{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T05:56:43Z","timestamp":1781675803808,"version":"3.54.5"},"reference-count":30,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T00:00:00Z","timestamp":1778630400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T00:00:00Z","timestamp":1778630400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100007601","name":"Horizon 2020","doi-asserted-by":"publisher","award":["848147"],"award-info":[{"award-number":["848147"]}],"id":[{"id":"10.13039\/501100007601","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Matern Child Health J"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Group antenatal care (GANC) is an alternative to traditional individual antenatal care (IANC), which combines health assessment, interactive learning, and community building in group sessions. GANC has been associated with positive health outcomes. To scale up GANC, more evidence is needed on the financial implications of its initial implementation and (long-term) cost-effectiveness. This study aims to review and synthesise the available evidence on the economics of GANC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We searched for observational and experimental studies assessing the cost aspects of implementing and running GANC with or without comparison with IANC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Information sources<\/jats:title>\n                    <jats:p>We searched PubMed, EMBASE, and Ovid Emcare up to 22 August 2024 using keywords and controlled vocabulary without restriction by year of publication.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Quality Assessment<\/jats:title>\n                    <jats:p>CASP Economic Evaluation Checklist.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Synthesis<\/jats:title>\n                    <jats:p>Narrative synthesis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A limited number of studies (n\u2009=\u20099) addressing the costs and\/or benefits of GANC were eligible to be included in the review. These studies varied considerably in setting, design, quality, type of cost data, cost categories included and perspective used.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Evidence on the costs of GANC is sparse. Future studies of the lifetime costs and health outcomes of GANC compared with IANC are needed to gain insight into the cost implications and cost-effectiveness of GANC and to scale up its implementation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>PROSPERO 2023 CRD42023454379.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10995-026-04276-x","type":"journal-article","created":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T08:50:15Z","timestamp":1778662215000},"page":"820-830","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Economics of Group Antenatal Care: A Systematic Review and Narrative Analysis"],"prefix":"10.1007","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5269-509X","authenticated-orcid":false,"given":"M. Elske","family":"van den Akker-van Marle","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathalie","family":"Leister","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashna D.","family":"Hindori-Mohangoo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilir","family":"Hoxha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marlies E.","family":"Rijnders","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"McCourt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,13]]},"reference":[{"key":"4276_CR1","doi-asserted-by":"publisher","DOI":"10.3310\/phr05090","author":"J Barnes","year":"2017","unstructured":"Barnes, J., Stuart, J., Allen, E., Petrou, S., Sturgess, J., Barlow, J., Macdonald, G., Spiby, H., Aistrop, D., Melhuish, E. C., & Kim, S. (2017b). Results of the first steps study: A randomised controlled trial and economic evaluation of the Group Family Nurse Partnership (gFNP) programme compared with usual care in improving outcomes for high-risk mothers and their children and preventing abuse. Public Health Research. https:\/\/doi.org\/10.3310\/phr05090","journal-title":"Public Health Research"},{"issue":"1","key":"4276_CR2","doi-asserted-by":"publisher","DOI":"10.1186\/s13063-017-2259-y","volume":"18","author":"J Barnes","year":"2017","unstructured":"Barnes, J., Stuart, J., Allen, E., Petrou, S., Sturgess, J., Barlow, J., Macdonald, G., Spiby, H., Aistrop, D., Melhuish, E., Kim, S. W., & Elbourne, D. (2017a). Randomized controlled trial and economic evaluation of nurse-led group support for young mothers during pregnancy and the first year postpartum versus usual care. Trials, 18(1), Article Article 508. https:\/\/doi.org\/10.1186\/s13063-017-2259-y","journal-title":"Trials"},{"key":"4276_CR3","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-017-1522-2","volume":"17","author":"BM Byerley","year":"2017","unstructured":"Byerley, B. M., & Haas, D. M. (2017). A systematic overview of the literature regarding group prenatal care for high-risk pregnant women. BMC Pregnancy and Childbirth, 17, Article Article 329.","journal-title":"BMC Pregnancy and Childbirth"},{"key":"4276_CR4","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l6890","volume":"368","author":"M Campbell","year":"2020","unstructured":"Campbell, M., McKenzie, J. E., Sowden, A., Katikireddi, S. V., Brennan, S. E., Ellis, S., Hartmann-Boyce, J., Ryan, R., Shepperd, S., Thomas, J., Welch, V., & Thomson, H. (2020). Synthesis without meta-analysis (SWiM) in systematic reviews: Reporting guideline. BMJ (Clinical Research Ed.), 368, Article l6890. https:\/\/doi.org\/10.1136\/bmj.l6890","journal-title":"BMJ (Clinical Research Ed.)"},{"issue":"3","key":"4276_CR5","doi-asserted-by":"publisher","first-page":"551","DOI":"10.1097\/AOG.0000000000001560","volume":"128","author":"EB Carter","year":"2016","unstructured":"Carter, E. B., Temming, L. A., Akin, J., Fowler, S., Macones, G. A., Colditz, G. A., & Tuuli, M. G. (2016). Group prenatal care compared with traditional prenatal care: A systematic review and meta-analysis. Obstetrics and Gynecology, 128(3), 551\u2013561. https:\/\/doi.org\/10.1097\/AOG.0000000000001560","journal-title":"Obstetrics and Gynecology"},{"key":"4276_CR6","unstructured":"Critical Appraisal Skills Programme (2018). CASP economic evaluation checklist. Available at: https:\/\/casp-uk.net\/casp-tools-checklists\/. Accessed: 18 September 2023."},{"issue":"1","key":"4276_CR7","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1016\/j.whi.2016.09.009","volume":"27","author":"A Crockett","year":"2017","unstructured":"Crockett, A., Heberlein, E. C., Glasscock, L., Covington-Kolb, S., Shea, K., & Khan, I. A. (2017). Investing in CenteringPregnancy\u2122 group prenatal care reduces newborn hospitalization costs. Women\u2019s Health Issues, 27(1), 60\u201366. https:\/\/doi.org\/10.1016\/j.whi.2016.09.009","journal-title":"Women\u2019s Health Issues"},{"key":"4276_CR8","volume-title":"Methods for the economic evaluation of health care programmes","author":"MF Drummond","year":"2015","unstructured":"Drummond, M. F., Sculpher, M. J., Claxton, K., Stoddart, G. L., & Torrance, G. W. (2015). Methods for the economic evaluation of health care programmes. Oxford University Press."},{"issue":"7","key":"4276_CR9","doi-asserted-by":"publisher","first-page":"1384","DOI":"10.1007\/s10995-016-1935-y","volume":"20","author":"S Gareau","year":"2016","unstructured":"Gareau, S., L\u00f2pez-De Fede, A., Loudermilk, B. L., Cummings, T. H., Hardin, J. W., Picklesimer, A. H., Crouch, E., & Covington-Kolb, S. (2016). Group prenatal care results in Medicaid savings with better outcomes: A propensity score analysis of CenteringPregnancy participation in South Carolina. Maternal and Child Health Journal, 20(7), 1384\u20131393. https:\/\/doi.org\/10.1007\/s10995-016-1935-y","journal-title":"Maternal and Child Health Journal"},{"issue":"10","key":"4276_CR10","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0222177","volume":"14","author":"L Grenier","year":"2019","unstructured":"Grenier, L., Suhowatsky, S., Kabue, M. M., Noguchi, L. M., Mohan, D., Karnad, S. R., Onguti, B., Omanga, E., Gichangi, A., Wambua, J., Waka, C., Oyetunji, J., & Smith, J. M. (2019). Impact of group antenatal care (G-ANC) versus individual antenatal care (ANC) on quality of care, ANC attendance and facility-based delivery: A pragmatic cluster-randomized controlled trial in Kenya and Nigeria. PLoS ONE, 14(10), Article e0222177.","journal-title":"PLoS ONE"},{"issue":"1","key":"4276_CR11","doi-asserted-by":"publisher","DOI":"10.1186\/s12978-019-0840-4","volume":"17","author":"A Harsha Bangura","year":"2020","unstructured":"Harsha Bangura, A., Nirola, I., Thapa, P., Citrin, D., Belbase, B., Bogati, B., B K, N., Khadka, S., Kunwar, L., Halliday, S., Choudhury, N., Schwarz, R., Adhikari, M., Kalaunee, S. P., Rising, S., Maru, D., & Maru, S. (2020). Measuring fidelity, feasibility, costs: An implementation evaluation of a cluster-controlled trial of group antenatal care in rural Nepal. Reproductive Health, 17(1), Article 5. https:\/\/doi.org\/10.1186\/s12978-019-0840-4","journal-title":"Reproductive Health"},{"issue":"2 Pt 1","key":"4276_CR12","doi-asserted-by":"publisher","first-page":"330","DOI":"10.1097\/01.AOG.0000275284.24298.23","volume":"110","author":"JR Ickovics","year":"2007","unstructured":"Ickovics, J. R., Kershaw, T. S., Westdahl, C., Magriples, U., Massey, Z., Reynolds, H., & Rising, S. S. (2007). Group prenatal care and perinatal outcomes: A randomized controlled trial. Obstetrics and Gynecology, 110(2 Pt 1), 330\u2013339. https:\/\/doi.org\/10.1097\/01.AOG.0000275284.24298.23","journal-title":"Obstetrics and Gynecology"},{"key":"4276_CR13","doi-asserted-by":"publisher","DOI":"10.1016\/j.midw.2023.103829","volume":"126","author":"S Jans","year":"2023","unstructured":"Jans, S., Westra, X., Crone, M., van den Akker-van Marle, E. M., & Rijnders, M. (2023). Long-term cost savings with Centering-based group antenatal care. Midwifery, 126, Article 103829. https:\/\/doi.org\/10.1016\/j.midw.2023.103829","journal-title":"Midwifery"},{"key":"4276_CR14","doi-asserted-by":"publisher","unstructured":"Li, T., Higgins, J. P. T., Deeks, J. J. (2019). Collecting data. In J. P. T. Higgins, J. Thomas, & J. Chandler, et al, (Eds). Cochrane handbook for systematic reviews of interventions. Cochrane collaboration. https:\/\/doi.org\/10.1002\/9781119536604.ch5 .","DOI":"10.1002\/9781119536604.ch5"},{"issue":"1","key":"4276_CR15","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-023-06224-x","volume":"24","author":"JR Lori","year":"2024","unstructured":"Lori, J. R., Kukula, V. A., Liu, L., Apetorgbor, V. E. A., Ghosh, B., Awini, E., Lockhart, N., Amankwah, G., Zielinski, R., Moyer, C. A., & Williams, J. (2024). Improving health literacy through group antenatal care: Results from a cluster randomized controlled trial in Ghana. BMC Pregnancy and Childbirth, 24(1), Article 37. https:\/\/doi.org\/10.1186\/s12884-023-06224-x","journal-title":"BMC Pregnancy and Childbirth"},{"issue":"1","key":"4276_CR16","doi-asserted-by":"publisher","DOI":"10.1186\/s43058-022-00370-7","volume":"3","author":"N Martens","year":"2022","unstructured":"Martens, N., Crone, M. R., Hindori-Mohangoo, A., Hindori, M., Reis, R., Hoxha, I. S., Abanga, J., Matthews, S., Berry, L., van der Kleij, R. M. J. J., van den Akker-van Marle, M. E., van Damme, A., Talrich, F., Beeckman, K., Court, C. M., Rising, S. S., Billings, D. L., & Rijnders, M. (2022). Group care in the first 1000 days: Implementation and process evaluation of contextually adapted antenatal and postnatal group care targeting diverse vulnerable populations in high-, middle- and low-resource settings. Implementation Science Communications, 3(1), Article 125. https:\/\/doi.org\/10.1186\/s43058-022-00370-7","journal-title":"Implementation Science Communications"},{"issue":"1","key":"4276_CR29","doi-asserted-by":"publisher","first-page":"S147","DOI":"10.1016\/j.ajog.2014.10.316","volume":"212","author":"S Mazzoni","year":"2015","unstructured":"Mazzoni, S., Hill, P., Heinrichs, G., Webster, K., Hoffman, M. C. (2015). Group prenatal care for women with diabetes. American Journal of Obstetrics and Gynecology, 212(1), S147-148. https:\/\/doi.org\/10.1016\/j.ajog.2014.10.316","journal-title":"American Journal of Obstetrics and Gynecology"},{"key":"4276_CR17","doi-asserted-by":"publisher","unstructured":"McKenzie, J., Brennan, S., et al. (2019). Synthesizing and presenting findings using other methods. In J. Higgins, J. Thomas, & J. Chandler (Eds.), Cochrane Handbook for systematic reviews of interventions (2nd ed, pp. 321\u2013348). John Wiley & Sons. https:\/\/doi.org\/10.1002\/9781119536604.ch12","DOI":"10.1002\/9781119536604.ch12"},{"issue":"5","key":"4276_CR18","doi-asserted-by":"publisher","first-page":"587","DOI":"10.1093\/heapol\/czz178","volume":"35","author":"B McKinnon","year":"2020","unstructured":"McKinnon, B., Sall, M., Vandermorris, A., Traor\u00e9, M., Lamesse-Diedhiou, F., McLaughlin, K., & Bassani, D. (2020). Feasibility and preliminary effectiveness of group antenatal care in Senegalese health posts: A pilot implementation trial. Health Policy and Planning, 35(5), 587\u2013599. https:\/\/doi.org\/10.1093\/heapol\/czz178","journal-title":"Health Policy and Planning"},{"issue":"5 Supplement","key":"4276_CR28","doi-asserted-by":"publisher","first-page":"17S","DOI":"10.1097\/01.AOG.0000559375.74743.96","volume":"133","author":"AR Meadows","year":"2019","unstructured":"Meadows, A. R., Barrett, F., Manigat, C., Murphy, J., Blanchfield, B. Group Prenatal Care: A Promising Quality Measure in Ambulatory Obstetrics. Obstetrics & Gynecology, 133(5 Supplement), 17S. https:\/\/doi.org\/10.1097\/01.AOG.0000559375.74743.96","journal-title":"Obstetrics &amp; Gynecology"},{"issue":"4","key":"4276_CR19","first-page":"31","volume":"34","author":"SE Mooney","year":"2008","unstructured":"Mooney, S. E., Russell, M. A., Prairie, B., Savage, C., & Weeks, W. B. (2008). Group prenatal care: An analysis of cost. Journal of Health Care Finance, 34(4), 31\u201341.","journal-title":"Journal of Health Care Finance"},{"issue":"1","key":"4276_CR30","doi-asserted-by":"publisher","first-page":"S190","DOI":"10.1016\/j.ajog.2013.10.408","volume":"210","author":"N Nguyen","year":"2014","unstructured":"Nguyen, N., Allen, A., Gorman, M., Hersh, S., Frias, A. , Cooper, A., Group prenatal care for women with pre-gestational type II diabetes mellitus: A cost-effectiveness analysis. American Journal of Obstetrics and Gynecology 210(1):S190 https:\/\/doi.org\/10.1016\/j.ajog.2013.10.408","journal-title":"American Journal of Obstetrics and Gynecology"},{"key":"4276_CR20","doi-asserted-by":"publisher","first-page":"415.e1","DOI":"10.1016\/j.ajog.2012.01.040","volume":"206","author":"AH Picklesimer","year":"2012","unstructured":"Picklesimer, A. H., Billings, D., Hale, N., Blackhurst, D., & Covington-Kolb, S. (2012). The effect of CenteringPregnancy group prenatal care on preterm birth in a low-income population. American Journal of Obstetrics and Gynecology, 206, 415.e1\u20137.","journal-title":"American Journal of Obstetrics and Gynecology"},{"issue":"1","key":"4276_CR21","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1016\/S0091-2182(97)00117-1","volume":"43","author":"SS Rising","year":"1998","unstructured":"Rising, S. S. (1998). Centering Pregnancy: An interdisciplinary model of empowerment. Journal of Nurse-Midwifery, 43(1), 46\u201354.","journal-title":"Journal of Nurse-Midwifery"},{"issue":"1","key":"4276_CR22","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s10995-015-1802-2","volume":"20","author":"RA Rowley","year":"2016","unstructured":"Rowley, R. A., Phillips, L. E., O\u2019Dell, L., Husseini, R. E., Carpino, S., & Hartman, S. (2016). Group prenatal care: A financial perspective. Maternal and Child Health Journal, 20(1), 1\u201310. https:\/\/doi.org\/10.1007\/s10995-015-1802-2","journal-title":"Maternal and Child Health Journal"},{"issue":"1","key":"4276_CR23","doi-asserted-by":"publisher","DOI":"10.1016\/j.xagr.2023.100301","volume":"4","author":"F Sadiku","year":"2023","unstructured":"Sadiku, F., Bucinca, H., Talrich, F., Molliqaj, V., Selmani, E., McCourt, C., Rijnders, M., Little, G., Goodman, D. C., Rising, S. S., & Hoxha, I. (2023). Maternal satisfaction with group care: A systematic review. AJOG Global Reports, 4(1), Article 100301. https:\/\/doi.org\/10.1016\/j.xagr.2023.100301","journal-title":"AJOG Global Reports"},{"key":"4276_CR24","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2021.722927","volume":"9","author":"HC Turner","year":"2021","unstructured":"Turner, H. C., Archer, R. A., Downey, L. E., Isaranuwatchai, W., Chalkidou, K., Jit, M., & Teerawattananon, Y. (2021). An introduction to the main types of economic evaluations used for informing priority setting and resource allocation in healthcare: Key features, uses, and limitations. Frontiers in Public Health, 9, Article 722927. https:\/\/doi.org\/10.3389\/fpubh.2021.722927","journal-title":"Frontiers in Public Health"},{"key":"4276_CR25","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmedr..102244","volume":"35","author":"MA Wagijo","year":"2023","unstructured":"Wagijo, M. A., Crone, M., Zwicht, B. B., van Lith, J., Billings, D. L., & Rijnders, M. (2023). Contributions of CenteringPregnancy to women\u2019s health behaviours, health literacy, and health care use in the Netherlands. Preventive Medicine Reports, 35, Article 102244. https:\/\/doi.org\/10.1016\/j.pmedr..102244","journal-title":"Preventive Medicine Reports"},{"key":"4276_CR26","unstructured":"World Bank (2024a). Consumer price index (2010=100). Available at: https:\/\/data.worldbank.org\/indicator\/FP.CPI.TOTL. Accessed: 06\u201314\u20132024a."},{"key":"4276_CR27","unstructured":"World Bank (2024b). International Comparison Program (Benchmark) 2021 cycle. Available at: https:\/\/databank.worldbank.org\/source\/icp-2021. Accessed: 10\u201317\u20132024b."}],"container-title":["Maternal and Child Health Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10995-026-04276-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10995-026-04276-x","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10995-026-04276-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T05:36:18Z","timestamp":1781674578000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10995-026-04276-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,13]]},"references-count":30,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["4276"],"URL":"https:\/\/doi.org\/10.1007\/s10995-026-04276-x","relation":{},"ISSN":["1092-7875","1573-6628"],"issn-type":[{"value":"1092-7875","type":"print"},{"value":"1573-6628","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,13]]},"assertion":[{"value":"17 October 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 April 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 May 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare that they have no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}