{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T05:51:51Z","timestamp":1768456311937,"version":"3.49.0"},"reference-count":43,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2022,2,17]],"date-time":"2022-02-17T00:00:00Z","timestamp":1645056000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004417","name":"Global Fund to Fight AIDS, Tuberculosis and Malaria","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004417","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Antenatal (ANC) and postnatal care (PNC) are logical entry points for prevention and treatment of pregnancy\u2010related illness and to reduce perinatal mortality. We developed signal functions and assessed availability of the essential components of care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Cross\u2010sectional survey.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Afghanistan, Chad, Ghana, Tanzania, Togo.<\/jats:p><\/jats:sec><jats:sec><jats:title>Sample<\/jats:title><jats:p>Three hundred and twenty\u2010one healthcare facilities.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Fifteen essential components or signal functions of ANC and PNC were identified. Healthcare facility assessment for availability of each component, human resources, equipment, drugs and consumables required to provide each component.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measure<\/jats:title><jats:p>Availability of ANC PNC components.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Across all countries, healthcare providers are available (median number per facility: 8; interquartile range [IQR] 3\u201317) with a ratio of 3:1 for secondary versus primary care. Significantly more women attend for ANC than PNC (1668 versus 300 per facility\/year). None of the healthcare facilities was able to provide all 15 essential components of ANC and PNC. The majority (&gt;75%) could provide five components: diagnosis and management of syphilis, vaccination to prevent tetanus, BMI assessment, gestational diabetes screening, monitoring newborn growth. In Sub\u2010Saharan countries, interventions for malaria and HIV (including prevention of mother to child transmission [PMTCT]) were available in 11.7\u201386.5% of facilities. Prevention and management of TB; assessment of pre\u2010 or post\u2010term birth, fetal wellbeing, detection of multiple pregnancy, abnormal lie and presentation; screening and support for mental health and domestic abuse were provided in &lt;25% of facilities.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Essential components of ANC and PNC are not in place. Focused attention on content is required if perinatal mortality and maternal morbidity during and after pregnancy are to be reduced.<\/jats:p><\/jats:sec><jats:sec><jats:title>Tweetable abstract<\/jats:title><jats:p>ANC and PNC are essential care bundles. We identified 15 core components. These are not in place in the majority of LMIC settings.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.17106","type":"journal-article","created":{"date-parts":[[2022,2,2]],"date-time":"2022-02-02T04:04:48Z","timestamp":1643774688000},"page":"1546-1557","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Where is the \u2018C\u2019 in <scp>antenatal care<\/scp> and <scp>postnatal care<\/scp>: A multi\u2010country survey of availability of antenatal and postnatal care in low\u2010 and middle\u2010income settings"],"prefix":"10.1111","volume":"129","author":[{"given":"Barbara","family":"Madaj","sequence":"first","affiliation":[{"name":"Centre for Maternal and Newborn Health Liverpool School of Tropical Medicine  Liverpool UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Somasundari","family":"Gopalakrishnan","sequence":"additional","affiliation":[{"name":"Centre for Maternal and Newborn Health 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