In March 2019, we worked with partners to  conduct an evaluation using qualitative and quantitative methods to assess the effects and acceptability of group ANC on:

• ANC retention (four or more ANC visits)
• Knowledge of healthy behaviors during pregnancy
• Number of birth preparations made (including saving money, arranging for transport, and preparing items for the baby)
• Women’s empowerment
• Overall satisfaction with ANC services, including quality and acceptability of care
• Workflow and context mapping