13.3  The basic and specialised components of FANC

The FANC model divides pregnant women into two groups: those eligible to receive routine antenatal care (called the basic component), and those who need special care based on their specific health conditions or risk factors (the specialised component). Pre-set criteria (described below) are used to determine the eligibility of women to join the basic component. Women selected for the basic component are considered not to require any further assessment or special care at the time of the first visit, regardless of the gestational age at which they start the antenatal care programme.

Women are questioned and examined at the first antenatal visit to see if they have any of the following risk factors:

Previous pregnancy:

• Ended in stillbirth or neonatal loss
• History of three or more consecutive spontaneous abortions
• A low birth weight baby (400 g)
• Hospital admission for hypertension, pre-eclampsia or eclampsia. (You will learn about these conditions in Study Session 19.)

Current pregnancy:

• Diagnosed or suspected twins, or a higher number of multiple pregnancies
• Maternal age less than 16 years or more than 40 years
• Mother has blood type Rhesus-negative: this can result in serious harm to the fetus if it is Rhesus-positive, because the mother makes antibodies which can cross the placenta and attack the baby’s tissues
• Mother has vaginal bleeding, or a growth in her pelvis
• Mother’s diastolic blood pressure (the bottom number) is 90 mmHg or more
• Mother currently has diabetes, heart disease, kidney disease, cancer, hypertension or any severe communicable disease such as TB, malaria, HIV/AIDS or another sexually transmitted infection (STI).

You will refer women in the specialised component to a higher level health facility for additional monitoring and specialised care determined by specialists in these areas, while you continue to follow the activities of the basic component with these women.