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URC implements evidence-based interventions to improve coverage and quality of essential antenatal care, including early detection and management of the most common obstetric complications, such as preeclampsia, obstructed labor, risk of premature labor/birth, HIV and other high-burden maternal infections, and care of nutritional deficiencies.
By supporting reliable and consistent delivery of best practices for antenatal care, these interventions decrease women’s risk of serious maternal morbidities and mortality, reduce poor outcomes for newborns, and contribute to USAID’s global agenda for ending preventable child and maternal deaths and the Every Newborn Action Plan to End Preventable Newborn Deaths.
Focused Antenatal Care
In recent years, the health community has shifted away from classifying pregnant women as “low risk” or high risk”—an approach that required many antenatal visits and was hard to implement effectively. Many pregnant women have at least one risk factor, and not all develop complications, but some low-risk women develop complications, particularly during childbirth.
URC is committed to increasing the proportion of women who benefit from focused antenatal care—a four-visit model of integrated, individualized care to help maintain normal progress through pregnancy and facilitate early detection and treatment of complications. Focused services provide specific, evidence-based interventions for all women, carried out at key times during pregnancy. Our work aims to improve the quality of each antenatal visit so that every pregnant woman fully benefits from the wide range of preventive, counseling, and testing services.
We believe that successful focused antenatal care visits open the gate for increasing deliveries at health facilities and provide opportunities to introduce other services, such as HIV counseling and testing and child survival services.
Antenatal Care at Work
Malaria in pregnancy poses a substantial risk to mothers and their unborn or newborn children. Through the USAID Ghana Systems for Health Project, URC integrates an intervention package within routine antenatal care to prevent malaria, detect malaria cases with rapid diagnostic tests and microscopy, and provide intermittent preventive treatment in pregnancy. The project trains health workers in malaria case management and has developed and distributed a job aid to guide health workers on protocols for malaria in pregnancy.
Through USAID ASSIST, URC supports teams of more than 150 facilities to improve the quality of obstetric and newborn care. As a result, measures to prevent anemia among pregnant women (iron, folic acid supplementation, antimalarial medications, and deworming) in Mali increased from about 21% (17 sites) in November 2009 to 100% (144 sites) in August 2014, while compliance with eclampsia treatment standards increased from 0% (17 sites) to 85% (33 sites) in the same period.