{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T19:48:23Z","timestamp":1790365703571,"version":"4.1.0"},"reference-count":36,"publisher":"Public Library of Science (PLoS)","issue":"7","license":[{"start":{"date-parts":[[2024,7,12]],"date-time":"2024-07-12T00:00:00Z","timestamp":1720742400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100007746","name":"W.K. Kellogg Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007746","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The J9 Plus (J9) maternal-child accompaniment program is based on four pillars: group antenatal care (GANC), group pediatric care, psychosocial support, and community-based care. We aimed to evaluate the impact of the J9 model of care on perinatal outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methodology<\/jats:title>\n                    <jats:p>We conducted a convergent mixed methods study of maternal-newborn dyads born in 2019 at H\u00f4pital Universitaire de Mirebalais. Quantitative data was collected retrospectively to compare dyads receiving J9 care to usual care. A secondary analysis of qualitative data described patient perspectives of J9 care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Antenatal care attendance was significantly higher among women in J9 (n = 524) compared to usual care (n = 523), with 490(93%) and 189(36%) having &gt;4 visits, respectively; p &lt;0.001, as was post-partum visit attendance [271(52%) compared to 84(16%), p&lt;0.001] and use of post-partum family planning methods [98(19%) compared to 47(9%), p = 0.003]. Incidence of pre-eclampsia with severe features was significantly lower in the J9 group [44(9%)] compared to the usual care group [73(14%)], p &lt;0.001. Maternal and neonatal mortality and low birth weight did not differ across groups. Cesarean delivery [103(20%) and 82(16%), p&lt;0.001] and preterm birth [118 (24%)] and 80 (17%), p &lt;0.001] were higher in the J9 group compared to usual care, respectively. In the qualitative analysis, ease of access to high-quality care, meaningful social support, and maternal empowerment through education were identified as key contributors to these outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Compared to usual care, the J9 Plus maternal-child accompaniment model of care is associated with increased engagement in antenatal and postpartum care, increased utilization of post-partum family planning, and lower incidence of pre-eclampsia with severe features, which remains a leading cause of maternal mortality in Haiti. The J9 accompaniment approach to care is an empowering model that has the potential to be replicated in similar settings to improve quality of care and outcomes globally.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0300908","type":"journal-article","created":{"date-parts":[[2024,7,12]],"date-time":"2024-07-12T13:28:43Z","timestamp":1720790923000},"page":"e0300908","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":6,"title":["Integrated group antenatal and pediatric care in Haiti: A comprehensive care accompaniment model"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5082-2841","authenticated-orcid":true,"given":"Meredith","family":"Casella Jean-Baptiste","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Julmisse","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oluwatosin O.","family":"Adeyemo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thamar Monide","family":"Vital Julmiste","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica L.","family":"Illuzzi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,7,12]]},"reference":[{"issue":"9","key":"pone.0300908.ref001","doi-asserted-by":"crossref","first-page":"e40828","DOI":"10.2196\/40828","article-title":"Group Antenatal Care in Ghana: Protocol for a Cluster Randomized Controlled Trial.","volume":"11","author":"JR Lori","year":"2022","journal-title":"JMIR Res Protoc."},{"issue":"2","key":"pone.0300908.ref002","first-page":"52","article-title":"Does group prenatal care affect satisfaction and prenatal care utilization in Iranian pregnant women?","volume":"39","author":"F Jafari","year":"2010","journal-title":"Iran J Public Health"},{"issue":"1","key":"pone.0300908.ref003","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1186\/s12978-018-0644-y","article-title":"Increasing postpartum family planning uptake through group antenatal care: a longitudinal prospective cohort design.","volume":"15","author":"JR Lori","year":"2018","journal-title":"Reprod Health."},{"issue":"2","key":"pone.0300908.ref004","first-page":"1","article-title":"Randomized controlled pilot of a group antenatal care model and the sociodemographic factors associated with pregnancy-related empowerment in sub-Saharan Africa.","volume":"17","author":"CL Patil","year":"2017","journal-title":"BMC Pregnancy Childbirth"},{"issue":"2","key":"pone.0300908.ref005","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1002\/ijgo.12788","article-title":"Women\u2019s experience with group prenatal care in a rural community in northern Nigeria.","volume":"145","author":"SE Adaji","year":"2019","journal-title":"Int J Gynecol Obstet"},{"key":"pone.0300908.ref006","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12978-019-0820-8","article-title":"The power of peers: an effectiveness evaluation of a cluster-controlled trial of group antenatal care in rural Nepal.","volume":"16","author":"P Thapa","year":"2019","journal-title":"Reprod Health"},{"issue":"5","key":"pone.0300908.ref007","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1093\/heapol\/czz178","article-title":"Feasibility and preliminary effectiveness of group antenatal care in Senegalese health posts: a pilot implementation trial.","volume":"35","author":"B McKinnon","year":"2020","journal-title":"Health Policy Plan"},{"issue":"7","key":"pone.0300908.ref008","doi-asserted-by":"crossref","first-page":"e0219471","DOI":"10.1371\/journal.pone.0219471","article-title":"Nurses\u2019 and midwives\u2019 experiences of providing group antenatal and postnatal care at 18 health centers in Rwanda: a mixed methods study.","volume":"14","author":"T Lundeen","year":"2019","journal-title":"PLoS One"},{"issue":"6","key":"pone.0300908.ref009","doi-asserted-by":"crossref","first-page":"e9","DOI":"10.1542\/peds.99.6.e9","article-title":"A randomized controlled trial of group versus individual well child care for high-risk children: maternal-child interaction and developmental outcomes","volume":"99","author":"JA Taylor","year":"1997","journal-title":"Pediatrics"},{"issue":"2 Pt 1","key":"pone.0300908.ref010","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1097\/01.AOG.0000275284.24298.23","article-title":"Group prenatal care and perinatal outcomes: a randomized controlled trial.","volume":"110","author":"JR Ickovics","year":"2007","journal-title":"Obstet Gynecol"},{"issue":"10","key":"pone.0300908.ref011","doi-asserted-by":"crossref","first-page":"e0222177","DOI":"10.1371\/journal.pone.0222177","article-title":"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.","volume":"14","author":"L Grenier","year":"2019","journal-title":"PLoS One"},{"issue":"1","key":"pone.0300908.ref012","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1186\/s12978-018-0476-9","article-title":"Group antenatal care models in low- and middle-income countries: a systematic evidence synthesis.","volume":"15","author":"J Sharma","year":"2018","journal-title":"Reprod Health."},{"issue":"3","key":"pone.0300908.ref013","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1542\/peds.100.3.e1","article-title":"Health care utilization and health status in high-risk children randomized to receive group or individual well child care","volume":"100","author":"JA Taylor","year":"1997","journal-title":"Pediatrics"},{"issue":"6","key":"pone.0300908.ref014","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1001\/archpedi.152.6.579","article-title":"Group well-child care for high-risk families: maternal outcomes.","volume":"152","author":"JA Taylor","year":"1998","journal-title":"Arch Pediatr Adolesc Med"},{"key":"pone.0300908.ref015","unstructured":"IHE\/Haiti IH de l\u2019Enfance, ICF. 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World Bank Open Data","year":"2021"},{"key":"pone.0300908.ref020","first-page":"177","article-title":"Institut Ha\u00eftien de Statistique et d\u2019Informatique (IHSI). Enqu\u00eate Mortalit\u00e9, Morbidit\u00e9 et Utilisation des Services (EMMUS-VI) 2016\u20132017","author":"l\u2019Institut Ha\u00eftien de l\u2019Enfance (IHE)","year":"2018","journal-title":"le Minist\u00e8re de la Sant\u00e9 Publique et de la Population (MSPP);"},{"issue":"2","key":"pone.0300908.ref021","doi-asserted-by":"crossref","first-page":"59","DOI":"10.7812\/TPP\/15-116","article-title":"Addressing the Child and Maternal Mortality Crisis in Haiti through a Central Referral Hospital Providing Countrywide Care","volume":"20","author":"LD Jacobs","year":"2016","journal-title":"Perm JSpring"},{"issue":"5","key":"pone.0300908.ref022","doi-asserted-by":"crossref","first-page":"e491","DOI":"10.1016\/S2214-109X(18)30073-1","article-title":"Community health and equity of outcomes: the Partners In Health experience","volume":"6","author":"D Palazuelos","year":"2018","journal-title":"Lancet Glob Health"},{"key":"pone.0300908.ref023","first-page":"7","article-title":"Partners in help: Assisting the poor over the long term.","volume":"29","author":"P. 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