13.1.3  Comparions of traditional and focused antenatal care

Table 13.1 summarises the basic differences between the traditional and focused antenatal care approaches.

Substance use includes tobacco, alcohol, khat, illegal drugs, hashish, cocaine and others

Table 13.1  Basic differences between traditional and focused antenatal care.
CharacteristicsTraditional antenatal care Focused antenatal care
Number of visits 16–18 regardless of risk status4 for women categorised in the basic component (as described later in this study session)
Approach Vertical: only pregnancy issues are addressed by health providersIntegrated with PMTCT of HIV, counselling on danger symptoms, risk of substance use, HIV testing, malaria prevention, nutrition, vaccination, etc.
Assumption More frequent visits for all and categorising into high/low risk helps to detect problems. Assumes that the more the number of visits, the better the outcomesAssumes all pregnancies are potentially ‘at risk’. Targeted and individualised visits help to detect problems
Use of risk indicatorsRelies on routine risk indicators, such as maternal height <150 cm, weight <50 kg, leg oedema, malpresentations before 36 weeks, etc.Does not rely on routine risk indicators. Assumes that risks to the mother and fetus will be identified in due course
Prepares the family To be solely dependent on health service providersShared responsibility for complication readiness and birth preparedness
Communication One-way communication (health education) with pregnant women onlyTwo-way communication (counselling) with pregnant women and their husbands
Cost and timeIncurs much cost and time to the pregnant women and health service providers, because this approach is not selectiveLess costly and more time efficient. Since majority of pregnancies progress smoothly, very few need frequent visits and referral
ImplicationOpens room for ignorance by the health service provider and by the family in those not labelled ‘at risk’, and makes the family unaware and reluctant when complications occurAlerts health service providers and family in all pregnancies for potential complications which may occur at any time

13.1.2  Failings of the traditional approach to antenatal care

13.2  Important elements of FANC